“O” or Oh no! The effect of bed rest on an intimate relationship

February 4th, 2010

During pregnancy intercourse, and more particularly orgasm, can be the most intense a woman has ever experienced. Because of the increase in blood supply during pregnancy, a woman’s perineum and sexual organs are all engorged (filled to the brim) with blood and this engorgement results in heightened sensitivity. Many women report that some of the best sex they’ve ever had was while they were pregnant. And while many may worry about the effects on the growing baby, you’ll be happy to know that an orgasm does not at all harm the baby. Even though the uterus contracts, the growing baby is so well insulated in the amniotic fluid and the strong, muscular uterus they experience mama’s orgasm as a soft ripple in the waters.

Pregnancy can also have a negative effect on a woman’s sexuality. Many women lose all interest in sexual intercourse while pregnant due to hormone  fluctuations causing a significant drop in libido. Lack of desire can also be due to the usual aches and pains of pregnancy, fatigue, nausea, the additional weight and change in body configuration leaving many women less than in the mood.

No one can predict how a woman will feel sexually while she is pregnant. Some women who enjoy robust sex lives prior to pregnancy lose all interest once they become pregnant. Likewise, more reserved women may begin initiating sexual intercourse during pregnancy. Even from pregnancy to pregnancy women report variations in their sexual libidos. They may be insatiable during one pregnancy and completely uninterested during the next.

But what about bed rest? Can women on prescribed bed rest engage in sexual intercourse? Unfortunately, most women on prescribed bed rest are advised against engaging in sexual intercourse.  Since an orgasm results in rhythmic contractions of the pelvic organs, a woman at risk of preterm labor absolutely must avoid such activity. Even without the added pregnancy intensity, anything that can cause uterine contractions and lead to preterm labor must be avoided. Some indications for bed rest may allow for some sexual activity. Gestational diabetes and hypertension (but not pre-eclampsia) for example, may require modified bed rest yet may allow for (limited?) sexual activity. When a woman is prescribed bed rest, she should ask her obstetrician or midwife specifically what her  limitations are when it comes to sexual activity

As we previously established, intimacy is a very important component of an adult relationship. It may seem like a bed rest prescription means the death of intimacy-at least for the duration of the pregnancy. But nothing could be further from the truth! Intimacy is the act of sharing between a couple; spending time enjoying one another, exchanging private thoughts and emotions, engaging in activities that they find mutually enjoyable. This can still happen between a pregnant woman and her partner.  Likewise, while intercourse may be prohibited, not all physical contact is taboo. Consider these alternatives:

  • a back and shoulder massage
  • a foot massage
  • brushing each others hair
  • deep kissing

Bed rest is not all bad for a relationship. Bed rest may actually usher in a new phase of intimacy for a couple as their efforts to find alternative ways to share intimate moments work to draw them closer.

Maintain Intimacy While On Bed Rest

February 1st, 2010

A pregnancy ushers in a new era for a couple. First pregnancies in particular while usually welcomed, completely change the dynamic between partners. For many couples, the pregnancy heightens intimacy and they are surprised to find that they enjoy some of the most sensational sex of their relationship. But when a pregnancy is high risk and complicated by bed rest, sex-and intimacy- can quickly become a distant memory.

For a woman with a high risk pregnancy and on prescribed bed rest, sexual intercourse is very likely the furthest thing from her mind or the mind of her partner. Usually both parents-to-be are consumed with the health and well being of mother and baby and refrain from sexual intercourse fearing injury to the baby. However, this is one time when intimacy, emotional intimacy and not physical intimacy, is essential. Due to the stress surrounding a high risk pregnancy and bed rest it is important that partners set aside time to be intimate, to care for one another as lovers and friends, throughout the pregnancy in spite of the bed rest. I want to be clear, I am not telling high risk pregnant couples on bed rest to engage in sexual intercourse. Whether or not they can engage in sexual activities is something that they need to discuss with their obstetrician or midwife.  I am encouraging couples to maintain intimacy-specifically, emotional closeness.

