Why sex is difficult for new mums after baby's birth

Having a baby can seriously damage your sex life. Afterwards, making love is hardly likely to be your top priority, but it is something that should not be overlooked.

In the past it has received little attention as the focus has been on the psychological problems faced by new mums as well as the social upheaval the arrival of a baby brings.

But exactly where do you start? Is the most important issue when to resume sex? Or should you and your partner agree to wait until it's no longer painful?

And what about sexual desire, arousal, orgasm, vaginal dryness or sexual satisfaction?

All of these thorny problems need to be discussed by the mother of a new baby and her partner, if only to prevent further difficulties some time after the birth.

From research, it's clear pregnancy itself can have a depressing effect on a woman's libido, usually starting in the first three months and lasting even six months after the baby is born.

Going off sex is complicated. Pregnant women often perceive sex as less important, even irrelevant, and the importance of sex and satisfaction with sex declines.

All these feelings are magnified in women who weren't very keen on sex in the first place, even before they became pregnant.

Then there's the body image problem. Almost all women feel unattractive in the latter half of pregnancy - I know I did.

Most wonder if they'll return to anything like their pre-pregnancy selves. And this affects their sex drive.

In one study, more than half of women had negative feelings about their bodies even a year after they had given birth and this altered the perception of their sexual selves and relationships.

Breast-feeding can also be an issue, and women who do so tend to suffer from vaginal dryness, sore nipples, leaking milk, failure to get aroused and a lack of interest in sex or painful lovemaking.

With all that going on, it is hardly surprising many will feel they should stop sex rather than stop breast-feeding, if their partner is prepared to be supportive.

Oestrogen levels are low in breast-feeding women, who leads to dryness and thinning of the vaginal lining, so a woman needs to be reassured that these feelings aren't her fault, and so does her partner.

It's a difficult time for both partners but made easier if they can be frank and sympathetic with each other.

I would encourage every woman to speak to her midwife, who is ideally placed to advise on counselling as well as lubricants and oestrogen pessaries that will not affect her milk production.