Sex after baby: How to reclaim the passion

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/ Source: TODAY books
By <strong>Hilda Hutcherson</strong></p>

If you’ve just had a baby, sex is probably the last thing on your mind. In her new book, “Sex and the Baby Years,” Dr. Hilda Hutcherson explains why reclaiming your sex life is important, and how to get “in the mood” when your life has been taken over by breast-feeding, diapers and nap schedules.

Got questions? Check out our live "Sex After Baby" chat on Wednesday morning.

Part Three: Sex After Baby: Back in the Saddle

Picture this: You’re lying in bed, nestled next to your partner and holding your newborn. For a moment, everything is calm. Your guy rubs your shoulder. Your baby coos in her sleep. You’re the image of a perfect, happy family.

Then his hand moves down to squeeze your breast. (Um, ouch.) Her eyes blink and she opens her mouth. He wants sex. She wants ... food? Attention? A clean diaper? I don’t have to tell you who’s going to win this round — every time.

Oh, sure, the idea of sex seems nice — you want to want it, after all. The actual execution? Not so much. Between a sore body, sleep deprivation, and the overwhelming task of tending to a tiny person who can’t do anything for him- or herself, even just a few minutes of passion seem as attainable as the Holy Grail.

That’s okay. Lest you ever forget, let me remind you: You just had a baby. Whether through vaginal delivery or by C-section, your body has been through some major changes, and it’s going to take time to heal. Consider all the other factors in play — from hormonal shifts to body image issues to pure exhaustion — and you can see why sex usually isn’t on most new moms’ radar screen.

Eventually, though, even the most frazzled parents need to get close again. Once you have kids, it’s easy to start identifying yourselves as Mommy and Daddy and to lose sight of the relationship you had before you gave birth. That’s why it’s so important to set a foundation for intimacy now so you can continue to enjoy a healthy sex life for years to come. In this section, we’ll look at how to deal with some of the most common roadblocks to post-baby sex.

Chapter 10: Post-Baby Libido: You Want to Want It — But You Don’t Really Want It

You’ve gotten the go-ahead for sex from your physician. But a green light doesn’t necessarily mean you’re ready to step on the gas. Although your husband may be raring to go (and maybe he isn’t, either), sex might be the last thing on your mind. Here’s why:

Hormones, hormones, hormones. It makes sense: The hormone levels that skyrocketed during pregnancy now plummet, taking your sex drive with them. If you’re breastfeeding, your libido can take another hit as your body starts releasing prolactin, a hormone associated with decreased sexual desire. Once you finish nursing and your hormone levels even out, your libido should return.

Fatigue. You need energy to enjoy sex. But when you’re existing on minimal sleep and taking care of your baby’s every need, that can seem about as likely as winning the lottery. Simply put, you’re just too busy — and exhausted — to get busy. New parents are almost always going to choose shuteye over sex. So try to nap when your baby naps. Eventually he or she will develop a regular sleep schedule and you’ll get a break.

Body image. It’s true: Once you have a baby, your body changes. I’m not even talking about those extra pounds — even if you get back to your pre-pregnancy weight, the landscape of your body has been altered. Your hips are little wider. Your belly isn’t as flat as it used to be. Your breasts aren’t quite as perky. These transformations can all contribute to lower self-esteem, and that can take a toll on your libido. What doesn’t change? Your vagina. It’s a myth that childbirth stretches you out permanently. So don’t worry that you or your partner won’t enjoy sex as much as before. Your vagina will return to normal, especially if you do Kegel exercises to strengthen the surrounding muscles (see Chapter 11). All told, your concerns about your body can harm your sex life more than any changes to your body itself.

Mommy mode. You carried this little being in your body for all those months — it’s only natural that now your focus is firmly on your baby. The problem? If that focus shifts too far from your relationship with your partner, your sex life can end up on the back burner. Worse, you may even stop viewing yourself as a sexual being: You and your partner are now simply “Mommy” and “Daddy.”

