In May, I was delighted to speak about the role of the pelvic floor  at the & Breathe Postnatal Postnatal Sex! Workshop held in aid of SafeHands for Mothers.

 I was glad to speak with several mums individually through the afternoon, but later felt saddened to realise how many mums were still suffering with their bodies; not feeling reconnected to their abdominals and pelvic floor; feeling their sex lives were disappointing and, most worrying of all, not sure where to turn to for help and advice.

After last year’s &Breathe workshop Getting your Mojo back! I wrote this blog post for their site and now have adapted it for readers here at SupportedMums.

Let’s talk about sex

Through my work as a physiotherapist who specialises in coaching women, and men, on how to find and work their pelvic floor I have had lots of conversations about our bodies and how they cope with sex after a baby. Sadly, nobody seems to be expecting postnatal sex to be any good.  Popular press seems to be limiting our expectations. Why shouldn’t postnatal sex be as good as pre-baby??  I know many women who have found that childbirth improves their experience.  Once the vaginal canal has been stretched it is more comfortable and accommodating, and they often enjoy having a more filled out body, feel sexier, and also enjoy seeing their partner in a new role as parent.

WHAT IS ‘GOOD’ SEX?

I hasten to remind you that I am a physiotherapist, not a sex therapist, so I am not even going to go down the road of what constitutes ‘hot’ sex – that’s different for everyone and another topic entirely.  My expertise is the exploration of your body and what might classify as good sex. First you should definitely be able to actually have sex.  It sounds simple, but it’s not always the case.

• All your parts and your partners’ should be able to fit together successfully without feeling there is a block.
• Then it should be without pain.
• And most importantly with pleasure for you.

Personally, I think of it as the type of sex that keeps your relationship with your partner connected, bonded and fun. It keeps you feeling like a woman and lover, not just a mother. It keeps you feeling valued and loved and allows you to value and love in return.

WHEN THINGS ARE REALLY NOT RIGHT

If you are not having sex because there is a deep problem with yours or your partners’ libido (totally not ever in the mood), or physically something is stopping you even trying (this could be a physical block, some bad healing, an infection, discharge, scarring) then you need to get to the root of why this is mentally and how to heal physically and mentally.  If you are ready to have sex and you feel you just CAN’T then now is the time to take action.  Book an appointment to see your GP for a proper examination, and don’t be afraid to discuss the issues so you can start to get the bottom of the situation.

WHEN IT IS JUST A BIT FLAT

However, even if you are having sex, sometimes it’s not quite the same as before.  Perhaps you’re feeling  is that there’s no real medical reason why it shouldn’t be ok, but its just not really ‘doing’ it for you.  Then, I have three things for you to look into.  These three things could help you shift from things being a bit boring or uncomfortable, or not very satisfying, back to a place of ‘ok I can get more sexy and heat up a bit from here by myself’.  And that’s a good starting point.  Over the next series of posts, # GET YOUR MOJO BACK  we’ll be covering:

• Are you flexible enough?
• Do you have enough lubrication?
• Do your pelvic floor muscles squeeze in the right way?
• How to exercise your pelvic floor the right way.

1.  ARE YOU FLEXIBLE ENOUGH?

As I also treat antenatal and postnatal pelvic girdle pain as part of my work I am convinced that you have got to have really good movement at the base of your spine, where it meets your pelvis, and in your hips in order to really get comfortable for sex. The Karma Sutra looking like advanced yoga may be no co-incidence! The problem is that you can go stiff in your back and hip joints very quietly, experiencing no pain at all, no apparent loss of ability to walk, sit, or carry things or babies. With our bodies it is easy to not notice what you are missing. In everyday life, clues that your back/hips might be stiff are:

• You wake in the morning feeling like a granny and have to physically ‘get going’ for a few minutes or half an hour before you feel like yourself;
• After you have been sitting for a while your first few steps are painful or difficult you seem to be living with back ache;
• When you try to pick up your pace to run or walk fast or do your sport you get backache or a proper pain or your legs feel really heavy, like you are walking through thick treacle;
• on reflection you can’t really stand up properly straight anymore!

With sex itself stiffness might present as:

• a sense that you can’t let go and fully relax;
• you can’t take your partners weight onto you;
• you can’t get comfortable; or
• your can’t get close enough.

This last manifests as not getting enough external stimulation on the clitoris, which makes reaching an orgasm dependent on penetration alone – which can be pretty tricky for most of us! If you think stiffness might be a problem for you:

• spend a week or two focusing on stretches for your lower back, inner thighs and hips;
• if you had pelvic girdle pain during pregnancy and it is still niggling, go back to your physiotherapy team ask for a postnatal review and assessment of your spine;
• if you think that your delivery might have triggered a back or hip problem ask your GP to refer you for a physiotherapy assessment;

If it was a ‘traumatic birth’ (was your baby’s head very big, did you have to get into some awkward positions, did you have to have your legs put into stirrups, did you struggle to walk properly for a few days?) you’re quite likely to need to see a physiotherapist in case, even if no-one’s told you that’s on offer.  And if you had a Caesarian, there can still be quiet trauma that’s impacting your movement and mojo, caused by being unable to feel your lower half properly or then sleeping on a hospital bed for a night or two.

2. DO YOU HAVE ENOUGH LUBRICATION?

Painful sex can be caused by a lack of vaginal lubrication. All the hormone changes of pregnancy, delivery and breastfeeding can change our natural production of essential body fluids in the vagina area. Couple this with lower libido and rushed foreplay and then sex feels sore as body parts struggle to slide and glide past each other. Forget KY Jelly. There are now some beautifully packaged, organic, pH balanced personal lubricants which can enhance your love life and help keep you moisturised and comfortable. YES is the first organic (yes, organic!) lubricant on the market and it’s certified by the Soil Association, no less.  

3. DOING THE RIGHT SQUEEZE…

Do your pelvic floor muscles just ‘squeeze’ or actually create some grip and tone? Women don’t have that many nerve endings inside the vagina. Inside, we feel ‘pressure’ and ‘deep touch’ more than light sensations. The sexual pleasure we feel comes from the rubbing and build up of friction of the penis against the vaginal walls. The vaginal walls at the base and the sides are layered with the pelvic floor muscles. Clues that lack of pelvic floor tone might be a problem for you are:

• It just feels a bit dull and boring inside during sex
• You want to try to grip but nothing happens
• You feel there is too much room inside (you might also notice this with using tampons)

If you think this might be a problem for you:

• make pelvic floor muscle training a focus for few weeks trying to make some impact on your muscle tone;
• concentrate on getting a good technique
• and perhaps MOST importantly!  Then you have to do ENOUGH exercises to make the muscle change and grow.