Lifestyle, Motherhood

Sexuality After Childbirth

After giving birth to your first child, the first thing you’re worried about is most probably how to keep this little human healthy and get them though the next day. Sex is probably the last thing on your mind, but as you or your partner start to get your libido back, one or both of you are unlikely to find yourself feeling the way you did before.

When you decide to have sex again is completely dependent on how ready you feel, but it is not advised to have sex within 6 weeks of giving birth. Due to postpartum discharge, episiotomy or vaginal tears, that period poses a high risk of uterine infection, postpartum haemorrhaging and pain. 

Sex after childbirth might take a little bit more work and thought than before as the change in hormone levels in addition to the physical and emotional strain of delivery can take its toll, but you should not be discouraged. Your partner is also likely to experience some libido changes of their own in connection with being attracted to the physical changes in your body, being happy for the birth of the baby or possibly, being worried about physically hurting you or having sex with a new-born baby around.

When you’re both feeling ready, begin by talking to your partner about what you are feeling and what you are willing to attempt. Build the intimacy beforehand by making the time, finding the space and ensuring privacy away from the baby. Ease yourself into it by urinating beforehand to relieve bladder pressure, running a warm bath or taking pain medication if necessary.

If you had a natural birth, you are more likely than not to experience vaginal laxity which can be influenced by factors such as genetics, the size of the baby and the number of previous births. If you can remember to do your Kegels three times a day, 10 times in a row with sufficient timing in between then power to you! However, there are now modern, hassle free methods to substitute this with, such as the BTL Emsella chair which simulates over 11 000 pelvic floor muscle contractions by sitting on it fully clothed for 28 minutes.

An alternative to this is vaginal laser rejuvenation which is offered through for example Femilift and BTL Ultrafemme 360. Both the Femilift and Ultrafemme 360 are CO2 laser technology that gently heat vaginal tissue to contract existing fibres and stimulate the formation of new collagen. This improves the blood flow to the whole vaginal area and builds strength while reducing muscle relaxation. The procedure is done using a single probe which is inserted and rotated gently inside the vagina to encourage cell regrowth.  

Vaginal laser and radiofrequency rejuvenation has an added benefit of helping relieve atrophic vaginitis (dryness) which could be caused by the considerable drop in oestrogen and progesterone levels that mean that the vagina is not able to maintain the same level of natural lubrication. This could serve as an alternative to applying water-based lubricants.

Beyond that, attempt different sex positions to maintain control of the depth of any penetration, keep talking to your partner, and if it becomes too much, stop.

Some interesting side effects for breastfeeding moms could be feeling sensual while breastfeeding which is as a result of oxytocin which helps milk let-down and sexual arousal. Some might even experience a milk leak in response to an orgasm. If the idea of this makes you uncomfortable, feeding or pumping before sex can reduce the chances of it happening.

Breastfeeding can be an effective contraceptive method only when the following four conditions are present– baby is less than 6 months old, baby receives no other food/fluid but breast milk, baby feeds at least once at night and menstrual periods have not resumed. If you are considering contraception, speak to your gynae as some types of contraceptives are not suitable for breastfeeding mothers.

The most important thing to remember is that this is your body. You are no doubt beyond grateful for everything your body has done to deliver you your baby, who you would sacrifice anything for, but it doesn’t mean you have to. When you start to feel like getting your own body confidence back it’s more than possible.  

About Dr Natalia Novikova

Dr Natalia Novikova is a gynaecologist with an interest in aesthetic gynaecology and urogynaecology practicing in a well-established Hospital, Mediclinic in Gardens, Cape Town, and Intercare Day Hospital Sandton in Johannesburg.

Dr Novikova is an advanced minimally invasive gynaecological surgeon with a special interest in urogynaecology, allowing her to bring a full package of skills to women seeking assistance with female genital reconstructive surgery and non-invasive procedures, improving genital appearance as well as treating incontinence, vaginal dryness, laxity and other problems.

She is passionate about provision of high-quality care to women with gynaecological issues and empowering women to make the best health choices for themselves.

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