You, Me, and Baby Makes Three: Female Sexual Health after Childbirth

Tweet Have you ever heard a new parent say that if they had to choose between sleep and sex, they would choose sleep? This statement can be shocking to hear, especially for those who don't have infants or young children in the home. Tons of things change when little ones come into your life—everything from sleep, mood, relationship dynamic, vehicle choices, and of course, your sex life can be impacted in some way.

A woman’s sexual desire can ebb and flow throughout her lifetime. For women who have given birth, the pregnancy and postpartum periods in particular can be a time of change in terms of one’s level of sexual desire. During pregnancy it is extremely common for women to experience fluctuating levels of sexual desire, so the amount of sexual activity that a woman and her partner engage in during pregnancy tends to vary from couple to couple. However, there seems to be a steep drop in sexual interest and activity after childbirth, for both the birthmother and her partner. In fact, research has shown that 86% of women and 88% of men report having sexual problems after the birth of a child.

During childbirth, there are many physical changes that happen to a woman’s body, and these changes may be responsible for some of the sexual problems couples experience after the birth of a child. For example, women who give birth vaginally are at risk of experiencing genital tearing, having an episiotomy (surgically planned incision on the perineum during labour), or having an assisted birth that requires instruments like a vacuum extractor or forceps to help pull the baby out. These factors can cause injury to the genital area (genital trauma), which is associated with painful intercourse (dyspareunia) in the first few months postpartum. Women who experience genital trauma during childbirth also tend to wait longer after childbirth to start having penetrative sexual activities again.

In the Sexual Health Research Lab (SexLab), we are aware that “sex” is way more than just penis-in-vagina intercourse; but unfortunately, most of the research on postpartum sexuality focuses on penis-in-vagina sex and the pain that it might cause.  That said, genital trauma can still affect all sorts of aspects of sexual function, like sexual satisfaction, desire, and orgasmic ability. Given all of these potential negative effects that a vaginal birth can have on a woman’s – and her partner’s – sex life, one might assume that having a Caesarean section (C-section) would prevent any sexual problems in the postpartum. In fact, recent surveys of Canadian women and men have found that a common reason for preferring a C-section over a vaginal birth is the belief that C-sections are better for a couple’s future sex life. Another recent study found that many women believe that having vaginal birth makes a woman’s vagina “loose” or “used”.

Okay, so it seems as though the general public opinion is that having a vaginal birth will lead to sexual problems. So, if women are concerned about their future sex life, then they should all have C-sections, right? Well let’s hold our horses – before we start writing off vaginal births all together, let’s see what the research actually tells us, shall we?

Drum roll please…. most studies that examine many different aspects of sexual function (e.g., sexual desire, sexual satisfaction, dyspareunia, etc.) have not found a difference in the self-reported sexual functioning between women who have had a vaginal birth and women who have had a C-section. These studies usually give questionnaires to women asking about their sex lives and interest in sex. In SexLab, we can objectively measure sexual function using some neat equipment, in addition to questionnaires. One way that we can measure sexual function is to look at sensitivity in the genito-pelvic region. There is some research to suggest that women who are more sensitive to touch and heat in those regions have better sexual function than those who are less sensitive to touch and heat. We can also measure sexual arousal by using special equipment to measure blood flow to the genitals while participants watch erotic films.

So, why does SexLab care about postpartum sexual function and whether it’s better or worse or the same after a vaginal birth or a C-section? Well, we believe that it is important to understand how different modes of delivery can potentially impact a couple’s sex life given that the rate of C-sections are increasing worldwide, with rates in Canada (26.9%) almost doubling the World Health Organization (WHO) recommended rate of 15%. In fact, in some South American countries, the rates of C-sections are as high as almost 50% of all births! Although it is unclear why this trend is occurring, some people suggest that this is because more women than ever are specifically requesting to have a C-section. It is possible that one of the reasons some women are requesting C-sections is because they are worried about the impact that having a vaginal birth will have on their future sex life. Granted, most people feel that sex is an important aspect of their lives, which means it is equally as important for women to know all of the facts (or at least what the research tells us thus far) when it comes to sex and childbirth.

