#73 | The Six Week Postpartum Visit: No, We're Not Ready to Have Sex

Let's dig into the six week postpartum visit. So much happens after you have a baby in those first six weeks, it's quite hard to understand why new moms are not seen until then. Just as an FYI, mothers who give birth at home or the birth center are generally seen it two days, four days and two weeks after having their baby. The good news is in 2018, ACOG and ACNM. Both revise their guidelines to recommend that new mothers are seen on an ongoing basis, and within three weeks of giving birth, with a final visit of the 12 week postpartum mark. So that's good progress. But in reality, the standard six week visit still reigns. So what is the purpose behind this visit? For most of us, we associate this visit with the green light to go ahead and return to having sex. But the truth is the vast majority, actually over 80% of women are not physically, emotionally or mentally ready for this. Well, it's true that there are women who are ready well before six weeks most are far from it. The six week visit basically came into being because it corresponds with the approximate time that a woman's uterus should be fully healed, it means her bleeding will have ceased, and that any tearing or stitching that she had during birth will have healed and if so, you get the go ahead to return to normal levels of physical activity, which includes sex. But the truth is that most new mothers take many more weeks and even months to recover physically, let alone emotionally and mentally. Unfortunately, many mothers are still experiencing even vaginal pain six or 12 months past having a baby. Additionally, the sleepless nights the around the clock feeding and caring for your baby the exhaustion, the overwhelm the high levels of prolactin if you're breastfeeding and low levels of testosterone, even the elevated levels of stress hormones, which are necessary to keep you alert to all your baby sounds and needs contribute to a low if not non existent sex drive. Yet, we still get the take home message at the six week visit that all is good, all clear. Go have fun. If you look at the sex habits of postpartum couples 83% report that they have sexual problems in the first three months and 64% still report difficulty at six months. The problems don't just include low desire or interest, but pain, discomfort, bleeding, dryness, irritation, these are all things that if you're experiencing them, you're certainly not going to want to be having sex. For a new mom just having a shower or getting dressed and maybe eating breakfast or lunch is a major accomplishment for the day. So it's not surprising that feeling sexy and craving touch are pretty low on the priority list. If you think about it, it really makes sense that our biology and nature would discourage us from wanting to get pregnant again after we've just given birth. So we really should be easy on ourselves and try not to feel guilty or ashamed that we could care less if we ever have sex again, or at least not for quite a while. But rest assured that things will normalize what you are feeling is temporary, it's normal, and it will go away. There will come a day when you feel like putting on your best clothes and giving off those sexy mama vibes. But all too often we hear stories of new moms praying that their doctor tells them that they're not ready to return to sex, or even coming home from their six week visit to tell their partner a lie about getting clearance to return to sex. It is normal and natural to want to attend to your partner's needs, but it is equally normal and natural to feel completely touched out and want nothing to do with physical intimacy. If this is the case for you, an open honest conversation will help you and your partner to understand how to support each other and to give yourself the time you need. It's so important to not neglect your relationship. So despite not feeling sexy, or necessarily wanting physical intimacy, you still can foster emotional intimacy you can touch without needing to have sex. But of course, if you touch and you feel inspired to do so you can have sex you really can have sex anytime after your postpartum bleeding ceases. What's more important to discuss at the six week visit is how you're doing? How are you sleeping? How are you eating? Are you doing any form of exercise? Are you feeling any signs of postpartum depression or postpartum anxiety? Does your mood feel good? Do you want birth control? And rather than asking the question or giving the green light to have sex again, maybe it's better to say? How are you feeling about your relationship? Are you getting the help and support you need? Are you interested in sex? Ultimately, healthy, loving and connected parents are the best possible gift you could give your child. So taking steps from day one to preserve your connection to your partner is far more valuable than whatever timeframe you choose to return to having sex. So those are my thoughts on the six week postpartum visit. I hope that was helpful. And I hope it sheds a little light on how we can do better supporting postpartum mothers in the early weeks and months after having a baby. As always, thank you for tuning in. And thank you for being part of our community. And we'll be back on Wednesday with another episode.

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