Will having sex harm my unborn child?
This is a very common concern for first-time parents, says Dr Abigail Lukhaimane, an obstetrician and gynaecologist at Life Fourways Hospital in Johannesburg. “Moms- and dads-to-be usually worry about the possibility of sex causing a miscarriage, as well as whether their baby can see the penis during intercourse. The fact is your baby is very well protected – not only by the amniotic sac (liquid), which acts as a shock absorber or buffer, but also by the cervix (the mouth of the womb), which is closed, so there’s really no need to be concerned. What’s far more important is your level of comfort during sexual intercourse. If you start feeling uncomfortable as the pregnancy progresses, you should change positions.” There are, however, high-risk pregnancies where intercourse is not advised, explains Dr Malikah van der Schyff, a specialist obstetrician and gynaecologist at the Constantiaberg Mediclinic in Cape Town. “Examples include threatened or recurrent miscarriage, a lowlying placenta or premature labour scares. Your doctor will let you know if there are any problems and will advise you accordingly.”
Where has my libido gone?
Early pregnancy symptoms such as nausea, vomiting, loss of appetite, breast tenderness and exhaustion are anything but a turn-on, says Dr Lukhaimane. “With your body undergoing such tremendous changes on the physical, emotional and psychological roller-coaster ride to parenthood, it’s hardly surprising that sex is often the last thing on your mind. Women often feel like human incubators and focus solely on their growing babies with little or no concern for themselves or their partner. It’s important to keep comminucating with your partner about your feelings and any issues that may be getting in the way of being physical, such as feeling less than desiderable because of your changing body shape or your weight gain. Talking things through and kissing and cuddling will help the two of you to stay connected.
Why is sex always on my mind?
Your libido during pregnancy can vary from one extreme to the other, says Dr van der Schyff, and the early symptoms from all those pregnancy hormones in the first trimester will certainly not make you feel in the mood. However, these do tend to disappear in the second trimester and, for some women, this stage of pregnancy is a time when they feel sexier than ever. This, in itself, can increase your libido, but your heightened desire may also be due to hormonal changes and an increase of blood flow to your body, making certain areas more swollen and sensitive, which means more intense orgasms.”
When can we get it on after the birth?
Your body will need time to heal regardless of whether you have a vaginal birth or a C-section, so you should wait until the vaginal bleeding has stopped and any tenderness has resolved as there’s a risk of infection, advises Dr van der Schyff. “Most women tend to hold off until about six weeks after delivery, once their doctor has given them the thumbs up at their postnatal checkups. Remember to take things slowly as you may be sensitive and dry if you’re breastfeeding, so always use a lubricant. Sex can also be painful or uncomfortable due to scar tissue from vaginal tears or having an episiotomy, while C-section stitches can also be tender and can take up to six weeks to heal.”
Will I ever get my mojo back?
Being a new mom is daunting and demanding, says Dr van der Schyff. “Your sex drive suffers due to lack of sleep, anxiety, fear and exhaustion, so finding a romantic moment between feeds and nappy changes can be quite a challenge! Although all these factors may contribute towards you no longer feeling sexually attractive, these are not insurmountable odds as this phase doesn’t last long. Your partner needs to step up in both a supportive and imaginative way, reminding you that he still finds you sexy; performing little tasks such as running a bubble bath, making you a cup of tea or having a conversation devoid of nappy changes and feeding times. Since your best sex organ is your mind, all of this will go a long way to allay any silent fears and reinforce that you were a couple first. If things don’t settle down within a month or two, it’s important to chat to your doctor.”
WHICH CONTRACEPTIVE SHOULD I USE?
Contraception should be discussed before delivery, together with your baby’s feeding options, advises Dr Lukhaimane. “There are two reasons for doing so in order to prevent any surprises along the way,” she explains. “Firstly, if you’ve decided that your family is now complete, you may opt for permanent sterilisation or long-acting reversible contraception (intrauterine contraceptive devices) to be performed at delivery via C-section. Secondly, if you’re planning on breastfeeding, the lactational amenorrhea method (LAM) may be a good initial choice, as long as all of the following criteria are met:
- Your menstrual cycle doesn’t commence within the first two months post delivery.
- Your baby is younger than six months.
- Your baby is exclusively breastfeeding on demand and does not get any other food, water or liquids.
Remember that LAM is only effective for six months, she cautions, and may be inconvenient or difficult for working mothers. It also offers no protection against sexually transmitted infections or HIV. “If you’re delivery without affecting breast milk production. If you keep up your breastfeeding routine, you shouldn’t find any issues with your established milk production, although some medical practitioners do advise increasing feeds, or additional expressing, to balance and maintain these levels. It’s important to chat to your doctor about the pros and cons of the different contraception methods available today. You should also discuss both your tolerance levels and any undesirable side effects such as migraines or loss of libido with previous contraceptive use, as there may be a better alternative that will prevent these issues.” Apart from the Pill and transdermal patches, she continues, modern contraception is definitely moving towards the long-acting reversible contraceptives (LARC’s), such as implants and intrauterine contraceptive devices, such as the Mirena. “These products are convenient if you’re sensitive to the effects of oestrogen and offer long-acting, extremely reliable and immediately reversible contraception. Make sure to ask how not able to meet the LAM long it may take for the criteria, the majority of contraceptives such as the progesterone-only pill, commonly known as the ‘mini pill’, can be safely started six weeks post contraception to be effective, and about any possible delays in a return to fertility when removed as you will need to consider this when planning another baby”.