Let's Talk about Sex After Baby

 

Krystle and I want to talk about the stuff that does NOT get talked about enough. The subjects that women might be too embarrassed to bring up to each other or their friends honestly don't have the knowledge to point them in the right direction. Leaving everyone to think peeing themselves or having painful sex is just a part of the mama gig. 

Today, I'm sharing more about sex after baby. This blog post made its original debut on my personal blog BalancedAmes after we started having sex again post baby #2. 

Sex After Baby

Because this is our second rodeo, I thought it would be a good time to open up a little bit more about what has worked for us as we return to our sex life post baby:

  1. Feel Ready.It is important for BOTH parties to feel ready to return to sexual activity. I was 9 weeks postpartum this time around when we got back in the saddle. I felt completely healed and excited about it. Drew was patiently waiting.
  2. Communication.I told Drew I did not want him to take off my bra. For those of you that do not know, milk can spurt out of your boobs during intimacy. My mega right boob is always locked and loaded plus it is just huge and it does not make me feel sexy. He disagrees that these things are an issue, but respects how I feel. Just like last time, Drew checks in with me to make sure everything is feeling okay for me.
  3. Take it Slow.Now isn't the time to try some crazy new position. I would suggest doing it in a position that is comfortable for both of you and taking things slow.
  4. Nap Time Nookie.Sometimes by the end of the day one or both parties is exhausted. That can make the idea of intimacy seem like a tall task. Thank goodness both the boys cooperated on Saturday for us. Drew put Max down as I put Trey down and we met in our room.

Both of us thought it went really well! And it was very pleasurable for me, even after two babies.

 Image by  Jenna LeRoy Photo . 

Image by Jenna LeRoy Photo

You might be thinking, wait why is she sharing this? Because I KNOW this is not everyone's experience. Maybe your experience did not go so well or you KNOW you aren't ready downstairs but it has been a long time since delivery. I feel SO blessed to have a sister, close friend and blog reader/contributor that are all women's health physical therapists. This means I have information right at my fingertips (literally could text them if I had a personal question). I wanted to do this post so that every women would have the information she needs.

Let's talk about women's health.

It is ALL About Preparation

I'm singing the praises of Expecting and Empowered. My sister Krystle and I's comprehensive pregnancy fitness guide that includes training for the pelvic floor. Krystle (a women's health physical therapist) wrote exercises for EVERY week of pregnancy. SO many of the women in our private E and E community are SINGING the praises of this section too. Mamas that have had multiple kids are saying they are no longer peeing themselves because they are TRAINING their pelvic floor. Doing the E and E exercises prepares a woman's pelvic floor to PUSH the baby out and helps her to avoid common postpartum issues (like peeing yourself after babies, organ prolapse and painful postpartum sex).

Directly from the introduction of Expecting and Empowered:

"The other main role of your pelvic floor is sexual function. Often not discussed is that 36% of women have trouble returning to their normal sex life after delivery. Sexual health is a big part of our overall health and lives, and is something that CAN and SHOULD be enjoyed after babes. Taking care of your pelvic floor while carrying your baby will aid YOU in this."

Me having a plan to train my pelvic floor this pregnancy made all the difference. My OB was highly impressed that my pelvic floor held up so well (having children very close together is typically very hard on the female anatomy) and that I recovered so quickly after baby #2. I did not have issues after Maxwell, but I had felt my pelvic floor had more trauma and needed longer to recover. BOTH times I had the same small 1-2 degree tear.

We would HIGHLY recommend doing a pelvic floor program during pregnancy and postpartum. The good news is: we've made these for you. The pelvic floor section of the pregnancy and postpartum guide are JUST as important as the strength section and LUNGES. Although these are small muscles not visible to the outside world, you will THANK yourself for training them and prioritizing your female health. 

Expecting and Empowered Pregnancy Guide

Expecting and Empowered Postpartum Guide 

Pelvic Floor.jpg

 

The next few questions and answers I pulled from an old blog post. I wanted everyone to have a little more information on what is normal verse when you might need to get some help. I'll introduce my friend Lauren at the end of the post.

