Sex in pregnancy and early parenthood is an area that often receives little time and attention in our thinking and conversations. After all there are so many other things happening at this exciting and busy time. It’s easy to glaze over any changes in intimacy in the short term, but why should we put sex back on our thinking agenda?
This article is for everyone. It is the second part in a series that’s hoped to help women, men and couples understand the changes that can happen over pregnancy and the transition to parenthood. In this article we hope to help shake off the taboo of sex in pregnancy and the transition to parenthood that can lead individuals and couples to suffer (worries, pain, relationship problems) in silence. The information provided is based on findings from research conducted by a range of professionals.
Online there is a range of information reassuring us that, unless advised otherwise by our medical practitioners, it is perfectly safe to have sex during pregnancy. For many this is comforting news that allows them to enjoy a healthy sexual relationship with their partner, but for others it may feel like added pressure. This may be particularly true for those experiencing some of the more difficult symptoms associated with pregnancy, including a reduced sex drive, uncomfortable/ painful physical symptoms or emotional difficulties/ concerns adapting to changes in their body.
Whether or not you have been affected by concerns relating to sex during pregnancy it is helpful to know, what is ‘typical’. On average, female sexual interest and activity has been found to decline slightly in the first trimester of pregnancy, show variable patterns in the second trimester, and decrease sharply in the third trimester. In fact most couples report that they do not practice intercourse for about 2 months around the delivery.
After delivery, self-reports in research studies have shown that sexual interest and activity tends to be reduced for several months when compared to a couple’s pre-pregnancy level of intercourse. As well as changes to a couple’s routine, sexual problems occur relatively often.
After delivery women report a range of sexual problems often including symptoms such as vaginal dryness, painful penetration, pain during sexual intercourse, pain on orgasm, vaginal tightness or looseness, bleeding or irritation after sex, and loss of sexual desire.
In one study 83% of women reported experiencing sexual problems in the first three months after delivery and 64% at six months post delivery. This is a surprisingly high number when looking at the rates of clinical reporting, which are much lower, suggesting that many women do not report or seek medical help for such problems. The rates are also surprising when considering reports of resumed sexual activity, with women typically reporting that they have recommenced sexual activity with their partners within six months of the birth.
Sexual problems appear to link with method of delivery, in a review of the literature there were mixed findings in relation to vaginal compered with cesarean delivery. With a number of studies finding no differences in sexual functioning between women who had a cesarean delivery and those who had delivered via spontaneous vaginal delivery. Post delivery sexual problems have more consistently been associated with assisted vaginal delivery.
Research indicates that one important aspect of delivery linked with future sexual problems is perineal trauma (damage to the area between the vagina and anus). Relative to women with an intact perineum, women with perineal trauma have been found to be significantly more likely to report post delivery pain during or after intercourse. This increase occurs whether the damage has occurred as a result of an episiotomy (a surgical cut in this area) or spontaneous perineal tearing.
Sex is a complex, important and sensitive issue. Sexual satisfaction has a very important relationship with marital satisfaction, which is key in building marital strength and strong family relationships. The taboos that still continue to surround sex, can mean that women and couples find it difficult to discuss intimacy openly between themselves and with medical professionals.
It is important for couples to be aware of sexual issues that can occur throughout pregnancy and during postnatal care. Knowing about sexual problems can prepare couples for possible changes in sexual frequency and satisfaction. Awareness also encourages open communication between partners and increases the likelihood of women seeking help in the even of sexual problems.
If you missed Part 1, read it now!
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About the Writer
Dr. Alexandra Legge is a Consultant Clinical Psychologist at The Centre for Psychology in Singapore with extensive experience of working with children, young people and their families with a range of emotional and psychological difficulties. She also has particular expertise in working with people who have developmental conditions, such as Autism, Aspergers and Learning Disabilities.