The expectations and pressure to have sex after childbirth

Before giving birth to their first child, Julie* thought she'd be having sex with her husband after the advised six-week wait.

But due to surgery to repair some birth trauma, it was one year.

Every time the couple attempted penetrative sex, she experienced discomfort and anxiety.

"Every time we tried … I would have an attack of anxiety to the point where I would just be a mess."

Julie, 32, says while her husband never pressured her, she felt like she was failing as a woman.

"My body had just done this miraculous thing — why couldn't it get past this? A penis is so much smaller than my first-born's 35.5cm circumference head!"

Her experience is one that would resonate with many new mums.

And there are those who have the added pressure from partners to have sex when they either physically can't, or have little desire to do so, explains sex therapist Kassandra Mourikis.

"There is a lot of relationship pressure — pressure from the partner who is becoming frustrated and sometimes even resentful because they are no longer having sex and don't know when it will resume.

"And there is societal pressure for women to resume being sexual beings and meet their partner's needs, with very limited focus on women's pleasure and what they actually want."

Having realistic expectations is important for the health and happiness of everyone involved.

So what sexpectations can couples have after childbirth?

Being pressured to have sex is sexual violence

Before we dive in, an important note about sexual coercion.

Sexual coercion is when someone pressures or tricks you into doing sexual things when you don't want to. It involves behaviour that may not always be criminal, but is usually abusive in some way.

For help you can contact 1800 RESPECT, the national body for supporting people impacted by sexual assault, domestic or family violence and abuse.

The many ways new mums are impacted

For many women, "sexual function" declines during pregnancy and does not return to its baseline during the postpartum period, research shows.

Not wanting or enjoying sex has shown to be as high as 83 per cent of women at two to three months postpartum, and 38 per cent at six months.

And up to 18 months later women can report having much lower levels of sexual pleasure and emotional satisfaction.

Meg, who has two children aged one and two, says she massively underestimated how breastfeeding would halt her sex life.

"It was to the point my husband thought I stopped being attracted to him and I thought there was something wrong with me," the 27-year-old from Queensland says.

Amanda Newman is a women's health specialist and GP with Jean Hailes for Women's Health.

She says changes for women can be a mix of physical, emotional, psychological and environmental.

"There are changes in desire, there are changes in opportunities to have sex, changes in the body and changes in hormones."

Vaginal dryness is one of the most common physical factors of sexual pain.

"Then penetration can feel like sandpaper or razor blades," Dr Newman says.

(A good lube can be helpful here!)

There may also be pain or discomfort in the abdomen, pelvis, vagina and vulva.

Postnatal depression can cause women to lose interest in sex, and the drug treatment for depression can also do the same, Dr Newman says.

The primary carer also experiences feeling "touched out" by their child, leaving little room for affection with their partner.

"When one partner is exhausted by touch and the other is dying for touch, that is a common obstacle," Ms Mourikis says.

And body image issues can be exacerbated through pregnancy and childbirth.

"For some people, when they become a mum, they don't see themselves as sexual anymore — or they feel they aren't allowed to be sexy."

Sometimes male partners might also hold that belief.

It's a couple's issue

One of the big problems with the pressure new mums face to resume having sex is the responsibility placed on them, says Ms Mourikis.

"The burden is on that woman to do something about it."

But it's a couple's issue, she explains.

"Figuring out what factors are influencing you can be helpful in understanding why you might not be in the space for sex.

"And for your partner to understand that too … that can help the partner with feeling like it's less about them and it won't be like this forever."

Dr Newman says it's likely several influences coming together, not just one thing.

You may choose to seek professional to support to help unpack what is going on from you, and that may include speaking to your GP, a psychologist and sex therapist who has experience with new mums.

Julie says when her and husband Adam* eventually had successful penetrative sex, she felt "elated".

"I don't remember exactly how it happened, but it was after a night out with friends.

"Perhaps I was just more relaxed or perhaps my body just needed that extra time to heal, but it finally happened for us."

Adam says he knew penetrative sex would happen "eventually", and wasn't too worried it took longer than the expected six weeks.

"We weren't big on sex all the time, so it wasn't unusual to go a couple of months without having it."

When sex isn't possible, connect in other ways

Redefining sex and intimacy is key in staying connected when sex isn't possible.

Women in same-sex relationships are less likely to struggle with this as they are more likely to define sex outside of penetration only.

"And they're less likely to use sex as a weapon," Dr Newman says.

The more broadly you think about sex, the more likely it can continue in a way that feels pleasurable for both partners, says Ms Mourikis.

"If penetrative sex is painful [for example] that doesn't mean you can't masturbate together or massage your partner's erogenous zones."

Also seeing foreplay as encounters throughout the day — not just the moments leading up to sex — can help create intimacy.

"Be really intentional about having time to cuddle and talk about things that aren't related to the baby," Ms Mourikis says.

Dr Newman says the "skin hunger" that partners of the primary carer usually experience can be confusing.

Meg says she wishes her husband would realise sex isn't the be all and end all.

"We have the rest of our lives for each other, we only have our babies for a short time.

"Growing and nurturing a baby and trying to look after yourself is hard work."

*Names changed for privacy.