Amy: Explain for us pelvic floor dysfunction in regard to the postpartum period. What increases a women’s chances of experiencing these problems?

Lauren:This is directly from one of my patient handouts: Pelvic Floor Dysfunction (PFD) is an umbrella term used to encompass several different bowel, bladder, and sexual disorders, and chronic pelvic pain syndromes, that affect or are caused by the pelvic floor muscles inability to contract, relax, and/or bulge effectively. These conditions may or may not have pain associated with them.

Typically, we find that most women have some sort of dysfunction, especially after being awesome and carrying a baby for 9 months! Everything is so thrown off mechanically, and it takes time to heal to resume prior activities. Women who tend to be at risk for PFD had theses issues with previous pregnancies, had any of the above issues in the pre-partum period, or return to prior activities too quickly and don’t allow enough time for healing.

Amy: Is urinary incontinence ever normal after birth? What about pain during sex?

Lauren:There will be a period of time (usually within the first 6-12 weeks) where you may experience incontinence and discomfort while you are healing. I never want to suggest that it is “normal,” but “expected” might be a better word. If these symptoms linger, then it’s time to see your therapist. Many patients report that sex is different after baby and it will take time to regain strength and muscle function to find sex pleasurable.Persistent pain during arousal, penetration, or that lingers after sex is not normal and is a sign of dysfunction.

Amy: But, what are signs and symptoms that it is time to see a women’s health physical therapist after birth?

Lauren:It is common to give yourself 6 weeks of pelvic rest following delivery. It is never normal to leak or have pelvic floor pain that is lingering in the post-partum phase. I often hear patients say they leak urine when they return to running, crossfit, or high-impact activities and are told that this is “normal” or “that’s the way it’s going to be and just deal with it.” THIS IS NOT TRUE. Leaking is a symptom of pelvic floor dysfunction. If you leak, stop the offending activity and see a therapist. Pelvic/perineal pain is also not normal and can be a sign of hypertonicity (spasm) of the pelvic floor, which can be addressed with PT. I have treated many women who have leaking, pain with intercourse or prolapse (falling out feeling) after delivery, which are common complaints.

So what the heck can I expect if I go to a women's health physical therapist?

Lauren: In the postpartum phase (usually after 6 weeks of pelvic rest), a pelvic health therapist will assess the patient’s pelvic floor muscle strength, coordination, and if there are any areas of pain related to pelvic floor dysfunction. The therapist will also check diaphragmatic breathing mechanics, if the patient developed a diastasis recti, scarring from perineal tear or c-section scar, or any other pelvic dysfunction related to pain or incontinence.

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Yes, this means the women's health physical therapist will be assessing INSIDE of you. I've gone to one and sent my friends and everyone has had SUCH a helpful experience.

If after reading this, if you feel like you need to be seen by a women's health physical therapist you can ask your OB for a referral. Mine was HAPPY to write me one. I saw a women's health PT before and after Max to make sure I was knew how to use my muscles for delivery and to stretch my perineum, make sure my incision was healing after birth and that my pelvic floor was ready to resume activity (running and sex).

Next, you can search for someone that specializes in women’s health by using this link: http://www.womenshealthapta.org/ pt-locator/. There is a tab that allows you to locate someone that specializes in pregnancy/postpartum, urinary incontinence, or pelvic pain. Call and ask them questions and ask if they have worked with your condition! This is the best way to make sure they'll be helpful for your condition.

Hope this was a helpful blog post for y'all.

EDIT: After this blog post I received A LOT of feedback that I missed a major problem women are having after babies. Read Let's Talk Sex (After) Baby: A Follow Up Post to learn more.

-Amy Kiefer 

About Lauren: I work at a hospital-based outpatient physical therapy clinic called Honor Health in Scottsdale, Arizona. I have been a physical therapist for 6 years and specialize in women and men’s pelvic health. Arizona is a very active state, so outside of work I enjoy running, hiking, hot yoga and spending time with my husband and two dogs. We love to travel and explore new cities and visit friends around the country.