Pregnancy sex. Sit around a table with a group of girlfriends and the stories you’ll hear will vary…to say the least. One friend is hot and hyped. Another, dryer than the desert. Someone is leaking breast milk. And that other friend found an eye-opening off-label use for the birthing ball. The mental pictures can last a lifetime.
To help us understand how the emotional and physical changes of pregnancy and postpartum can affect our sexuality, we caught up with Perelel Panel experts Allison Oswald, a board-certified women's health Doctor of Physical Therapy, and reproductive psychiatrist, Dr. Sarah Oreck, MD, MS. Read on for their insights on maintaining communication, connection and hot sexy passion.
Sex and Pregnancy
How can the physical changes of pregnancy affect women's pleasure?
“Of course each woman’s experience is unique, but overall women experience so many physical changes that have the potential to impact pleasure. During pregnancy, a woman’s blood volume increases greatly which can directly impact the sexual organs, actually resulting in more sensitivity, arousal and lubrication. Therefore for some women, pleasure actually increases, especially at the beginning.
However, as the pregnancy progresses there are a few things that shift that may actually lessen pleasure. These include an increase in body weight, therefore women may feel less desirable and less comfortable in their skin. The increase in weight can also place added pressure down on the pelvic floor causing heaviness and possibly swelling. Other changes might include nausea, fatigue and stress which we all know negatively impact desire and pleasure. And finally, if a woman is experiencing any sort of pregnancy-related pain or discomfort, she is less likely to want to participate in sex due to her physical state and the fear associated with it,” Dr. Oswald says.
How can women increase their desire for and connection with their partners during pregnancy?
“I find that increasing desire and connection with a partner starts with communication. Check in with yourself and your partner about how you're feeling during the pregnancy and what needs are perhaps being neglected or unmet. As you're growing your family, the focus can be on taking care of other children or preparing for the new baby's arrival. Relationships take work and effort. Ask for what you need from your partner to grow intimacy—whether that's touch, acts of kindness, support with household chores or a date night with your partner,” Dr. Oreck suggests.
"Check in with yourself and your partner about how you're feeling during the pregnancy and what needs are perhaps being neglected or unmet."
Also consider “exploring other ways to be intimate, if penetrative intercourse is not in the cards. And this might take a woman becoming more connected with her pregnant self, exploring what she desires, what feels good and how she might be able to share that with her partner. If penetrative intercourse is an option for a couple, being willing to explore different positions based on comfort and feeling safe can be very helpful in driving desire as well,” Dr. Oswald says.
Postpartum and Your Sex Life
Is it common for women to struggle to make the leap back into intimacy after birth? What are some reasons that can happen?
“Of course it is common, after delivery and the healing involved from the birth and the pregnancy take a toll on the body. In the immediate postpartum there could be swelling, stitches, pain, pressure, heaviness and bleeding, to name a few. This is not a recipe for intimacy. Depending on a woman’s experience, she may be having symptoms of prolapse or incontinence, along with more dryness from hormones. Not to mention the lack of sleep and stress of having a new baby. I often hear women describe themselves as feeling “touched out” from the constant needs of a newborn, leaving them wanting space from others touching them, which would impact intimacy of course,” Dr. Oswald says.
What strategies can women use to emotionally ready themselves to be intimate after having a baby?
“The most important strategy is to check-in with yourself and take your temperature on what you're feeling. Once you've done that, communicate. It’s essential to take things slowly and to communicate clearly about your level of desire and concerns about pain or discomfort. Clearly communicating how you are feeling can avoid any feelings of resentment or rejection by either partner. Explore your own sexuality and what feels good to you—this may be different than before your pregnancy and explore with your partner as well when the time is right,” Dr. Oreck suggests.
"There is so much women can do and know to support their own healing and recovery."
What happens to your pelvic floor during labor and delivery with a vaginal delivery? Is everything going to be okay?
“The pelvic floor muscles actually stretch tremendously during a vaginal delivery, some say up to three times their length. Unlike what many believe, the uterus pushes the baby out and the pelvic floor muscles should actually get out of the way. Depending on the length of labor, time pushing, and position of birth, the pelvic floor muscles are affected differently along with the pelvis itself. About 80 percent of women experience some perineal tearing (episiotomies are much more rare these days) varying from grade one to four.
- Grade 1: Pelvic floor muscle is not torn. (Perineal skin only.)
- Grade 2: Pelvic floor muscles are torn.
- Grade 3: Pelvic floor muscle is torn to the anus.
- Grade 4: Pelvic floor muscles is torn into the anus.
Therefore, depending on each woman’s experience the pelvic floor recovery is unique. Some women will heal with time and others need more support. But it is my belief that all women would benefit from pelvic floor rehab after baby. There is so much women can do and know to support their own healing and recovery,” Dr. Oswald concludes.
Did we pull the covers off your sex questions? Have any more for our experts? Drop us a DM on social and read more about the health benefits to having more sex next.
Jessica Lopez is a writer and new mother based in Southern California. She has written for Cup of Jo, BRIDES, Byrdie, THE/THIRTY, and more, and she currently enjoys (over)thinking and writing about parenthood. You can connect with her on Instagram, if you’d like.
This article is for informational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and we recommend that you always consult with your healthcare provider. To the extent that this article features the advice of physicians or medical practitioners, the views expressed are the views of the cited expert and do not necessarily represent the views of Perelel.
