How to Do It: Getting back to, ahem, business after having a baby

[minoanmiss]

Content advisory: childbirth, sex.

My husband and I recently had a baby. It was a vaginal birth and according to my doctor, it all went well. There was an episiotomy and I struggled with the recovery. Now, almost three months later my doctor gave the green light. But I am terrified to try having sex. My husband does not mind at all and is willing to wait as long as I need to feel not terrified at the thought of penetration. I know we could explore other ways to have fun but the thing is, I love penetrative sex. I have tried masturbating and everything works fine down there (I was genuinely concerned the fear would paralyze my clit and I would not be able to have an orgasm, but thankfully that is not the case). My question is: How do you get back on (or under) that horse after what felt like but was not a traumatic experience for your vagina?

—Horny But Terrified

Dear Horny But Terrified,

Congratulations on your new family member. The closest I could find to a definition for trauma experienced in childbirth is this paper by Mari Greenfield, Julie Jomeen, and Dr. Lesley Glover, which attempts to lay the groundwork for one. Regardless of the T-word, this transition you’ve just undergone, along with the associated medical procedures, is pretty intense, so I hope you’re giving yourself patience. Your feelings and hesitance are valid.

I spoke with Sylvie Bee, a sexological bodyworker who entered the field because of her own postpartum experiences. Her first recommendation is to see a pelvic floor physiotherapist for an exam, which can evaluate whether any of your muscles are overly tense, in need of strengthening, or otherwise a hurdle to enjoyable penetration. Sylvie told me that pelvic floor specialists are usually happy to perform these exams, and you can usually schedule an appointment with them directly. Regardless of whether therapy is needed, pregnancy and birth is likely to have changed what feels good for you. Depending on the legality in your area, a sexological bodyworker can help you methodically map out your current pleasure zones. (If a bodyworker requires you to have seen a pelvic floor specialist first, that’s a good sign.) You can also do this—slowly, with a lot of lube and even more patience—alone or with your husband. Try different types of stimulation—stroking lightly and firmly, tapping, massaging—in different areas and make note of what feels good.

If you’re experiencing increasing anxiety, or feeling stuck, it’s worth asking for a referral to a mental health professional who specializes in new parents.

Comments

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[minoanmiss]

I posted this one because I realized I've only recently seen any discussion of what must be an ancient issue -- resuming one's sex life after having a child. Maybe it's because I haven't been pregnant myself so I haven't had a doula give me any words of advice, but it just seems like a subject that should be discussed so much more. How many people don't even know how to ask for the advice LW sought here?

[green_grrl]

How do you get back on (or under) that horse after what felt like but was not a traumatic experience for your vagina?

You pushed out a baby and had an episiotomy! How is that not traumatic? I mean, sure, it went better than tearing or other possible outcomes, but fears aren’t invalid if you didn’t win the gold medal in the pain Olympics.

I feel so bad for this LW. Women are so conditioned to just suck it up and push through at the expense of their own physical and/or mental health.

[ethelmay]

Yeah, it seems to me if it "felt like a traumatic experience," then it WAS one. I mean, what else is trauma about than what it felt like, and what the repercussion feelings are? And it's also possible there is an observable problem with how the episiotomy was repaired. (It's not that uncommon for an episiotomy to cause worse damage than would otherwise have occurred.) A lot of women get less lubrication while breastfeeding as well, which doesn't help. (It's not universal. Some women are the opposite and get less lubrication during pregnancy and more during breastfeeding.)

[joyeuce]

Yes, this. My notes say, and the head of midwifery later assured me, that my daughter's birth went fine. That ... was not my experience. It started with staff who apparently didn't believe anything that I told them, such as firstly that my waters had broken and secondly that I was experiencing labour pains in my legs, and went downhill from there. And then afterwards I was violently sick and dehydrated. And later my stitches fell out and I got infected. And I had flashbacks and intrusive memories for several years. And what with one thing and another, it was two years before penetrative sex happened again.

[ethelmay]

Oof. My sympathies. I had PTSD after a difficult birth as well. It happened not to give me that much trouble with resuming sex, but I remember thinking at the time it was kind of odd it didn't. It certainly seemed like the kind of thing that could have.

[joyeuce]

Thank you.

[ashbet]

Even with me having a HIGH libido, it took me 4 months to recover enough from childbirth/episotomy to have penetrative sex without pain.

(I also have some medical trauma from having requested “no episiotomy” in writing and getting one routinely performed anyway — the whole pregnancy was a mess, with life-threatening issues twice, and the misery of hyperemesis gravidarum until delivery, and my OB was, in retrospect, pretty awful. This was 30 years ago, I really would have benefited from online parents’ groups if I’d had access to them!)

First, the LW is not obliged to “try” until she feels ready. Doctors usually issue the all-clear for sex after 6 weeks, but that doesn’t mean it will be ENJOYABLE.

A pelvic-floor physical therapist can check for any issues and provide some reassurance, but it sounds like anxiety is a big factor here.

This is sooooo frequently an issue for people with vulvas who are trying to get back on their feet sexually after a birth!

[castiron]

In addition to the advice here, I'd suggest that LW get a dildo and experiment with that. That way there isn't the pressure of worrying about your partner's reaction if it's painful.

[azurelunatic]

and/or a set of dilators! I very much appreciated having those after my radiotherapy.