BINTO Q&A with clinical sexologist, Dr. Johnson

“Will the penis hit the baby’s head? Wait, can the baby see the penis? After I deliver, is sex going to be painful? How will having a baby impact intimacy with my partner?” These are a few common and natural worries about sex during and after pregnancy—a topic that isn’t discussed nearly enough, which only creates misconceptions and fears.

 

To get the conversation started and our most pressing questions answered, BINTO sat down with Dr. Kelley Johnson, a clinical sexologist who holds a PhD in Human Sexuality. Dr. Johnson provides sexual education to her clients in public and private settings in North Carolina.

 

Thank you for sitting down with us! Why don’t you begin by telling us about yourself.

Dr. Johnson: I found a book on the human body in fourth grade and was enthralled with the chapter on reproduction. By middle school, people would come to me with all of their questions about birth control. After college, I received my Master’s in Public Health Education and went on to teach women’s health and sexuality at the University of North Carolina at Asheville. Later, I received a PhD at the Institute of Human Sexuality in San Francisco. I then went into private practice. I now provide education for schools, the general public, and individuals who are having sexual issues. I help people understand their own sexuality.

 

Let’s dive into pregnancy. Why is sex important during pregnancy?

Dr. Johnson: I don’t think sex is necessarily important during pregnancy. For some people, their sexual interest goes up during pregnancy. Others may have body image issues. Partners may have a block or barrier when it comes to being sexual with someone who is pregnant. OB-GYNs and midwives may even advise high-risk pregnant individuals not to be sexual.

Intimacy, however, is important. The couple needs to continue talking and discussing the changing body.  How is this impacting self-image? How is the partner is perceiving this change? Talking about fears of the unknown and what kind of parents they want to be are great topics to promote intimacy. Back and foot rubs, cuddling, and alone time where you can be connected in conversation are all forms of intimacy.

However, if intimacy can be sexual, that’s great.

 

How does pregnancy impact libido?  

Dr. Johnson: One’s libido may go up, stay the same, or plummet. There are countless factors that influence this. Nobody wants to be sexual when they feel rotten or exhausted, which many do during the first trimester.

During pregnancy, we do see an increased blood flow to the genitals. This can increase interest in sex. Some people really embrace their pregnant bodies and become more in touch with their sexuality. Fuller breasts and seeing the belly begin to poke out can be very sexual.

 

How does pregnancy change sex physically and emotionally?

Dr. Johnson: Physically, once one starts to show and get bigger, a couple will have to start working around this and get more creative. This also facilitates more communication—they must talk about the nitty gritty of sex. Sex is a way to emotionally bond. Good parents are bonded parents. But every couple is different. So much of it depends on their history, the pregnancy, and how they connected physically and emotionally before the pregnancy.

I’ve heard some partners worry about hitting the baby with their penis or the baby seeing their penis. This comes from a lack of education. It’s not how human anatomy works. But some of these misconceptions actually prevent couples from being sexual. This is why education and information is important.

 

What are some positions that are comfortable and enjoyable for pregnant individuals?

Dr. Johnson: Spoon sex is great! As the belly gets bigger, lying on the back isn’t always recommended. Rear entry is the easiest. The pregnant person is on all fours or on their knees with their arms elevated on a headboard, so the back is more vertical. Cowgirl and reverse cowgirl are also optimal positions. The pregnant individual can hold onto the partner’s shoulders, chest, or knees for balance. More oral sex or the use of a vibrator may be something that’s welcomed by pregnant persons.

 

How does having a baby change sex physically and emotionally?

Dr. Johnson: Having a new baby can cause you to fall in love with your partner all over again. Seeing your partner as a parent can be really sexy. The two of you as a couple are falling in love with your child—this is intimate and life-changing.

Of course, physical and emotional pain from birth can change sex. Depending on what the birth experience was like, the postpartum person may be extremely sore. The idea of having something around their genitals may be frightening. It can take some time to get over this. If the birth was not what the person desired or was traumatic, they may need to work through this emotionally.

Every person is different. Some are ready for sex before the six week postpartum appointment, but for others it takes much longer to be physically and emotionally ready.

 

After having a baby, when is it safe to start having sex again?

Dr. Johnson: Doctor’s advise to wait six weeks. During the six week postpartum check up, they will ensure all bleeding has stopped and the uterus and any stitches have healed.

It’s also important to discuss contraception. It can take a few weeks for certain birth control methods to go into effect. Ideally, for the birthing person’s health, it’s best for pregnancies to be spread out. It takes someone’s body awhile to heal, get back to a pre-pregnant state, and be ready to accommodate another pregnancy.

 

You mentioned that it’s common to anticipate pain or not want anything around the genitals after birth. How can one manage this concern and fear?

Dr. Johnson: When one decides they want to be intimate, it’s first important to be very well-rested. It’s also key to go very, very slowly. I recommend that clients masturbate to see what it’s like to be sexually aroused again. What is it like inserting one finger into the vagina? Take some time to build self-confidence.

You don’t want someone to push themselves through pain or say, “Oh, I’ve got to do this for my partner.” This creates a negative feedback loop around sex that is difficult to break.

 

How can partners be supportive of this fear?

Dr. Johnson: Communicate by checking in to see how the postpartum person is feeling. There can be months of complete exhaustion. If a partner goes back to work, they may not be aware of how difficult it is to take care of a child. Babies nurse, poop, and pee. Caring for them isn’t always a sexy job. A partner may need to put their sexual needs on the back burner for awhile.

There should be no pressure to be sexual. However, a couple must talk about where they are. You can’t just stop having sex and not talk about it.

 

Like Dr. Johnson, at BINTO, we believe information, education, and communication are powerful tools. Talking with experts like Dr. Johnson about topics that may not be covered at the dinner table, doctor’s office, or mother’s circle will help you and your partner navigate pregnancy and the postpartum period more comfortably and confidently.

 

Written by English Taylor. Women's health freelance writer and editor. English went to the University of Virginia undergrad and Northwestern for graduate school. She currently lives in the bay area but hails from Nashville (one of our favorite places!).