Our Bodies, Ourselves (97 page)

Understanding the physical and emotional changes you are experiencing can help ease the transition, as can talking with other mothers and recognizing society's mixed messages about sex and motherhood. Sharing your concerns openly and honestly with your partner, asking for help, and maintaining a sense of humor can also help you feel comfortable with your sexuality.

Most health care providers suggest waiting four to six weeks, or until your perineum has healed and discharge has stopped, before engaging in vaginal or anal penetration. (This is true whether you gave birth vaginally or by cesarean section.) Before that, your cervix is still dilated (more open than usual), leaving you vulnerable to infection. Making love without penetration, snuggling, and solo sex (masturbation) are all okay.

Just because it's okay to have sex doesn't mean you're ready. Many of us don't want to have sex for quite a while after birth. Give yourself permission to take however much time you need.

Frustration about everyday issues can be a roadblock to good sex when there's a new baby in the house. Anger or resentment about housework, role confusion, differing parenting styles, frequency of sex, not having enough time alone, and many other factors can lead to a lack of closeness and a limited sex life. Talking with your partner about these may help. If contact with your baby fulfills your desire for physical intimacy, your partner may feel jealous or left out.

When I nursed at night, the sight of me holding my full breast to this sleepy little baby used to drive Les nuts. When I'd get back into bed, he'd be wild to make love, fast and hard. It got to be quite a thing because I'd come back to bed feeling mild and sleepy. Les wanted to [have sex] and I wanted to snuggle. We fought over it a lot
.

Talking about your differences and setting aside special time to reconnect emotionally with your partner can lead to rediscovering physical intimacy together. Using “I statements” (“I feel——when you——”) to share your concerns and listening without judgment or blame can open the door to a healthy discussion, as well as to the bedroom.

After months and months of snarling, we just had to invent “middle ways” of being physical with one another. I think I picked it up from watching each of us with the baby—the nuzzling and snuggling that goes on with no expectation of orgasm, just affection
.

Back rubs, snuggling, massages, hugging, and invigorating conversation are all ways to feel close to your partner without the pressures of sexual performance or enjoyment.

Many new mothers experience vaginal pain or a pulling sensation at the perineum, particularly if stitches were needed, when first resuming penetrative sex. Decreased estrogen levels may cause vaginal tissues to become thin and sensitive and lead to decreased lubrication, even when you are sexually aroused.

Taking things slowly and using lots of lubricant can help lead you back to pleasurable sex. If you want to have intercourse, experiment with different positions. Sometimes the pulling is less if you're on top. Starting with finger penetration first may help you adjust to the changes and reduce anxiety.

Scar tissue from sutures will soften and perineal discomfort will likely ease within two to six
months. Vaginal dryness is linked to changing hormone levels, especially when breastfeeding, and will likely ease with weaning. If either problem persists after you have stopped breastfeeding, and over-the-counter lubricants don't work, talk with your health care provider.

If you had a vaginal birth, your vagina may feel stretched and less sensitive than before.

If you had a cesarean birth, certain sexual positions may cause or increase abdominal pain. You may want to experiment with different positions or delay sex until you have healed more.

Your breasts may become either more or less sensitive while you are nursing. If you experience heightened sensation, you may find that you enjoy it or that you prefer that your breasts be left alone for anything but breastfeeding, due to tenderness, feeling “touched out” from nursing all day, or difficulty separating the breast function of nursing from sexuality.

If you are breastfeeding, your breasts may leak or spray during orgasm. Some women enjoy this experience, while others find it unsettling. If it's a problem, you can wear a bra with nursing pads while having sex.

Some women experience sexual arousal while nursing. This is a normal sensation and is related to the release of oxytocin, which is associated with both orgasm and the letdown that happens as breast milk comes in.

Nursing mothers have higher levels of prolactin and lower levels of estrogen, which may result in less frequent or less intense desire. While many women find that breastfeeding reduces overall sexual drive, most women note that sexual drive returns when weaning or while continuing to nurse a toddler who does not nurse frequently. However, some women who nurse have a strong sex drive, and mothers who don't breastfeed may still have a lowered sex drive after becoming mothers.

There were times when I got into bed, gave my husband a peck on the cheek, and leaned back onto my pillow relishing the prospect of some sleep. Sex was the last thing on my mind, and usually I conked out in minutes. But he would sometimes gently stroke my body in a few choice spots, and before I knew it, I actually felt aroused and suddenly interested in making love. Where that energy came from, I still can't fathom
.

If you are having vaginal intercourse with a man, it's important to think about family planning before you are fertile again. Regular breastfeeding inhibits ovulation and will delay the return of your period. Most women who are breastfeeding will resume menstruation between three months and two years after giving birth. If you are not breastfeeding, your menstrual cycle usually resumes one to three months after giving birth. This means that you may ovulate (release an egg from the ovary) as soon as twenty-five days after delivery and could become pregnant again even before your period resumes.