To answer all these questions, the SexLab is conducting two studies to examine postpartum sexuality. The first is an online study for women who have not given birth to find out about perceptions of and preferences for pregnancy and childbirth, specifically as they relate to female sexuality. If you are a woman (18+) who has not given birth and are interested in completing this online survey, please click here: https://queensu.fluidsurveys.com/s/childbirthperceptions/. Please note that while we welcome all sexual orientations and gender identities, at this time we are only recruiting DFAB individuals (i.e., designated female at birth). Individuals who participate in the survey can be entered into a prize draw for an Amazon gift card.

The second study compares sexual function among women who have had a vaginal birth, women who have had a C-section, and women who have never given birth, by measuring things like genital sensitivity and genital blood flow. If you are a new mother (i.e., you had your first child within the last 2 years) in the Kingston, Ontario area and would like to participate in our study, please contact SexLab (email: sex.lab@queensu.ca or telephone: 613-533-3276).

Jackie Cappell, M.Sc. Ph.D. Candidate, Clinical Psychology, Queen's University

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Loaded Language: Why are you such a P***Y? You are such a C**T! Don’t be a D**K.

Tweet Some people use terms like, “pussy,” “cunt,” and, “dick,” to verbally degrade, taunt, tease, or just flat out attack another person.  Although some people may not think these terms are wildly distasteful, one of my friends mentioned that she found them to be disgustingly offensive. Why? Because they refer to body parts that people were born with and that are often closely attached to one’s identity. After hearing this explanation, I thought about what my friend said and asked myself, “Why would someone use these (genital) terms in particular?” We certainly don't hear people using swear terms related to one’s hands or feet in such a way (“You’re such a thumb!”).

When I looked online for definitions of these genital-swear terms, I found that TheFreeDictionary.com stated that pussy can be used in many creative (yet derogatory) ways: as “offensive, vulgar slang for the vulva, a woman viewed as a source of sexual gratification, and/or a man regarded as weak, timid, or unmanly.” So, the term conveys many meanings: it is offensive, vulgar, objectifying to women, and insulting to men (calling them weak and not masculine). To have these meanings associated together seems pretty offensive to me. Some people are born with vulvas, and while vulvas certainly can be used for sexual gratification, it would be unfair to say that is their main purpose or that they are weak. Vulvas have many uses, one of them being to give life to humans, which can be pretty empowering.

TheFreeDictionary.com defines cunt as, “vulgar, offensive slang for the female genitals, that is used as a disparaging term for a person one dislikes or finds extremely disagreeable.” The website goes on to say that although there is some relaxation towards how people feel about using words like fuck, many people still find the use of the word cunt to be unacceptable. Why is that? And why is there a pattern of negative terms related to female genitalia, in particular? To make my point, note that TheFreeDictionary.com states that the term dick can be used as a “vulgar term for a penis, or a person that is mean or contemptible.” It seems as though the term dick is not considered as offensive as pussy or cunt. Is there even another vulgar term used to describe the penis? I don't think so. Do other slang terms like anaconda, wang, pecker, or cock even come close (see onlineslangdictionary.com) in terms of the negativity of pussy or cunt? I don't think so.  Comparable slang terms for female genitalia from the same site include the following: axe wound, bang hole, bearded clam, cock pocket, and meat flap. UGH. What could this mean? Is there is more shame associated with female genitalia than with male genitalia? Is there more negativity associated with femaleness in general? What can we do to change the unfavourable connotations tied to the words we use to no longer be tied to body parts?

Instead of using a single (offensive) word to hastily characterize an individual, it might be more useful to be more descriptive in terms of people’s behaviours: telling someone that their irresponsible (or thoughtless, etc.) behaviour has caused you harm in some way might get you further than calling someone a cunt because you are angry or hurt on account of what they did. Framing a response to someone’s use of an unfavourable word in terms of your feelings first would be a lot more productive and beneficial (e.g., I felt insulted when you called me an X; can you please avoid using that term when you are angry with me?). Indeed, it is easier to target a behaviour or action (which can theoretically change) as opposed to reducing a whole person into one distasteful word—unless of course, you are not interested in resolving your conflict with that person.

By Heather Clark, BScH, Queen's University