Let's Talk about Sex!

Let’s talk about sex. After babies. Yeah, that’s right, we’re going there. Every mom knows about that magic six week visit when you go to the doc for a checkup, they do a quick exam, and say you’re “good to go”, much to the delight of your husband or partner. But… what if you’re not ready? What if you had a c-section? Or a vaginal tear? Or an episiotomy? Or (God forbid) hemorrhoids? What if you’re feeling tired and covered in bodily fluids that aren’t your own, which is just NOT SEXY?

When my daughter was born, she came very quickly, and the doctor decided to do an episiotomy to ease her delivery. Afterward, it didn’t matter whether that was the right thing to do or not because it had been done already. That said, I had so much pain that it hurt just to sit on a sofa, and I had to sit on a donut for at least a week, if not longer. But the pain eased with time, and I began to be able to sit normally, as long as it was a soft surface and I didn’t stay too long, and I didn’t even think to mention it to the doctor. So, when she did her perfunctory exam, she cleared me for normal activity, including intercourse.

For awhile I didn’t even think about it. If I did I would have been terrified. I’m lucky to have a husband who isn’t pushy and waited until I was ready. But eventually (and the passage of time has blurred the dates for me, but probably 2-3 months postpartum), we tried. And it HURT. Bad. I had to stop after less than a minute. But of course, I thought this was normal. I didn’t know better or really know that there were options to deal with it (more on that later). I never mentioned it to a doctor. Eventually, we were able to have sex again, but it continued to hurt for a year, no matter what position we tried or how much lubricant we used. And even beyond that first year, I would get pain in certain positions. That pain didn’t completely go away until at least five years after that original episiotomy.

So, why am I telling you this story? Because now I know better. Now I know that I didn’t have to live with it. I had options. There’s something called pelvic floor physical therapy that could have helped me in those early days and beyond. The thing is, I kind of knew about it. My neighbor was a pelvic floor PT. While I didn’t really know what was involved in that or what they could do, I did look at her website many times. But I decided it wasn’t bad enough to call. I wish I could go back in time and make myself more of a priority. But it’s so hard in those early days, isn’t it? It’s hard to take the time for ourselves. But what I want to tell my past self is this: you need to take care of yourself in order to take care of others. YOU are important, and your relationship with your partner is important. What would you want your son/daughter to do if they were having pain that was affecting their quality of life? Ignore it or take care of it?

Now years have passed, I am a pelvic floor physical therapist myself, and I help other women navigate this minefield that is postpartum intercourse (amongst many other issues). While some women have no problems, others have pain, dryness, or just don’t feel “in the mood” after having babies. While it’s okay to not be ready or to put that part of your life on hold, if you and your partner both want to be intimate but are navigating these or other obstacles, I encourage you to seek help.

I once had a patient who was having severe pain with sex ever since she had babies and would just grin and bear it. She never told her partner or a doctor or anybody. Her kids were in middle school. She finally casually mentioned it to the doctor who sent her to pelvic floor physical therapy, and you know what? She got better. She still never told her husband that she had pain, and never told him what she went to physical therapy for, but at least she wasn’t grinning and bearing it. She suffered needlessly for many years, but finally she was able to enjoy that part of their relationship again. I had another patient who was having severe pain with sex after her kids, and she thought it was normal, thought there wasn’t anything she could do about it, until she heard about pelvic floor PT. It turned out she just had scar tissue from her episiotomy, and after working on it for just a couple of weeks, she could have pain free sex. She had stressed and worried for months about what to do and how to get this part of her relationship back, and it turned out to be a very simple fix, she just had to ask for help. I’ve had several other mamas who have had c-sections, and they too sometimes have pain with intercourse post-delivery. This pain is also fixable. I have yet to have a mom come into my clinic with pain after babies that we couldn’t get back in the saddle. Pelvic floor physical therapy works.

