Sex After Birth

pelvic floor

Sex after birth is a “touchy” subject – pun intended. Pregnancy and birth are the biggest transformations a female body goes through, and they also come with life-changing emotional and psychological changes. Also, if you are in a partnership, it’s not just the two of you anymore, and the subject needs to be handled with care.

I had a wonderful and inspiring chat with Estrella Jaramillo, CoFounder of B-Wom an app that guides you through the journey of taking care of your body and feminine health.

Expecting is full of joy but implies also a lot of planning; one of the first things everyone asks you is how you would like to give birth.

What would you put in the to do list Estrella?

“There are exercises and techniques that you can practice to prepare for a vaginal birth. Seeing a physical therapist (PT) and learning to do lengthening and relaxation exercises will definitely benefit you. In fact, gaining that level of proprioception that will allow you to understand your pelvic floor and your core and how the different parts feel will help you throughout your postpartum recovery, too.
Also, a PT might recommend for you to perform the perineal massage in the last weeks of the pregnancy. Adding light pressure to the perineum area in a strategic way and massaging it will help generate elasticity, while simultaneously training your brain to the sensations you will experiment during birth. It is also important to understand that the pelvic floor doesn’t work in isolation. It works as one part of a larger system when we breathe, and is also involved in full body movement.”

Sadly, rare are the real and honest conversations women go through about giving birth and how this stresses their bodies. There is no need to scary anyone, of course, but being aware of what changes you’ll really experience might help you getting ready for them, right?

“At B-wom we believe that all forms of birth should be respected. However, we need to debunk some myths, and stop telling women that their bodies will be “forever ruined” if they give birth vaginally. With better care protocols for mothers and postpartum women, birth-related injuries can greatly improve and/or be avoided.
Every birth is different, and the implications differ within the same types of birth, too. Analyse all of your options and create a birth plan. It’s important to have honest conversations with your birth team early on, to make sure that you have the information you need to make decisions for yourself, and most importantly, to make sure that your birth team supports and agrees with those choices.

One thing to keep in mind is to take your own healing as seriously as you take your baby’s breeding. You need to stay healthy, mama! When talking about birth, we keep hearing “All that matter is that the baby is healthy” – but making sure that the mother is healthy is indeed fundamental for the baby.
Maternal mortality rates in the US are the worst in a developed country, even more so when it comes to women of color. There’s something to be looked into here.”

Sure there is, and I believe opening up the conversation will definitely help rising awareness within women all over the word. After all, we know knowledge is power.

What are the signals we have to listen to to avoid serious consequences?

“Research shows that over 75% of women report pain when they resume intercourse after birth. About a quarter still report some discomfort during intercourse even 18 months post delivery. If the pain is preventing you from having intercourse at all, you need to talk to a specialist. These symptoms can be mitigated with physical therapy. If there’s something that feels wrong, advocate for yourself. See a specialist, get an evaluation. Having a child does not mean your sex life has to end.

If possible, find a physical therapist after you have your baby and have them create a plan to restore your pelvic floor and core area that includes exercises for you. Definitely keep track of your symptoms (our app B-womallows you to do that).

Once you are ready to start exploring sex again, come in with no expectations: it won’t be the exact same, it will take time to adjust to the changes your body went through. If sex continues to be significantly painful after a while, there’s definitely something there, and there are solutions to these problems.”

What if a woman choose or has to go for a C-section. What are the key implications of this procedure on muscles and pelvic floor?

“Recovering from a C-section comes with its own challenges, obviously, as this is a major surgical procedure. One thing that at B-wom we like to point out is that there is a misconception in regards to C-sections and pelvic floor health. Many assume that if they had a C-section they don’t need any pelvic floor restoration because there was no damage. In reality, the women still carried the added weight for 10 months (particularly the last 3), and in the case of emergency C-sections, chances are there was some pushing and pressuring of the baby trying to exit the birth canal. Therefore, even though your pelvic floor, vagina and perineum didn’t go through the full process, there is still a chance the above mentioned factors have caused some debilitation to your pelvic muscle structure – and obviously, your core and abdominal wall.

Painful sex also happen to women that has a C-section. Also, our partner Physical Therapist Solange Ross explains, ‘the abdominals and the pelvic floor share the same connective tissue (fascia). Restrictions in the scar and underlying tissues [caused by the C-section] can create restrictions and pain in the pelvic floor muscles”. Most of our partner PTs recommend hipopressive abdominal exercises to regain tone in the core without adding pressure to the pelvic floor.”

There are any situations where training our pelvic floor might not be good?

“Like with any other exercise practice, this is not about good and bad exercises: it’s about which exercises are adequate for each person at different times and how to execute them. The pelvic floor muscles also need to move to a range of motion, like any other muscle group. As Solange explains it, “this means a balance in being able to contact (Kegel) and relax and elongate (which is what we do every day when we go to the bathroom). Often times when there is pain after birth and the muscles are healing they need to relax and elongate first to release pain in order to move through a full range of motion”. This range is fundamental when resuming sex and experiencing pleasure.

This part of the body is still considered a taboo, that’s why at B-wom we aim to provide women with guidance, so they understand their bodies and symptoms, know what habits are beneficial for them, and when to see a specialist. Taking control of our intimate and sexual health and experience is very empowering!”

Everything that is “down under” is still a big taboo when it comes to female bodies, and speaking of taboos – or stereotypes – emotions play also a key role in our lives.

What to you suggest to handle the immense flow or different emotions we go through when expecting – and after?

“This is such a special transition in life. Birth is the most physically and psychologically intense and even stressful process. Hormonal processes are changing, and these directly impact your emotional state and psychological wellbeing. Patience, acceptance and self-love are key during the postpartum period. We see the pressure that women feel, whether from their circle or just due to societal standards and expectations. Pressure for our bodies to “bounce back” and look the way they did pre-pregnancy, pressure to be ok and go back to work, to be the perfect mom… All of this has an impact on a woman’s libido and ability to relate sexually to the partner – or to ourselves!

Communication is key. Be gentle, start with the basic, relate erotically without pressuring yourself to perform. Identify how you feel, communicate clearly with your partner about any pain or symptom you might be experiencing, or any body image or emotional issues you are feeling. This is an intense experience, and it’s necessary to be very open and compassionate about it.”

As I always say, communication is key, Estrella is totally right. It’s key in everything we experience, it’s part of everyday life, as sex is. Sometimes it’s the most complicate thing to do, especially when we have to talk honestly with ourselves.

Hope this lovely chat with Estrella helps you to experience the wonderful journey of expecting a baby with the most positive way possible!

(Editor in Chief & Co-Founder of pureeros)

“I wish I knew all I’m discovering now about sexuality when I was 20”. I found myself hearing this too many times. When it comes to female sexuality, discovering our bodies, experiencing pleasure, understanding what we like and don't and put ourselves first, so far, taboos has prevailed. Time to change.

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