So how does this work? If a couple cannot have sex, how can they be intimate? I realize that many people reading this post will ask this very question. But let’s look at what it means to be intimate. Webster’s dictionary defines intimate as “most private or personal; closely acquainted or associated; very familiar.” In our culture intimacy or the act of being intimate has been relegated to a purely a physical act, that of sexual intercourse. However by the dictionary’s definition, intimacy or the act of being intimate means more than just physical intimacy. It also means to be close; sharing private thoughts and emotions and holding those thoughts and emotions in a special place between the two people involved.

Research shows that couples who master the art of maintaining intimacy during pregnancy and maintain intimacy after the baby arrives have a higher probability of long term success. These couples know that taking time to be alone together and to nurture their own connection is critical to their very survival as a couple. Even with a bed rest prescription, these couples still share private  thoughts, feelings, emotions and some abridged form of a physical relationship and as a result “keep the home fires burning.”

As Valentine’s Day approaches, I encourage couples coping with bed rest to nurture their intimate relationship.  You may want to have an intimate candle light dinner, listen to music together, talk, watch a favorite move or just snuggle. Whatever it is that draws you closer, do it. Remember it’s that love that you shared that created the little one that you so anxiously await. And as precious as that little one is, it should never eclipse the intimacy that the two of you share.

A Life and Death Decision

June 2nd, 2009

I was so saddened by the murder of Dr. George Tiller on Sunday morning as he ushered for fellow parishers at his church. I don’t know why crazy acts of violence like this so tip me off balance, it’s not like this is the first such incident, but they just seem so cruel and senseless to me. Kill someone because they kill someone. Is the eye for an eye mentality really the best form of judgment and best means to civil obedience?

I have a rather interesting perspective on abortion. First, it’s not for me. In a perfect society it wouldn’t even be necessary. Yet because we live in an imperfect society, I believe it’s necessary that we have legal, safe abortions available and I hope that they will continue to be available.

Secondly, while I was rotating though OB/GYN as a physician assistant student I assisted an attending physician with a D&C, dilation and curettage. The patient had been pregnant and the fetus had died in utero at 16 weeks. As the attending MD evacuated the contents of his patient’s uterus, my job was to filter the fluid and reassemble the fetus to be sure that we got everything. “Had a horrible experience of a patient passing a leg once,” the attending told me. “Now I make sure everything is accounted for before I’m done.”

That experience had a profound effect on me. I reconstructed that little body with tears streaming down my face. I saw firsthand how well developed a fetus is at just 16 weeks. I’ll never forget that experience and from that day on knew that I could never terminate a pregnancy. Turns out that was not even an issue for me as I had trouble sustaining pregnancies. Isn’t it ironic how life works??

Perhaps you are angered at women who terminate pregnancies because you are doing all that you can to sustain your pregnancy and save your baby. Perhaps you feel guilty because you terminated a pregnancy in the past and you are wondering if the precarious little life you are working desperately to save is payback for past transgressions. Whatever your position, I’d just like you to think about how we could make things better.

We are sexual beings and until we come to grips with sexuality in a healthy and responsible way, sexually transmitted diseases and unintended pregnancies will persist. As parents, educators, community activists and concerned citizens we can help create healthy, responsible attitudes towards sex. We can do it – without all the killing. But we cannot remain silent and we cannot assume that someone else will do it.

If you don’t want to speak out publicly about your views start small, in your little corner of the world. The little one that you are carrying will one day be a living, breathing, sexual being. What are you going to tell your child about sex? How will you teach your child to be responsible about sex? How are you going to equip and educate your child about his or her sexual responsibility so that they won’t ever even have to consider an abortion?

In between the baby registries, birth plans and college financial planning, please take a little time to consider how you want to broach this very delicate topic with your child. Write a little something down and put it away. It may seem hard to imagine now, but your decision today could one day be the difference between life and death.