Sex After Pregnancy Loss Is Complicated

A month after my miscarriage, I returned to my obstetrician’s office for a follow-up appointment. She took a look at my uterus and cervix to be sure they looked normal, and we discussed whether my partner and I wanted to try again. Her recommendation was to wait three cycles before trying to conceive—if we decided to—and she otherwise checked in on my emotional state.

I felt a dozen emotions all in synchronicity when I got that first period following pregnancy loss. The blood: its color, its meaning. A flood of grief. That “at least your body is working” mantra. Remembering the blood that indicated the beginning of the end. A glaring reminder that I was no longer pregnant. Hope that there will be future pregnancies that last. Not knowing. No control.

Menstruation can mean so many different things to women around the globe, and for those of us who have miscarried, that first period after the loss can trigger unimaginable memories…and maybe even a little bit of hope. That hope hurled me back into that space, even if only potentially—the physical act of getting pregnant again, the mental strength that must accompany a post-loss pregnancy, and the emotional toll that the magnitude of such a thing would take on my ailing mind. I was still reeling from the trauma I’d just lived through, but tucked in somewhere deep was a trust that it would not happen again. It just couldn’t. And so, we proceeded.

As I’ve combed through the various elements of life after loss, I’m struck by the ways in which loss can upend even our very personal and often complicated relationships with our bodies. Pregnancy can leave us intimately connected with them one moment, then feeling as if we’re veritable strangers the next. Or worse yet, despising or rejecting the very body we’ve been assigned, the one we must continue to live in.

Considering the feelings of betrayal that so often invade the minds of people who’ve experienced pregnancy loss, we might become prone to reassessing exactly how we feel about our bodies, how we feel in them, how we touch them, and, critically, how we like them to be touched. We find ourselves reckoning with a coupling that is deeply troubling in nature: the intermingling of death and desire.

Even though a woman may feel adrift after a pregnancy loss, she still exists as a sexual being—but how do you balance the two? Pregnancy and everything surrounding it already has the power to change sex—its meaning, its purpose, its function, its feeling. Sometimes, once couples begin trying to conceive, the mood shifts, especially if it isn’t an easy road to conception (but this can also occur when conception happens fast). And because returning to sex after pregnancy loss also carries the potential of getting pregnant once again, hope and heartache might intertwine in a place previously uncomplicated by these notions.

I’ve talked to so many women about this because, as you can see, it is layered and intensely complex. For some, sex stops being a bonding point or a way to experience pleasure and starts becoming rote or even unpleasant. This happened to one member of my Instagram community, Yael, who messaged me when I asked for stories about this issue. “I didn’t really want to have sex. We only did it to try to conceive. I used to like sex a lot—we had a really great sex life. But when we were trying to get pregnant again after the loss, it just became a task. I didn’t even physically enjoy it anymore. I think my fear got in the way.”

This is not an uncommon reaction. Pregnancy loss has the power to affect the way some women feel in and about their bodies, and how they want to share (and not share) them sexually. I remember talking to Jade, one of my patients who experienced this shift in her sexual desire—and the many ways in which it impacted her relationship—after she lost a pregnancy at nine weeks along. “Making it through to the end of a day feels like a feat in itself, emotionally speaking. So when it comes time to go to bed, all I want to do is sleep. Not cuddle, not talk, not kiss. I just want the day to end so my grief can finally take a beat,” she said. “And yet time after time, Ben will crawl in next to me and press his body against mine.” She continued, “It’s a loving act, I know, he just wants to reconnect physically—to bond—and…xit’s just too soon. It’s the last thing on earth I want to do right now.” Jade worried that her lack of interest was hurting her partner somehow, but her primal need to retreat took precedence. As it sometimes must.

My patients and the people in my communities continually reflect on the fact that among the grieving, there exists a recurrent theme: For so many, sexuality shifts, increases, gets lost, or, at the very least, is mired in the weeds of reproductive complications. Its meaning changes. Desire contorts. Some divest in physical connection altogether. I’ve heard stories of people retreating from their partners, burying their sexuality deep beneath their grief, oftentimes feeling undeserving of or wholly disinterested in pleasure. I’ve also heard stories of women wanting more than their partners can provide; of new fantasies taking hold and of the desire to experience more than one sexual partner—a want often rooted in the need to feel in control of the body and the ways in which it can be used.