Postpartum depression. Sometimes, a lower libido is just the tip of the iceberg. Rapidly decreasing hormones may cause you to feel weepy after giving birth. An event that should fill you with joy leaves you with tears and anxiety. Fortunately, these feelings typically resolve within a few weeks of giving birth. If they last longer, you may have postpartum depression (PPD), a true libido killer. About 20 percent of women experience PPD, which can occur any time in the year or so after they give birth.  Watch for signs like sadness, lack of energy, trouble concentrating, anxiety, and feelings of guilt and worthlessness. Adjusting to the new normal of parenthood is tough for guys, too: Although there’s not much research on this subject, PPD may affect 25 to 50 percent of new fathers, particularly those who are stay-at-home dads or whose partners are also experiencing PPD. For both women and men, counseling, support groups, and medicines help address PPD.

BREAKOUT BOX 1: The 3 'L' s of Breastfeeding

“Breast” may be best, but not when it comes to your libido. Because of breast milk’s benefits, I recommend that my patients nurse their babies if possible. Yet breastfeeding can hamper sex drive in several different ways. If you nurse, don’t stop just to boost your libido — but do be aware of these effects, which will likely resolve once you wean your little one.

Lower libido. As I mentioned earlier, breastfeeding triggers the release of prolactin.  Although this hormone is crucial for nursing — it stimulates milk production — it can send your libido South, too. Prolactin may make orgasm more difficult to achieve as well.  You might also find that you don’t view your breasts as an erogenous zone right now. They may be sore or tender to the touch, lick, or suck, so let your partner know what feels good.

Less lubrication. Because levels of the hormone estrogen drop during breastfeeding, you may notice that your vagina is dry and doesn’t lubricate as well as it should for comfortable sex. Invest in a good water-based lubricant with Vitamin E and Aloe, like K-Y Brand SILK-E to add moisture to dry vaginal tissues, thus enhancing comfort.

Leaking. Worried that your breasts might leak during sex? It’s entirely possible. Some women find that they leak or spray milk (called “letdown”) during orgasm, especially when they first start breastfeeding. You may be able to prevent letdown by pumping your breasts or nursing your baby before sex, or wear a bra with pads to bed. But if you do leak, no need to worry. It’s natural — and good sex is often messy!

BREAKOUT BOX 2: The Delivery Room vs. The Bedroom

Once barred from the delivery room, men are now invited — and expected — to be present at their child’s birth. For many guys, it’s an exciting, if nerve-wracking, experience. Yet for every new dad armed with a video camera and words of encouragement, there’s a man who rues ever witnessing the whole messy affair.

Sure, he’ll describe the event as “incredible” — but secretly he regrets not just staying at the head of the bed holding your hand. Instead, he saw things he wishes he’d never seen, whether that means watching a vaginal delivery or a C-section. A body part he previously associated with pleasure may now be totally desexualized, and he can’t go near it without flashing back to the delivery process. If you had a C-section, the scar may remind him of watching doctors slice open your abdomen. In either case, it’s clear that, for some men, childbirth is a libido killer.

Fortunately, this is one trauma that can be overcome quickly. Guys: Get back in the saddle and just do it! Even if you have to push yourself through the motions of intimacy those first few times, eventually the heady neurochemical cocktail of arousal will do its job, and you’ll want to keep riding.

Chapter 11: Easing the Way: Making Sex Comfortable

Even if you’ve got your libido back, you might feel nervous about sex. Most practitioners advise waiting about 4 to 6 weeks after delivery before you start having intercourse again. It’s normal, though, to continue worry about whether sex will be pleasurable until you do it. When you’re ready to give it a shot, try the tips in this chapter to help make intercourse more comfortable and enjoyable.

Does Delivery Make a Difference?

Although we often can’t control how we give birth, the way you deliver your baby can affect your sex life.According to recent research, women who deliver via vaginal birth appear to have greater sexual dissatisfaction than those who deliver through C-section. One study published in the June 2009 issue of the Journal of Sexual Medicine, for example, found that women who had planned C-sections had less pain and better sexual satisfaction and were more likely to resume having intercourse within 8 weeks of delivery than those who had vaginal births. Other studies have found that episiotomy (a surgical incision of the skin between the vagina and anus, or perineum, to enlarge the vaginal opening for childbirth) may delay the time it takes to resume intercourse. A 2008 report in Gynecologic and Obstetric Investigation also found that women who underwent episiotomy had more pain and vaginal dryness with intercourse.

