Not tonight dear, I'm about to have a baby!
For most women, pregnancy can be a rollercoaster ride with all the changes happening to their hormones and bodies. One of the victims of this period can be a couple's sex life.
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The first trimester of a pregnancy, with its nausea, breast tenderness and exhaustion, is often a time of decreased sexual desire for the newly pregnant.

The excitement of the second trimester, when the baby begins making its presence felt and the nausea dissipates, may lead to a rekindling of sexual intimacy.

And then, there’s the endless third trimester. “I felt like a cow,” says 34-year-old mother of three Winnie Twala about the final few months of her last pregnancy. “My husband loved my bigger breasts but they felt like udders to me. I also had swollen ankles and hectic heartburn.”

It’s not unusual for pregnant women to feel large, uncomfortable and decidedly unsexy as they near term. And even for those who feel fabulous right up to the minute they give birth, sex isn’t automatically on the agenda.

Lorissa February, 37, had an “easy” pregnancy with her last child. She says, “I felt healthy and glowing and completely ready for the baby.” However, she just wasn’t interested in sex at all.

Read: The baby-making journey

Cristine Scolari, a Johannesburg based clinical psychologist, explains that expectant moms and those who’ve just given birth are going through a lot, both physically and emotionally.

“While a woman may be able to have sex on a physical level, it’s sometimes more difficult to feel sexy on an emotional level,” she says. “Factors such as feeling overwhelmed or exhausted, being anxious or depressed, or not being happy with her body, all affect whether she feels sexual or wants to have sex.”

Is it physically safe to have sex in the third trimester?

Yes – in a normal pregnancy with no complications. “Sex will not hurt your baby or you,” says Catriona Boffard, a Joburg sexologist. In fact, she adds: “Research shows that sex during pregnancy helps to prevent premature birth.”

There are a few conditions that would make it unsafe to have sex in the third trimester. These include placenta praevia, where the placenta lies low in the uterus, sometimes covering the cervix; if you have unexplained vaginal bleeding or an abnormal discharge; or if your waters have broken. And Catriona says that labour can’t be started by sex.

“Your body won’t go into labour until it’s ready,” she explains. “The contractions you naturally experience during pregnancy are similar to those of orgasm, but it’s just the body’s way of preparing itself.” When it comes to things to avoid, Catriona says: “Don’t insert foreign objects into the vagina, such as foods or gels.”

Which position?

The shape of a woman in the last stages of pregnancy will generally determine the sexual position you choose as you’ll want to keep his weight off your baby bump. “Spooning, with your back to his chest, will probably be the most comfortable,” says sexologist Catriona Boffard.

You can also try lying side by side facing each other; sitting, with her on top; or him entering her from behind. Post-birth, and particularly if you had a c-section, these positions are also suitable for when you begin having sex again.

Also read: Dad's fears around sex during pregnancy

How soon can the fun resume?

Several factors come into play when determining how long a woman should wait after giving birth before having sex.

In a straightforward natural birth situation, where there were no complications, four to six weeks should be enough time for your body to recover completely – for your cervix to close, for any minor lacerations to heal, and for your post delivery bleeding to stop.

If an episiotomy (a surgical cut in the area between the vagina and the anus, or the perineum) was part of the birth, you need to wait until it’s completely healed.

This should take no longer than six weeks, but if you’re unsure, ask your gynaecologist to examine you before you try having sex. And when you do have, take it very slowly, use a lubricant, and be on top so you can control the degree of penetration.

If you had a caesarean section, bear in mind that this is major surgery. Doctors recommend a minimum of six weeks, giving you time to heal.

I don't feel like it

It’s not unusual for a woman not to feel like having sex either in the third trimester or after the birth of her baby.

She is, after all, undergoing some huge physical changes; and, after the birth, she’ll be coping with profound physical demands too, including continuing hormonal upheaval, interrupted sleep and the energy required for breastfeeding. She may also simply need time to adjust to her post-birth body.

Emotionally too, there are new demands. “As you take on new roles as parents, your roles as lovers can sometimes fall by the wayside,” says Catriona.

How to: Keep intimacy alive during pregnancy

During these periods of change, you and your partner need to communicate openly and honestly about your desires and feelings. “If you don’t feel like sex at all for a prolonged period, chat to your doctor or a psychologist about it, as it may be a sign of postpartum depression,” Catriona advises.

There could also be physical reasons why you’re not settling back into sex after your baby’s birth. If you continue bleeding for longer than four weeks, if you have a discharge with an unpleasant smell, or if sex continues to be uncomfortable or painful in spite of all the care you’re taking, see your doctor.

“But generally any of sort sexual activity is ne,” Catriona says. “Just take it slowly and gently, and make sure you feel comfortable.”

Tips for post-birth sex

  • Take birth control. It’s possible to fall pregnant again immediately after the birth of your baby, regardless of whether you’ve had a period or are breastfeeding. Speak to your doctor about birth control that is breastfeeding safe.
  • Don’t rush. Do only what feels comfortable.
  • Use lubrication. A water soluble lubricant is the answer. Breastfeeding can result in low oestrogen levels, which can in turn result in vaginal dryness.
  • Eat healthily and exercise. Even a brisk daily walk around the block with your baby in a pram is enough to start with.
  • Communicate, communicate, communicate. This is a time of upheaval for both you and your partner – you need talk about your desires.

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