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Friday, July 1, 2016

How Sex Changes During Pregnancy, Nursing, and Parenthood


From the positive pregnancy test to weaning the infant typically takes around two years, sometimes longer. This period involves huge changes in relationships, some wonderful, others challenging. Unfortunately, pregnancy resources often under-emphasize the subtle nuances of the sexual transition involved in becoming a family. And that’s a shame. Many pregnant couples and new parents don’t appreciate the sexual implications of having and raising children.

The Conventional Wisdom: Off the Mark

Here’s the conventional wisdom: Women’s libidos collapse during the first trimester, often rebound during the second, and fall again during the third. This  turn-off/turn-on/turn-off pattern makes some sense. Libido initially falls because women’s enormous physical and emotional shift into pregnancy distracts from sex. In addition, the physical discomforts of early pregnancy, notably, morning sickness, are another turn-off. During the second trimester, libido rebounds as morning sickness usually—but not always—subsides and expectant mothers begin to radiate the glow of pregnancy. Libido falls again during the third trimester because of fatigue and the discomforts of a big belly and swollen breasts.

But the conventional wisdom obscures a greater truth: Pregnant women’s feelings about sex vary tremendously.

For their book, Sexy Mamas, Anne Semans and Cathy Winks surveyed more than 700 women about their sexuality during and after pregnancy. “The women reported an enormous range of sexual experiences while pregnant,” Semans says. “Some reveled in a marvelous erotic awakening. Others felt totally turned off. When I was pregnant, my libido went to hell. I kept hearing about how aroused I’d feel during my second trimester. But that never happened. I felt turned off the whole nine months.”

Many men also experience dramatic libido changes during their wives’ pregnancies. Most expect to feel turned on by their wives’ changing bodies. Actually, many feel surprisingly turned off. Swedish researchers studied 112 pregnant couples. Some of the men couldn’t get enough sex with their pregnant wives, but others completely lost interest, especially during the third trimester.

Easier Orgasms?

During pregnancy, women’s orgasms sometimes become more pleasurable. “Because of increased genital blood flow,” Winks explains, “many women reported that pregnancy produced the most intense orgasms of their lives. Some women who had never had orgasms had them. And many said it was easier to come while they were pregnant.” The only negative Semans and Winks found, was that some women said their genitals became almost too sensitive. Sexual stimulation felt so intense it caused discomfort.

Safe for the Baby?

One reason people turn off to sex during pregnancy is fear that it might harm the fetus. It doesn’t. Even enthusiastic, bed-shaking intercourse does not harm the baby. On the contrary, if a pregnant woman finds sex relaxing and intimacy-enhancing, it can help the pregnancy by reducing her stress.

Another reason parents-to-be avoid sex during pregnancy is fear that the muscle contractions of orgasm might trigger premature labor. This is not likely:

• Scientists with the National Institute of Environmental Health tracked the orgasms of 596 pregnant North Carolina women. Third trimester orgasms were associated with 66 percent less risk of prematurity. “Assuming a normal pregnancy,” says Richard Perkins, M.D., a professor of obstetrics and gynecology at Creighton University in Omaha, “it’s very unlikely that sex will have any adverse effect on the fetus. Couples should be reassured about the safety of sex during pregnancy.”

• Triggers of premature labor include: smoking, skipping meals, disturbed sleep, spicy foods, cocaine use, strenuous physical work, and heavy alcohol consumption. Sex is not on the list.

• However, at or after term, lovemaking may trigger labor.

Some expectant parents get nervous about using sex toys. “For women with normal healthy pregnancies,” Winks explains, “our research showed that sex toys, including vibrators, are safe.”

However, some complications of pregnancy warrant abstinence: placenta previa, multiple fetuses, serious uterine irritability, and high risk of prematurity.

Resuming Lovemaking

Many baby books say that couples can resume lovemaking two to three weeks after a normal vaginal delivery without episiotomy, a week or two later with episiotomy, and several weeks later after a C-section. However, until the baby sleeps through the night, most new parents feel so exhausted that when they see a bed (or sofa or chair), they want sleep, not sex.  Most infants don’t start sleeping through the night until at least 12 weeks, so don’t expect much libido or sex until then.

In fact, it may take months for women to regain their pre-pregnancy libidos. One reason is persistent pain around the vagina, which may last several months. 

