Tearing from childbirth means I find sex is too painful

Q. I had my first a baby eight months ago. The birth was traumatic and I needed a lot of stitches to repair extensive tearing.

I now find myself feeling very tense every time it comes to sex. Sometimes it hurts so much I have to tell my husband to stop. It’s got to the point where he is afraid of hurting me and I’ve all but lost interest in sex. How do we get back to our previously relaxed sex life?

A. I do not know if you’ve seen your obstetrician about this. If not, you should visit your GP and ask for a referral. If you encounter resistance point out that the ongoing pain is making penetrative sex impossible.

Tears and stitching take time to heal, but not this long. With a traumatic delivery there can be damage to the pudendal nerve which provides sensation to the lower part of the vagina.

Given the level of pain your experiencing, it’s not surprising you are both avoiding sex. And when this happens, feelings of frustration and resentment are inevitable.

There are a few things you can do as couple to rebuild intimacy in the relationship.

The first response is to take penetration and intercourse off the agenda for the moment. This removes the pressure of pain and the pressure to perform.You need to agree to be sensual together. This provides an acceptable way to communicate intimately.

Plan a couple of at-home dates when the baby is settled and the phone switched to silent. Take a shower or bath, whichever relaxes you most. Make sure the room is pleasant. Use candles, background music, whatever appeals to you. Lying on the bed together, take turns to stroke, caress, and massage, touching every body part except the genitals. Give encouraging feedback, saying what you each like, both when touching and being touched. The important thing is to try and stay with the sensations you are experiencing and not to think ahead. Try to remain focussed. Talk about what you find pleasant. What would make it even more pleasant?

Think about where you really liked to be touched, leaving out the genital area. You are paying attention to your responses and avoiding anything that can recreate the problem.

Look at this as a relaxing time, an opportunity to reconnect and to be intimate.

With time, bring in touching the genitals very gently. It helps to use a water-based lubricant.

Continue to avoid penetration and, if aroused, come to orgasm outside the vagina. Experiment with ways to relax and enjoy pleasure in your body beyond the sexual organs.

In the meantime, you could try using a tampon with an in-built applicator, the smallest to begin with, to see if you can gradually insert something into your vagina. Stroke yourself and don’t force things. Be gentle and caring with your body. Take your time.

There is a lot you can do to re-establish intimacy, but I urge you to also seek medical advice.

* Marie Daly is a psychosexual therapist with Mind and Body Works. Visit www.mindandbodyworks.com