Let’s Talk About Sex (after) Baby

In Week 3 of my Postnatal Pilates class our topic is “Let’s Talk About Sex (after) Baby.” The reasons most women don’t want to have intercourse or don’t enjoy intercourse can usually be broken down into 3 main categories: 
➡️ Pain
➡️ Emotional Factors, and
➡️ Core Changes and Feeling stretched out “down there”

Let’s start with pain. Usually, pain is the result of decreased lubrication, scar issues, skin disorders or infection, and/or tight pelvic floor muscles. When it comes to lubrication, you may notice more dryness as a result of the decreasing estrogen right after giving birth along with the extra dryness that accommodates breastfeeding your baby.

For this reason, it will serve you well to supplement with generous amounts of lubrication. Lubricants can be silicone-based, water-based, or oil-based. Silicone lubricants are nice because they dry to a silky, powdery finish and can last through “marathon” sex (which is anything more than 15 minutes in a postpartum woman!) They shouldn’t be used with silicone pleasure aides or toys though. Water- based lubricants are probably the most common and have the added bonus of being condom/toy safe; however, choose products without ingredients like glycerin or paraben. Oil-based lubricants have a tendency to cling to the walls of the vagina which can be good but can also be harder for the vagina to flush clean, so beware if you are prone to irritations and infections. In addition, oil-based lubes are not compatible with certain condoms, mainly latex and polyisoprene ones. Lubricants should be applied liberally to the vagina (inside and out) and to anything that will enter the vagina as well.

The next category is scar issues. These can be perineal tears, episiotomy incisions, or C-section scars. Any scar in your body needs to be rehabilitated. Scars can form adhesions which can limit the range of motion and/or cause discomfort. Once soft tissue has healed (usually within 4-6 weeks) you can gentle mobilize the area by moving perpendicular to the incision, in circular motions along the incision, and the skin can even be lifted and plucked a bit to break up any deeper adhesions. In the case of perineal scars that are difficult to mobilize on your own, a Women’s Health Physical Therapist can assist. In the case of C-section scars, don’t forget there are 2 scars that need your attention. The external one that you can see and a much deeper scar where an incision was made on your uterus to retrieve your baby. Visceral-trained physical therapists and Maya Abdominal Massage therapists are able to
address this region.

Infections like UTIs, urinary tract infections, bacterial vaginosis, and skin conditions like lichens planus or lichens sclerosis will require medical attention and may contribute to pain with intercourse.

And lastly, vaginismus is a condition where the pelvic floor muscles are so tight that penetration is difficult. Often these women have never had pain-free intercourse or have struggled with tasks such as inserting a tampon or completing an annual pelvic exam for quite some time. Women’s Health Physical Therapists can work on relaxation training, down training tight pelvic floor muscles, and even using plastic, cone-shaped devices called vaginal
dilators to help with this condition.

Under the umbrella of Emotional Factors, I like to point out the difference between sexual accelerators and sexual brakes, terms I learned from Emily Nagoski’s book called Come as You Are (did I mention how much I love my job?!)  Sexual accelerators are sexually relevant stimuli in your environment. 

Basically, what turns you on?

These vary from person to person and can include things like bubble baths, candles, seeing a partner help with chores, watching an intimate love scene on TV, etc, etc. Sexual brakes are things in your environment that tell your subconscious to turn OFF.  Think bad breath, body odor, a long to-do list (see Perfectionism Blog next), sounds from the baby monitor on your bedside table, crushing the tiny nerves in your foot by stepping on a lego on the way to your lovemaking bed, etc. 

Your goal is to identify what is a sexual accelerator and what is a brake for you and then create an environment where you can turn on the ONS and turn off the OFFs.

And the last category of common reasons women either do not want to have intercourse or do not enjoy intercourse after the birth of their baby involves feeling disconnected to their core or stretched out in the nether regions.

There’s nothing like a saggy belly to jeopardize your self-esteem and make you feel less than sexy in the bedroom. Likewise, difficulty connected to your pelvic floor muscles can leave you feeling……”meh”. Learning some core exercises to firm up your abdomen and wake up your pelvic floor can help bring your sexy back. Pelvic floor muscles that know how to fully contract and fully relax can increase the intensity of orgasm and the enjoyment of intercourse. On the
bright side, your clitoris doesn’t change much after birth and is up to 80% responsible for your orgasm so put that feather in your cap, Ladies!

If you’d like to learn more practical ways to get yourself in the mood, while learning some Pilates moves that are safe for your Postpartum body (including those important core muscles), consider joining my next Postnatal Pilates class.

These 6-week sessions are a combination of education and exercise and can be completed in an online, self-paced format or in group virtual classes where you can receive real-time feedback on your form and immediate answers to your questions, or in private sessions from my home studio for local participants. To learn more or register, visit www.carriekoziol.com 


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