Kathy said:

"I would be very wary of attributing lower libido after child birth to
depression -- this makes it sound as though all women should be hopping
to
get back to as frequent sex as their husband likes right after the
earth-shattering, life-changing event of childbirth (especially first
childbirth and first motherhood), and if they are not in the mood, they
should take anti-depressants so they will be -- I think it is a good
thing
for the mother to be mainly tuned into her child rather than her
spouse....."

I agree with this assessment and I did not say ALL women should be
hopping to have sex as soon as they get home with their babies. OTOH,
when a woman goes out to seek help with the problem of low libido, she
might be talking about a more serious problem than just being touched
out. She might be asking for help with post-partum adjustment disorder.
I suggested that we might want to ask some other questions such as  "Is
there anything else you used to like doing that you no longer like?"  If
she says, no. Well, Kathy's assessment is probably accurate. If, OTOH,
she says "well yes, I no longer care about music or painting or
chocolate" we might want to explore a bit with her and maybe refer her
to a place where she can get some help.

Just last week I had a young woman call me at 4 months postpartum to ask
if it was OK to take Zoloft while lactating. She had been encouraged by
her friends to go to a doctor that would prescribe it to her. As we were
talking she said, "Do you mind if I ask you about sex?" I said go ahead
so she said "Well, I just can't stand to have sex for more than a minute
or two. I get bored and my mind wanders and I watch the clock. Is this
just cause I'm breastfeeding?" I asked her if there were other things
she used to enjoy that she couldn't take pleasure in anymore. She said "
I don't like to take walks, I don't even like to get up and turn the
lights on."  Why, then, would anyone expect her to enjoy being with her
husband?

I remember being all touched out by my kids. I remember not being
interested in intercourse while I was breastfeeding.  I don't think that
is the same as not being able to stand sex for more than a few minutes.

I guess I am always amazed at the prevalence of post partum adjustment
disorder in the mothers who have highly interventive births, and I am
always on the lookout for it.

I guess, too, I have seen estrogen impact a woman's milk supply
irretrievably. So I am not willing to concede that this is the only way
to address this problem.


Susan Keith-Hergert RN, MS, CPN, IBCLC

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