These potential outcomes exist partially because there are so many conflicting thoughts firing simultaneously in the mind, affecting the body. Some berate their bodies, others divorce them, some are tender and loving to them. Those who come to pregnancy loss with an already complex relationship with their bodies can find a newfound appreciation for the way their bodies work—burying themselves in the science of it all and becoming fixated on the statistics, the medicine, the intricate cogs of procreation. And others take that troubled relationship and, in the wake of a miscarriage, destroy any fragile appreciation they had for their body entirely.

This happened to Yael too. “I generally dislike my body. I’m very self-conscious, but usually my husband makes me feel really good about my body,” she said. “After my loss, I hated my body all the more. Despised it. And now it wasn’t about how it looked, but the fact that it failed. He couldn’t help me with that.” Her feelings spiraled. “I hated my body so much. It was hard to want to experience pleasure, because I didn’t even want to look at myself, touch myself, be touched. I was so angry at my body because it wasn’t doing what it was supposed to do. ‘Why is this happening? What is wrong with me? What is wrong with my body?’ It was a whole new realm of body loathing that I still haven’t really gotten over. These feelings trumped my negative feelings about my body image, but I constantly felt like it was failing me. And in turn, it was failing everyone I touched. I thought, ‘Look at how many people my defective body is impacting. Look at how my body is causing grief for others.’”

Sex—and masturbation, for that matter—can feel like a self-indulgent act that symbolizes an erasure of their grief in favor of emotional or physical or personal gain. These feelings are, of course, compounded by societal messaging that pigeonholes women as maternal, not sexual. In a culture that already discourages women—especially moms or those who will one day become moms—to embrace and express their sexuality, how can we possibly feel free to return to our sexual selves in the midst of our grief? We are judged under the best of circumstances.

Aliyah, a member of my online community who had a stillbirth at 30 weeks, said her sex life with her partner was difficult for the next two years. But she couldn’t be alone either. “Masturbation felt selfish. Something so sacred [my stillbirth] happened there, so it felt selfish to not include my husband there too. I felt alienated from my body. I had to rebuild a relationship with my body all over again.”

In contrast, for some women, masturbation was the only available kind of sexual expression. Libby messaged me after her termination, which was due to life-threatening preeclampsia, and we discussed this exact reaction. “Masturbation was the only way I could reach orgasm, actually, because I wasn’t performing, it was just for myself,” she said. “After my loss, it was very difficult for me. My husband had taken care of me in a new way—taking me to the bathroom, helping me out. It was so vulnerable and—not in a sexy way—very intimate. Masturbating, I didn’t have to think about him or his thoughts. I could cancel out the noise of what he might be thinking or seeing after watching me lose our baby. I was too afraid to ask him what he saw. What he thought. My self-esteem was already so compromised. And I was worried that my anxieties would become his too. But I had a lack of self-consciousness when it came to masturbating. It was a step toward self-care to masturbate.”

Masturbation and sex can be compassionate acts of self-care and restorative for romantic relationships. Take this message from Trina, a member of the Instagram community: “I felt like my body had failed me in losing my son three days after he was born. I’m single, but I sought out sexual partners because sex was a way to gain that back—to feel powerful in my body again. There was some guilt that came with the pleasure in the early days, but finding joy while navigating the self-facing, negative self-blame helped me navigate in a more clear-minded and balanced way. Sex helped me remember who I was.”

Tapping back into our sexuality is certainly not the only way to reconnect with our deeper selves and regain confidence in our sensuality, but it undoubtedly holds the power to offer the comfort and encourage the connection that our minds and bodies so often crave. Amelia confided in me via direct message that she cried the first time she had sex with her husband after her pregnancy loss. “It was about six weeks later, when we returned to penetrative sex. I cried right after because I finally felt really connected to my husband again. With my loss, I felt like I was on an island—water between me and everybody. When we had sex, I cried with relief to be connected to someone again. Because of that, I think that pleasure and grief must coexist.”

<cite class="credit">Samantha Hahn</cite>
Samantha Hahn

This essay was adapted from I Had a Miscarriage. You can order a copy here.

Originally Appeared on Glamour