Body Image and Sexuality in the Postpartum Period

Giving birth to a child is a monumental experience, and it affects women in various ways and on many levels, physically, emotionally, and of course, sexually. Many women experience a change in the way they view their bodies after having a child. Even women who are normally satisfied and accepting of their bodies, report feelings of disassociation from a body they feel no longer belongs to them.

Women are used to bodily changes. however,  they generally occur over time, as in puberty and pregnancy, or cyclically, as in premenstrual and menstrual symptoms. By contrast, just moments after experiencing the miracle of giving birth,  a new mother may suddenly feels possessed of a body that feels strange and different from her own.  The abdominal muscles barely function, making even getting up out of bed difficult, and she may experience episodes of urinary leakage, particularly upon coughing and changing positions. Her breasts have turned from what was once regarded as private and sexual, to having a more functional and less private, albeit important role in feeding the new baby.

Women react to these changes in different ways. Some women don't get anxious, accept the changes as a natural part of the eperience, and hope eventually everything will go back to normal on its own, and often, that is what occurs. Others obsess about their bodies, determined to return to a pre-pregnancy state within weeks and begin exercising from the hospital bed. However a new mother’s  reaction, both emotional and physical recovery from childbirth can be facilitated by accepting and loving her  new body, realizing that it needs nurturing as much as her new baby, and taking the time to learn about and understand the changes that have taken place.

This is true regarding sex after childbirth as well.  While some couples ease comfortably back into resuming sexual relations after giving birth, many women, for a variety of reasons, find that they have little or no interest in sex, are too tired to even contemplate sex, or when they do try to have intercourse, feel dryness and pain in the vaginal area.  It is important to know that many women report decreased sexual desire in the postpartum period and if a woman views relations with her partner as an additional demand on her body and time , she may  find it stressful and overwhelming. Furthermore, the birth process itself may have left scar tissue and tears, which, together with dryness resulting from nursing, can make intercourse painful. Often an episiotomy scar or an injured nerve in the pelvis, can cause intercourse to be painful. Due to hormonal changes, which can persist throughout the nursing period, lubrication may be  a problem. While some  women who visit their doctors after childbirth complaining of pain with intercourse may be told there is nothing wrong with them , some doctors may prescribe vaginal estrogen cream or even a referral to a physical therapist if scar tissue from the birth scar is a problem. Many women find that using a lubricant during this period may facilitate painless and pleasurable sexual intercourse.

It is important that a woman feel she may resume intercourse when she is ready and not feel pressured as soon as she gets the medical OK. . If a woman is feeling that having relations is just another demand on her body, it is crucial she communicate her feelings to her partner, who may be feeling rejected without realizing that she is feeling overwhelmed. Often women crave physical and sensual touch from their partner during this period, but not necessarily intercourse, and this, too is important to communicate.

Advice for new moms: 

As an exercise, stand in front of the mirror unclothed and take a good look at your postpartum body. Run your hands over your arms, breasts, abdomen, and tell yourself what you like about your new body.  Allow yourself sensual and relaxing experiences such as taking a warm bath, getting a massage, or spending an hour sitting in the sun with a magazine.

As soon as you are feeling strong enough, begin to exercise your pelvic floor and abdominal muscles.  Take walks with the baby to encourage your body to resume its pre-pregnancy fitness level, or try a postpartum aerobics video at home.. Exercise increases endorphin production, your body’s natural morphine to help ward off postpartum depression ,improve energy and boost libido.

Most importantly, decrease the demands you make on yourself as a new mother, wife, and any other roles you may have. Don’t be afraid to communicate your feelings with your loved ones and ask for and accept help to manage during this blessed but stressful period.