The type of delivery you choose should be based on the health of you and your baby, not your sex life. Still, it’s good to know what you might expect with both modes of childbirth so you can take measures to prevent pain during intercourse and other side effects. For couples ready to get back in the sexual swing of things, I recommend these steps:

Be patient. For some women, the tenderness that results from vaginal childbirth or episiotomy can clear up relatively quickly, but it may take others months to have intercourse without discomfort. It can also take time for the incisions from a C-section to heal. Wait for the go-ahead from your health practitioner before having sex again.

Take it slow. As you’ll learn in Chapter 12, you don’t have to dive right into intercourse. Hug, kiss, cuddle, share a fantasy and otherwise play to build stimulation and pleasure. Tell your partner what feels good, and what doesn’t.

Invest in a good lubricant. As estrogen levels drop after pregnancy, you may experience vaginal dryness, a problem that can be compounded if you’re breastfeeding by rising levels of the hormone prolactin. Try using a personal lubricant like the K-Y Brand SILK-E mentioned earlier, to add moisture to dry vaginal tissues.

Work it out. The muscles that surround and support your vagina may be weakened by pregnancy and childbirth. Strong pelvic floor muscles make it easier to experience orgasm and increase pleasure for you and your partner. You can tone and strengthen the muscles in your pelvic floor by practicing Kegel exercises. Squeeze your pelvic muscles as if you’re stopping your stream of urine, hold for 5 seconds, and release, repeating the cycle 5 times in a row (don’t do so while actually urinating). Eventually, work your way up to 10-second intervals.

BREAKOUT BOX: Dear Dr. Hilda

Q. Can we get pregnant again while I’m breastfeeding?

A. Absolutely. Although women who nurse experience a delay in menstruation, remember that ovulation may occur before you start having periods again. Ask your healthcare practitioner to recommend a type of birth control that will work for you during this time.

Chapter 12: Reclaiming Intimacy

It’s what some people jokingly call the “fourth trimester” — those first few months after pregnancy when your body and mind are still adjusting to having a new baby. We’ve already talked about the physical and emotional changes you might experience in this postpartum period and how they can affect your sex life. Wait, what sex life? You just added feedings, diaper changes, and countless other baby-related tasks to your already-packed schedule. You’re focusing all that love and affection on your baby, not your partner. If you have time for anything else, it’s probably going to be sleeping, catching up on email, or finishing that last chapter of your novel. For many women, sex rates dead last on their to-do list. And chances are, he’s wiped out, too.

Perhaps that’s why some 70 percent of couples report a decline in relationship satisfaction after having a baby. Sure, sex after pregnancy may seem like a chore at first, but it’s crucial for maintaining intimacy and closeness with your partner. And, ultimately, that can help make you both better parents. In this chapter, we’ll look at the ways you can start to reclaim your sexual connection.

Prioritize sex. You don’t have the luxury of spontaneous sex that you had in the past. That means you have to take more of an active role to make sure sex happens on a regular basis. Plan ahead, arrange for childcare, and otherwise make an effort to ensure that you’re able to set aside even a brief amount of time to focus on your sexual relationship with your partner.

Practice “choreplay.” Researchers in the Netherlands have found that the key to getting a woman turned on and to the heights of orgasmic bliss is a deep sense of relaxation and a lack of anxiety. They scanned the brains of 13 women and 11 men while they were manually stimulated to orgasm by their partners. The scans showed that, for women, the parts of the brain responsible for processing fear, anxiety and emotion slowed down the more aroused they became, producing a trancelike state at orgasm. Men showed far less change in these areas of the brain.

A great way to relax is to eliminate sources of stress in your life — but you can’t do it alone. If your guy wants sex, he should know that simply helping out around the house can go alone way to putting you in the mood. In fact, studies suggest that women with partners who pitch in with housework and childcare are happier and enjoy more sex than those whose men don’t tackle such chores. So, guys: Help her cross some of the less exciting stuff off of her to-do list, and you’ll help move sex closer to the top.

