Tricky stuff

Sex after childbirth

Sex after childbirth can be a difficult subject to discuss, but it’s a worry for many new mums and with a little planning and care should be something that brings you and your partner closer together.

Here Dr Rachel Mackey gives advice on how your body changes after childbirth and how to approach sex.

Childbirth will affect you and your partner’s sex life, but it will go back to normal after some time and practice.

Sex is normally the last thing on a woman’s mind in the weeks following childbirth. It’s not something that should be rushed into, considering the exhaustion and pain that can follow after having a baby.

Medical professionals generally recommend that women wait six weeks before starting to have sex again. But there is no set time that a woman should aim to start having sex again – it’s best to wait until you are physically and emotionally ready.

Let your body recover

It’s normal to not feel like having sex again in the first few weeks or months after having a baby. If you are feeling sore following an episiotomy or stitches, do give yourself time to recover. If you had a Caesarean, you will be recovering from a major operation. Allow your wounds to heal and stitches to dissolve before you have sex again.

If you still experience pain two months or so after the birth, talk to your GP or public health nurse. Sometimes, the way a tear or an episiotomy is stitched can cause long-term discomfort, which further surgery can put right.
The emotional after-effects of childbirth can also impact on a woman’s libido. It could also be a symptom of postnatal depression. If you feel depressed after having a baby, contact your GP or public health nurse.

Body conscious

Your body has spent nine months growing your baby. It can take more than two months for your uterus to return to its pre-pregnancy size. Don’t forget that your body has been through the major process of pregnancy and labour, and will need time to recover. It’s normal for extra fat to stick around, because nature intends this to be a store of energy for breastfeeding. Be proud of your body as it has done an amazing job of bringing your baby into the world.

sex after childbirth

Self-help tips

1. Taking care of yourself can go a long way in keeping the spark alive

2. Take your time. Set reasonable expectations as you adjust to motherhood. You don’t have to have rush into sex – try having a cuddle and just being intimate to help you get used to having sex again.

3. A lubricating jelly can help as hormone changes can make your vagina feel drier than normal.

4. Look after yourself. Eat well, drink lots of fluids and take rest whenever you can. Looking after a newborn is extremely demanding and you will need to keep your energy levels up.

5. Your body will be different now – appreciate the changes!
Do your kegels. After a vaginal delivery, your vaginal muscles may be temporarily stretched out. Continue to do your pelvic floor exercises to strengthen and tone up your vaginal muscles. Doing these exercises will help you to prevent or control urinary incontinence and also increase your enjoyment of sex. To do them, find the muscles you use to stop urinating. Squeeze these muscles for three seconds. Then relax for three seconds. Add one second each week until you are able to squeeze for 10 seconds each time. Repeat this exercise 10-15 times per sessions. Do not do kegels while you urinate.

sex after childbirth

“It is reasonable purely from a healing point of view to resume sex six weeks after a vaginal delivery, but for many women that is too soon and if they had a lot of stitches they might leave it longer.” – says Dr. Rachel Mackey. ” Women who have had a Caesarean section also can resume sex at this point but often it takes longer to recover.
It is completely normal to have a low sex drive after a baby. Partly, this is hormonal as oestrogen levels are low especially if you are breast feeding. It is also partly exhaustion and maybe a little anxiety resuming sex after delivery.

If a woman’s periods have returned for a few months and there are no obvious reasons for poor libido it would be a good idea to see your doctor to discuss it further.
One aspect of resuming sex after a baby is poor lubrication. This is more commonly seen in breastfeeding mums. A good oil based lubricant like Sylk (beware; oil based lubricants can’t be used with condoms) can really help. Sometimes vaginal oestrogen may be needed for a little while.

Symptoms that you shouldn’t ignore are persistent marked pain with sex and bleeding after sex. These are not normal and need further investigation.”

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Ask Sarah

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.


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Q My son is 18 months old and has just started saying his first words. It is an extremely exciting time in our house and my husband and I are eager to encourage his speaking as much possible. What advice would you give us on how we can foster this without bombarding and confusing him?

AThere is nothing better than hearing your baby begin to talk. All the hard work you have put in over the last two years is coming back tenfold.
Toddlers will vary significantly with ability and speed of which they talk however a guide would be about 50 words by 2 years of age. The most important thing to watch for is that your baby/toddler is cooing and babbling and begins to string sounds together like “Mama/Dada” They should have a wide range of speech sounds and like to imitate you and things they hear.
There are many ways that you can promote Speech and Language development at home:
1. Slowing down your own speech and taking time over conversations with your little one. Every day is a new experience when you are 18 months, nappy changes, bath time, baking a cake brings endless opportunity for you to interact and offer new words for them to hear and repeat. Make eye contact, smile and use exaggerated tones to keep things interesting and fun for your tot.
2. Review the toys that you have on offer to your tot and ensure that they give plenty of open ended play opportunities. Role play is a wonderful way to allow children to take the lead. Kitchens with lots of plates, cups and pots. Fill the pots with dry pasta and allow your child to cook and serve you. Playdoh, painting, gardening and sandpits are also great for allowing your child to take the lead and babble about what they are doing. Read plenty of books together and point and allow them time to answer any questions that you ask.
3. Limit screen time. Overuse of televisions and iPads do not give your child opportunity to interact in a two way manner.
4. Ask your child lots of open ended questions “What’s that?” “Where are we?” Point at things they know the answer to for boosting confidence (Car/ Car, etc.) When they don’t know the answer, explain it to them. Limit baby talk and speak clearly with good pronunciation, remember you are the teacher and they will copy you.
If you are concerned about your child’s speech and language development, be sure to speak with your GP or developmental Health Nurse. They are very skilled at understanding the difference between speech delays and spotting something that may require professional attention.
Enjoy watching their little brains absorb the world around them and listen to what they have to say. It won’t be too long before they won’t stop talking to you, asking “Why Mummy/ Daddy?” every 5 minutes….