It didn't take long, when I first started working as a sex therapist, to realise that a common trigger for a couple to develop sexual problems was the birth of a child. This was the 1970s, and there was limited research on sexuality, but there were a few theories which claimed to explain why so many women lost their sex drive once children came along.
One theory that was popular in those conservative times declared that, once a woman becomes a mother, she felt it inappropriate to be a sexual being. Another was that birth was such a physically satisfying event, better than orgasm, that she didn't have any need for sex. It has also been speculated that postnatal loss of desire is a natural form of contraception, allowing the mother time to devote her energies to the new baby before another is conceived.
The lack of objective evidence led me to investigate loss of sexual desire and enjoyment after childbirth for my PhD thesis. Three years of intensive work came up with a rather startling conclusion: the factor which accounted for most cases of loss of libido was fatigue. So mothers lost their sex drive because they were exhausted! Who would have thought?
50 percent of women reported a loss of drive (from mild to severe) in the 12 months (which was as far as my study went) after childbirth, but only 25 percent reported any loss of enjoyment. This is in line with more recent research that shows that many women either never had, or lose, the conscious physical desire for sex, but if the right things happen for them and sex seems like a reasonable idea, they can still find sex pleasureable.
Other factors which may play a part in postnatal loss of libido are altered body image, postnatal depression, breastfeeding, vaginal pain and hormonal changes. Interestingly, though, hormones probably play a minor role, as depression and loss of libido are reported by some adoptive mothers, and also by some new fathers.
A more recent study, reported in the Journal of Sexual Medicine in October this year, found that more than 90 percent of new parents were worried about changes to their sex lives since the baby's arrival.
If so many women lose libido after they have a baby, how do couples maintain their relationship?
My earlier blogs on sexual desire and mismatched libidos might be a helpful start. There is also the usual advice of making time for intimacy and sex (but be realistic, this might still be far less than before) and choosing the right time (probably not last thing at night). And consider the following:
1) Don't misinterpret what the changes mean. Fatigue has a dampening impact on libido, especially for women who find arousal and orgasm much more difficult when they are tired, stressed or preoccupied.
Men, however, often find sex helps them cope with stress. The new differences in sexual interest reflect different ways of reacting to the demands of parenthood, not that you don't care about each other.
2) Recognise that you are both dealing with the changed sexual relationship. Often the new father feels that his partner doesn't care about or understand how he feels. However, when I talk to the new mother, she is also missing the old sex life, particularly if she used to have good desire and easy orgasm, and she often feels both regret and guilt.
So, start a conversation, not an argument, about what is not happening. Gently, with a sigh, and your arm around her: "I really miss sex", and you may find you are commiserating together -– this may not lead to sex, mind you, but will help you see this is a shared problem rather than something only only one of you is suffering through.
3) A major barrier for a tired mother is what she thinks her partner expects from her if she says yes: does he expect hot sex, or will he understand that quiet, gentle, non-passionate sex is the best she can do? This requires easy, clear communication, as discussed in earlier blogs.
4) Sometimes the woman misreads her partner's persistent attempts at initiating sex to mean he cares more about sex than he does about her, but many partners tell me it is more that they feel lonely now that they get so little time alone. She may also be avoiding affectionate touch because she thinks this will lead to sex, isolating her partner further. Can she make approaches for affection, and with humour let him know that is all she can offer at the moment?
5) Can you both be comfortable with alternatives to your usual sexual activity? Depending on her energy level, these include private solo sex, partner-assisted masturbation, use of toys, oral sex...
6) If painful intercourse is a problem, it may be due to lack of arousal, so plenty of relaxing sensual foreplay and using a lubricant may help. New mothers can check out their vagina before the first attempt at intercourse by gently inserting a finger with lots of lubrication and exploring whether there are any tender places. If all is good, you can be more relaxed when you resume intercourse. If you locate an area that is painful, check it out with your medical practitioner first; this can avoid associating sex with pain and having long term effects.
7) If you have started arguing about sex, but you still value your relationship, consider getting professional help to find your way back to each other.
So, yes, there is sex after children. It may not be the same, at least for a (long) while, but looking after each other when you are going through tough times (including prolonged periods without sex) can ultimately take your relationship to stronger and more intimate levels.