Sex in pregnancy and beyond: Rejoice in the differences.

Daisy and Nick can't help it. Their relationship is on display during the prenatal visit. If Daisy is sensitive and tearful, Nick reaches out to her. His feelings are bubbling over "Isn't she gorgeous?" he declares. "Isn't that the most beautiful belly you have ever seen?" Her love and appreciation are clear too. She looks at him, smiling and a bit shy. He loves to play with her belly during measuring and palpating time. Their mutual pleasure is a joy to behold. They touch a lot. At 37 weeks the intensity of her post-orgasm contractions makes her think that she is in labor. She is not yet, but when she is, as so often, I am privileged to be present as this man supports his loved woman through the birth process, with great understanding. Sometimes in labor, the intensity of a relationship takes your breath away. I remember that with John and Lorraine. I had not had a sense of them as a couple during prenatal visits, but their connection was so powerful during labor that I felt that I shouldn't be in the room.

For some couples with great relationships, togetherness is not the recipe for labor. Their conncetion may be strong but expressed differently. Mary was one of those "I do it myself" women who preferred her huband in charge of the older kids and did not want anybody to touch her. Paul and Mary were just a different kind of team. But they communicated well, clearly and in loving ways.

Differences in coupleness come up when talking about sexuality, often in postpartum visits following discussions of contraception. Sex is everywhere in popular culture. People feel that they know how they are supposed to feel. Differences come up because couples are different. "Men are from Mars, Women are from Venus" Yes, but some women have a lot more Mars and others a lot more Venus! Men too. For many couples sexual intimacy is central to their expression of coupleness. For others it may be less central.

I saw Julie at 2 weeks postpartum and when we discussed contraception and postpartum sexual intimacy, she said "Oh, we already started that". Many couples are ready 2 weeks after having a baby, particularly if there were no sutures and everything is going well. Others at six or seven weeks postparum are exhausted at the very mention of sex "Oh goodness, not yet.... just too tired" said Elizabeth. For these women, it's mostly about how recovery is going.

Sometimes a conversataion about sexuality is about the Mars Venus balance. Rachel said about sex,  "Honestly, I could live without it. It's sometimes seems such a waste of time. Am I really weird?"  Jenny is worried that her pleasure should include orgasm. Sometimes it's about fluctuating hormones. Breastfeeding makes Sarah feel very sexual and very sexy. For Becca, the physical connection with her baby makes her disinclined to be sexual with Tom.

Every woman, every couple, is unique in how they express their love and intimacy. Let's all accept and rejoice in that.