My s_x is broken

I worried about postpartum sex while I was pregnant. Like, when will there be time for sex? or, will my partner think I am me sexy? As soon as I popped this kid out, it became clear that my body and my relationship to my body and my sexuality–to the very wonderful deliciousness that created this child in the first place–had dramatically changed.

There are many better written accounts about the physical trauma of birthing (Chrissy Tiegen or the Body Full of Stars book). What most of them have in common is the shock, the, “Why didn’t anybody tell me about this!?” No sane person would (should?) share with a pregnant woman anything bad that happened to them. And no sane pregnant woman would want to hear about them either. There’s also shame, stigma, and the solitude of going through something hard when it seems everyone else has it easy (which, really, we should know by now is never the case).

I am still not sure what exactly–what information, what mentoring–would have helped me prepare for the bleeding that continues for weeks (like, where does it come from? and why won’t it stop?); the way your breasts feel when a hungry mouth attaches to them, especially one that has a physical challenge and leaves bleeding, achy nipples, and oh man, that sensation when your milk comes in and suddenly you are carrying two solid, heavy stones on your chest; the medical staff demanding a stool from you when the last thing you want if you gave birth vaginally is to feel ANYTHING coming out that route; the actual ripping of flesh, that can rip in many different ways and in different parts and that needs to be sewn up and might be sewn up wrong; the impossibility of sleeping when tired or eating when hungry; the heart-stopping, all-consuming precipice of postpartum depression.

After 6 weeks, when I went to see my OBGYN (because that’s when the medical establishment has decided postpartum “ends”), she said, “all good” and I was super excited for sex– nervous too–and exercise, and to resume tiny bits of pre-baby life.

That night I pounced on my partner as soon as the baby was asleep (for a few hours at least). We fumbled, like newbies, like we’d never had has sex before. But it quickly became clear that something was actually wrong. Not only did it hurt like hell–I sort of expected that–but it just seemed impossible that it would actually go in. As if the space for it had closed. As if there was no hole. We stopped to regroup and figure out if maybe we were doing it wrong. Maybe we forgot how things worked? We tried again. No, for sure for sure, it was physically improbable that anything was going to go in.

Am I the only one who thought that birthing a multiple-pound being would result in stretching rather than tightening?  

I asked all the moms I knew: “Did sex hurt?” All but one said, “oh yeah it hurts;” a lot, for a long time, more than a year. For some, the pain didn’t start until later, when they thought they had been spared. Some tried it once and never again. Some just never tried. A dear friend told me to keep trying, through the pain and discomfort. But who on earth enjoys sex when it hurts?!

I wrote to my doctor: “Sex isn’t working.” “Is this normal?” “How do I fix it?” My next appointment revealed that the sutures to close the gash left by my baby’s exit had healed in such a way that they created a barrier of entry. When she showed me in a mirror, it looked like the little bit of tissue that connects the bottom of your tongue to the bottom of your mouth. Like it could be plucked, like a guitar string.

“We can cut it, if you want. Or you can just try stretching by yourself.” Urgh. I was certain I didn’t want another intervention. Also, breastfeeding dries up all the nature moisture from the vagina, so she prescribed an estrogen cream (which I bought but never used because a side effect is cancer).

She referred me to a vagina therapist for the internal pain. Ok, that’s not what they are called, but they should be. Pelvic floor therapists focus on the pelvic floor, the muscles, ligaments, and nerves that hold up, like a hammock, your bladder, uterus, vagina, and anus, and help them work well (and like, not fall into one another squishing pee and poop out without your control). In some countries, like France, you get pelvic floor therapy after birth simply because EVERY WOMAN benefits from it (even if there are some sexists reasons why France does it). In the US, though, they make you go through an insane process to “figure out” what is wrong, through loops and loops of paperwork and appointments to find out why sex hurts and why you pee when you sneeze, despite the fact that pelvic floor dysfunction is extremely common, well-studied, and easy to fix through therapy, and incontinence affects 1 in 3 women! They should teach you this when you are a teen, and when you get pregnant, and it should part of postpartum care. WHY IS THIS NOT THE CASE? I read an article from the UK that said that in countries were pelvic floor therapy isn’t common there are tons of products to help women live with incontinence (pads, weird tampon thingies) while little is done to fix this super fixable problem. I wonder why… hmm….someone is making money off women’s suffering.

My vagina therapist said my pelvic floor was just dandy. She said she’d never seen such a productive and strong kegel in a woman who just gave birth (hey, I’ll take a compliment wherever I can get it). The outside tissue had great spring to it, as she depressed it, inch by inch, with a q-tip to test its response. I thought, “Yay!” But a little secret of postpartum (and parenthood in general) is that things might be fine at one point and then not fine at the next. Like, your kid might sleep through the night until 9 months and then something happens and he doesn’t anymore. Your pelvic floor is a living, thriving part of your body and if you are not actively working on it and engaging it, it will slack and make you leak and live in pain. Being fat, having bad posture, my hip and hamstring congenital issues, not working out the muscles that support all of the pelvic area, AND not having rested completely in the first few weeks of postpartum (but really, I want to punch anyone that said that to me, because not everyone has the luxury), all contribute to a further deterioration of the the pelvic floor that results in more pee and more pain. The good news is that, like the rest of our body, it can be improved through exercise and therapy.