When deciding on a birth control method, you face special considerations as a new mother. Some methods of birth control, such as hormonal methods that include estrogen, should not be used by nursing mothers; some methods, such as diaphrams and cervical shields, need to be refitted due to changes in the uterus, cervix, and vagina after childbirth; and some are less effective once a woman has given birth. For a full discussion of the efficacy, benefits, and potential harms of all birth control methods, see
Chapter 9
, “Birth Control,” especially “Breastfeeding
as Birth Control,”
and “Suitable Contraceptive Methods to Use
While Breastfeeding.”

In the first hours and days after giving birth, you will likely experience a range of feelings. It is not unusual to feel multiple, contradictory emotions, all at the same time.

She was placed on my chest, and I began to cry from the overwhelming sense of emotions I felt. I was feeling so many things simultaneously: relief, love, excitement, awe, astonishment, pride, and achievement. It was truly a momentous occasion, very surreal and very beautiful. When I looked deeply into my newborn daughter's eyes for the very first time, I kissed her softly and whispered: “Hi, Baby. Welcome to the world, we've been waiting for you.”

During the first few months after giving birth, we learn what it means to have a baby in our lives. Our babies eat and sleep at unpredictable times, and we find ourselves on call around the clock.

Thoughts and emotions in the early weeks and months of motherhood can be influenced by many factors, including our physical recovery from being pregnant and giving birth, our feelings about the birth, the health of our babies and how “easy” they are, how ready we feel to become a mother, our financial resources, the other demands we face, and the amount and kind of support we get from people around us.

Flight attendants on airplanes explain that in the event of an emergency, when oxygen is needed, passengers with children should first secure their own oxygen masks before fitting masks on their children. This is a lesson we can apply to the turbulence of our experience with motherhood: We cannot properly care for our children unless we properly care for ourselves.

As new mothers, we may focus on our babies to the exclusion of ourselves. We may feel ashamed to ask for help, not realize that help is needed, or not even realize that asking for help is acceptable or possible. Some mothers may believe that the involvement of a partner or support from family members means we aren't good enough. Our culture idealizes mothers who are eternally self-sacrificing. But help and support are crucial, and being attentive to your own needs can boost your ability to meet your child's needs. It is important not to think of the mother's needs and the baby's needs as mutually exclusive and instead to find creative ways to meet both people's needs without sacrificing the other.

Because I am single and have a disability, I could not and cannot get away with trying to be a supermom. I knew then and know even more clearly now that it does indeed take a village. I have relied heavily on my community of friends, some family, and a key group of child care providers. I am reminded how people enjoy being part of an emerging family, that isolation is the bane of parenthood, and that letting others help is a gift to everyone, especially the child. Asking for help has brought friends closer to me and my son in a more intimate way. I am grateful for that
.

Mothering is hard work, and new mothers need many different kinds of care: practical help, emotional support, financial support, nurturing, and guidance. Unfortunately, it can be hard to find the care and community we need. Our society provides little concrete help, whether in terms of paid maternity or paternity leave, subsidized child care, or other forms of support. In addition, aspects of our culture, such as families living far apart rather than in intergenerational households and neighbors often not knowing
one another, make it likely that we will be alone with our babies for long stretches of time. Independence and self-reliance are prized in the United States, even though it is unrealistic for new mothers.

Courtesy of the
Worcester Telegram & Gazette
/Jim Collins

Several mothers and babies celebrate the sixth birthday of the Worcester (Massachusetts) Healthy Start Initiative. The initiative receives federal funding to promote community-based programs for uninsured and low-income women and their babies.

When we feel helpless or lost or confused, talking about what we're feeling may seem like the wrong idea. But often telling someone—your partner, a family member, a close friend, or your midwife, physician, or therapist—how you feel can help ease the stress and isolation that so often characterize new motherhood.

[My partner] was working hard all the time and feeling stressed out about his new responsibilities as sole financial provider for the family. We argued a lot. There were times when I couldn't even believe I had a baby with him! . . . I remember saying “No one told me about all this!” to a friend, and she told me that she thought the same thing after she had her first baby. Then I realized that the more I talked to other mothers, the better I felt. I was not alone! One of my friends gave me Sheila Kitzinger's book
The Year After Childbirth.
I read it cover to cover…
.

I made a point to go over to the house of a friend who also had children a couple times a week. Getting out of the house and with other moms really helped. My partner and I started going to a really great therapist. Just taking the time to focus on our relationship felt so good. In a short time, we were communicating well again and our therapist told us that many new parents go through this. . . . If I could give one piece (or two!) of advice to a new mama, it would be to get together with other like-minded mamas often, and be patient with yourself. You are doing a great job!