Another is nursing. Postpartum, estrogen drops, and levels of two other hormones rise, prolactin and oxytocin. “Prolactin and oxytocin have libido-dampening effects,” Winks explains, “not to mention, that women are still recovering from labor, their breasts are engorged with milk, which can feel uncomfortable, and they’re dealing with the fatigue, sleep-deprivation, and other stresses of new motherhood. Few women feel sexual the first few months of breastfeeding, and some don’t regain interest in sex until they wean.”

“In addition,” Semans says, “couples have to come to terms with breastfeeding. Some women fear their partners will be turned off by huge breasts dripping milk. Meanwhile, some men consider breast milk a turn-on. Couples should discuss how they feel about it. Any feelings are possible.”

Is Motherhood Sexy?

A third reason women lose libido after delivery is the cultural belief that motherhood isn’t sexy. Winks explains: “Growing up, women learn that they should be sexy babes until they procreate. But once they’re moms, many believe they’re no longer sexy—or sexual. They think they’re supposed to be self-sacrificing for the child, and sex is the opposite of that, so many women—and some men—struggle with being sexual as parents.”

“Once you become a mother,” Semans adds, “sex may be viewed as an indulgence. Lots of moms buy into this and desexualize themselves. In addition, motherhood is exhausting and time-consuming. Many new mothers told us they wanted to have sex, but had no time or energy for it, that it was no longer a priority.”

Even if you’re not having genital sex for a while, try to maintain a sensual connection. Kiss, hug, cuddle, maybe trade massages. Sex may be on hold, but most new parents find nonsexual affection reassuring as they adjust to being parents.

University of Wisconsin researchers followed the sexuality of 570 pregnant couples. Through the fifth month, 85 percent continued to make love. But as the due date approached, the proportion declined sharply. At one month post-partum, only 16 percent made love, largely because both parents, especially the new mothers, felt exhausted, and because of lingering after-effects from the birth. By four months post-partum, 88 percent were making love again, and at 12 months, the figure was 91 percent.

Sex for New Parents

If you want to maintain your sexual relationship as parents, you have to make it a priority. With a child, impulsiveness and spontaneity disappear. Everything needs to be planned, including sex. “Set aside time for sex,” Winks advises. “Make sex dates. If possible, one or two nights a month, have your child spend the night somewhere else and enjoy a romantic evening together. You might work out a trade with another family. Trading sleep-overs can be a godsend for parents’ sex lives.”

Parenthood Makes Better Lovers

Even though pregnancy, nursing, and parenthood change sexual relationships—and often strain them—Semans says parenthood ultimately makes people better lovers: “The qualities that parenthood requires—generosity, patience, nurturing, imagination, partnership—all translate well into lovemaking. Many of our respondents said that parenthood had made their relationships more intimate. That was heartwarming, and we heard it often.”

Need Help?

If you don’t make love for a long time after the birth of a child, consider sex therapy. How long is a long time? That’s subjective. For some couples, it’s six months, for others, it’s after the child stops nursing, and for some, it’s when the situation starts driving one of them crazy. You want children to affirm your relationship, not drive a wedge between you. If you don’t return to a sex life you can both live with comfortably, sex therapy usually helps. To find a sex therapist near you, visit the American Association of Sex Educators, Counselors, and Therapists, the Society for Sex Therapy and Research, or the American Board of Sexology.

References:

Ekwo, EE et al. “Coitus Late in Pregnancy: Risk of Preterm Rupture of Amniotic Sac Membranes,” American Journal of Obstetrics and Gynecology (1993) 168:22.

Hernandez-Diaz, S et al. “Triggers of Spontaneous Preterm Delivery: Why Today?” Pediatric and Perinatal Epidemiology (2014) 28:79.

Omar, NS et al. “Coitus to Expedite Onset of Labor: A Randomized Trial,” BJOG [formerly British Journal of Obstetrics and Gynecology] (2013) 120:338.

Petridou, E et al. “Are There Common Triggers of Preterm Deliveries?” BJOG  (2001) 108:598.

Savitz, DA and P Murnane. “Behavioral Influences on Preterm Birth: A Review,” Epidemiology (2010) 21:291.

Sayle, AE et al. “Sexual Activity During Late Pregnancy and Risk of Preterm Delivery,” Obstetrics and Gynecology (2001) 97:283.



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