Mix it up. If you’re nervous about starting intercourse again, try woman-on-top, which allows you to control the speed and depth of penetration. If you had a C-section, try lying on your sides facing each other or spooning, which keeps pressure off of your incision.

Revisit birthing lessons. Remember all that deep breathing you learned during childbirth classes? It’s not just beneficial for labor. Deep belly breaths will help you relax and focus on pleasure, and may even result in bigger, better orgasms.

Have a quickie. Once you’ve started to reclaim some sleep, you can use your baby’s naps for another activity: sex. Get your little one off to dreamland and then explore the rest of your house. Your dining room table, kitchen floor, and the shower can all set the stage for a fun, sexy quickie.

Explore alternatives. Not comfortable going all the way yet? Kiss, cuddle, spoon, give each other massages, touch each other, or enjoy oral stimulation to feel intimate without intercourse. Talk with your partner about your limits, so you can enjoy each act of intimacy for what it is without worrying that it will turn into a demand for sex.

Take advantage of technology. Lots of couples feel weird having sex when their baby is in the same room. So put your baby monitor to use. Although most guys would rather not hear their baby cry during sex, keeping it on — set to a low volume — may actually help you relax. It sounds counterintuitive, but you might actually have less anxiety if you know you can hear your baby cry.

Take care of yourself. It’s hard to feel sexy when you’ve got baby puke in your hair. Trade baby duties so you can take the time to visit the salon, gym, or get a massage. Better yet, turn one of your date nights into a fun, flirty shopping trip — shopping for lingerie, that is. Split up at the store, choose some favorite pieces, and then retire to the dressing room to put on a little fashion show. If something really blows your mind, splurge on it. Either way, you’ll help boost your body image and self-esteem, and stoke the flames of your libidos.

Don’t give up. New dads actually perform a vital relationship function, which is to bring their partner back into the relationship and restore the primacy of their couple-hood: a crucial necessity if they’re to flourish and succeed as a family. As couples therapist Esther Perel says, “When the father reaches out to the mother, and the mother acknowledges him, redirecting her attention, this serves to rebalance the entire family. Boundaries get drawn, and new zoning regulations get put in place delineating areas that are adult only. Time, resources, playfulness and fun are redistributed, and libido is rescued from forced retirement ... the role of more autonomous parent is to help the primary caregiver disengage from the kids and reallocate energy to the couple.” So, guys: Keep trying. Even if she shoots you down, she’ll secretly relish the compliment that you still find her sexy. Eventually she will say “yes” — and you’ll have helped do your part to reestablish intimacy.

Just do it, already. I’m not saying you should have pity sex just to please you partner, but giving in once and a while will eventually help you both get back into it. That’s because arousal begins in your body, while desire begins in your mind. You don’t always need desire to feel aroused. And remember, the less you have sex, the less you want it. The more you have it, the more you want it. So get busy!

In Sum

You can see now why I urged you to enjoy sex during conception and pregnancy — maintaining a healthy sex life as new parents is easier said than done! Remember, it took nine months to make a baby. It’s going to take more than one night to re-make your sex life. Take things slowly — baby steps, if you will — to help ease anxiety and fear of pain with intercourse. And don’t be afraid to think outside the box: You may need to be bolder sexually, to go where you haven’t gone before. Reclaiming your sex life is a process, but it will happen naturally once you get things started.

With the advice in this section, you’ll be able to reconnect with each other and re-establish that intimate bond you share as a couple. As Louann Brizendine, MD, writes in The Female Brain, “Without frequent touch, the brain’s dopamine and oxytocin circuits and receptors can feel starved. Couples may not realize how much they depend on each other’s physical presence until they are separated for a while ... In both males and females, oxytocin causes relaxation, fearlessness, bonding, and contentment with each other. And to maintain its effect long-term, the brain’s attachment system needs repeated, almost daily activation through oxytocin stimulated by closeness and touch. ... Activities such as caressing, kissing, gazing, hugging, and orgasm can replenish the chemical bond of love and trust.”

Perhaps you’ll even feel more connected during sex. After all, you’ve shared an incredibly emotional experience. Strengthen this bond now, so you’ve got a solid foundation for sex during parenthood.