But what if the issue is not pain? After kids, it’s hard to find your way back to that part of yourself and your relationship. For the first few years, my husband and I didn’t have much desire. Even now that our kids are 5 & 7, it’s still an issue. Those early days are filled with sleepless nights, spit up, poopy diapers, breastfeeding, and are quickly replaced by the terrible twos and threes, the f***ing fours, and then piano lessons, swimming, karate, and managing everyone’s schedules and finances. In addition to that, my husband works evenings and I work mornings so that we don’t have to pay for childcare, but that just leaves us with weekends when we are even in the same place at the same time, and we are usually exhausted from our busy weeks. Where does sex fit into that? Do we have to resort to a schedule to have sex? I remember a scene from the movie “Fun with Dick and Jane” where Tea Leoni’s character and Jim Carrey’s character start to be intimate but then say, “Let’s have sex… on Saturday!” It’s supposed to be a joke, because we don’t think of planning sex as being, well… sexy. They don’t plan sex in movies; they just start kissing and then wake up in bed next to each other cuddling. But is that real life? No. Not even before kids. Maybe having a sex date can be sexy. Maybe that’s a good way to stay intimate with your partner. When things are busy, planning a time for sex can be a good way to make sure it happens.

So… how does one actually do that? Especially with young kids? Let’s make a plan together. First, schedule a time when you will both be home, the kids are in bed or can be distracted with tablets or tv while you lock yourself in your bedroom (we used to use a bathroom because it was the only door in our house with a lock…), and you won’t be TOO exhausted. Second, a day or two beforehand, start touching your partner more (playing with their hair, cuddling on the couch, kisses/hugs when you see them or pass them in the house, etc.). Maybe send them sexy texts or e-mails about what you’re looking forward to. Start building some excitement. Third, when the day comes, make a little effort. Take a shower, do your hair and makeup, wear something that makes you feel good about yourself. If you feel like you look good, you’ll feel sexier, and more desire comes along with that. You’re not doing it for your partner. You’re doing it for yourself. Finally, when the time comes, don’t make excuses. If you’ve decided this is something you want, stick to your guns and just do it.

Sex dates can be sexy!

"Let's have sex... on Saturday!"

That said, if you and your partner want to take a break from sex or aren’t ready for sex, there are other ways to find intimacy. Spending a night cuddling on the couch, touching each other in passing, kissing and hugging, and just sitting and talking can all be good ways to connect with your partner. Additionally, if you’ve tried making sex dates, and you still don’t feel desire, there could be another underlying issue. You could be suffering from postpartum depression, you could have a hormonal imbalance (thyroid insufficiencies are really common postpartum), or maybe some other issue that you need to discuss with your OBGYN. It’s also normal to have decreased desire while you’re breastfeeding.

Regardless of what your obstacles are, the bottom line is this: take care of yourself after babies! If you want to get back to sexy time, figure out a way to do it, and if you don’t, wait until you’re ready. There’s no right and wrong, but don’t make the same mistake I did and ignore the issue or decide it’s not important enough to deal with. You can be sexy and be a mama too. It’s normal to have difficulty finding your way back to your sexy self, but you can do it. Take time for you and get help if you need it. If you’re having pain, find a pelvic floor physical therapist (use the PT locator at pelvicrehab.com). If you’re having issues with postpartum depression, contact your OBGYN or mental health practitioner, and visit www.postpartum.net for additional resources. If you’re breastfeeding and having vaginal dryness, talk to your OBGYN about vaginal estrogen or other non-hormonal options. Likewise, if you’re not feeling desire and think something else might be wrong, talk to your OBGYN about testing for hormonal imbalances or other issues. And most importantly, talk to your partner! Set expectations, boundaries, and goals. If you’re not feeling sexy or feel like you and your partner are not on the same page, see a sex therapist. The American Association of Sexuality Counselors, Educators, and Therapists has a good locator: https://www.aasect.org/

Love yourself, love your babies, and love your partner, whatever that means for you. And if you're local to Long Beach and need help, contact us to schedule a consultation. Happy sexy time!