The vagina therapist’s assessment of the bad sutures was that I needed to let them heal longer. She said the inside and the outside had healed, but not the middle (she provided no mirror for me to see). She also said that a little stretching would help. “If you bleed, you’ve gone too far.” I really should write to her and ask what she meant by “too far,” like, is it good or is it bad, because that’s what happens every time. 

Pain and discomfort make sex undesirable but they aren’t the only challenges to a healthy sex life post-baby. I mean, they are probably the most impactful, given that almost 50% of women with some kind of pelvic floor dysfunction–be it incontinence or pain–avoid intercourse. But besides being so bone-tired that nothing seems sexier than sleep; Besides the soft folds that have taken permanent residence everywhere, and especially my belly, and make me feel unsexy; Besides the mood-killing raspy snores of our baby in the crib at the foot of the bed. Besides all that, sometimes, often, it feels like I just can’t put the right cassette in, or the right CD, or whatever the hell is the millennial equivalent of putting the right tune for the right moment. I just can’t switch in and out of mommahood, and definitely not suddenly. When your boobs are food, it is hard to shift them back to being part of the sexual menu. I can’t be cleaning diapers and praying my child has an easy time going to sleep and then, just like that, become a sexual maven. Quickies, and going from zero to action, are out of the question.

I am struggling to switch the sexy on.

Even masturbation has been a challenge. We live in a tiny studio, so “me time” isn’t a thing in our household. And now, this personal experience feels just a tiny bit icky. How can I muster kinky thoughts and sensations with my child nearby? And asking my husband to take the baby so I can “do” it, just feels wrong. Both my OBGYN and my vagina therapist told me I should be doing lots of self care (and it is among my favorite kinds of sexual expressions), but I just can’t muster the sexual energy. And when I do, it feels almost like cheating to use it up rather than share this energy with my partner. I asked my husband if he could just help me masturbate, that way we could both be together (it counts, right?), but I know that when we make it happen, I will feel so guilty that it will not be fun. Feminist sexual liberation comes to mind–I should focus on my pleasure first and always–but sex is relational to me and it is an important part of our marriage and relationship.

And let’s not forget also about how married sex isn’t the same as fun, single sex. And how sometimes, despite all that he does–and it is a lot–I resent that I bear a bigger burden in child rearing than my husband. And how when we both feel misunderstood and overwhelmed, nobody really wants to have sex. And how birth control can eff your libido up, and even though we use it correctly, I am constantly terrified that I could pregnant. And how we both wish sex could happen without any effort from either one of us.

So what now? Sex impacts our overall quality of life. For me, it is something that has heavily influenced my identity and which made me a mother (I mean, I became a mother by CHOICE because I wanted to and I could, but sex was the vehicle by which that happened).

My plan is first to deal with the physical stuff and then figure out how to deal with the relationship part. Got to strengthen my pelvic floor with squats, clams, hip raises, and yes, kegels. Also, lots of stretching from the video “Down There.” Every day, 3 times a day. I gotta stay focused on exercise, focusing on strength not weight loss because I need my own sexy on. And I gotta get back to acupuncture, massage, and chiropractic work. Perhaps igniting regular, long-standing babysitting relationship would extra helpful now. Therapy might be good, but honestly I don’t have the energy to initiate the process again (go to my OBYGYN, wait 2 months to get an appointment with 1 of 2 therapists in the whole Kaiser SF system dealing with tons of women facing the same issues (again why is this not basic, routine care?), have super long sessions with my child in the room because I wouldn’t have any other way of going). And there’s also some resentment towards a medical system that through it all–pregnancy, birth, and postpartum–has never put my best interest first (and don’t get me started with how badly they were dealing with postpartum depression). I did research pelvic floor reeducation machines, a smaller version of what they use at therapy, and I might get myself one.

The relationship stuff–making the time, channeling the right sexual energy at the right time, waking up the kink–those seem a bit harder to solve, or at least not as well researched and fixable as the physical stuff.

Patience, compassion, honesty, and love will help.

Talking about it feels like a good start.

 

There will no more milk stains on the floor

I nursed my baby for the last time, uneventfully, on the morning of the first day of spring, just 2 week shy of 4 months.

I cried all day.

A new bout of mastitis had put me on my back for 2 days, my 3rd one. The fever and the pain–pain that reached back into my spine every time my son nursed–and the swollen lymph node on my armpit convinced me to call the clinic. I’d thrown everything it at it: raw garlic, honey, lime, cayenne, echinacea, probiotics, apple cider vinegar, lecithin, vitamin C, heat, massage, cold, pumping, ibuprofen, Happy Ducts, belladona. You name it, I was taking and doing it all. Finally I decided to get a 3rd and more aggressive course of antibiotics. This was going to be last one I was going to take.

Nursing was never easy for us, my child and I. It was downright traumatic, physically and mentally.

I was originally going to write about why. To justify somehow to you, to myself, and maybe even to my son when he reads this one day, why I made this decision. I was going to write about his 2 tongue tie releases and 1 lip tie release, and the 3rd, deeper, tie that we didn’t get released because we just couldn’t handle it. And about the long list of supplements and therapies I took to help with supply and fight mastitis; about how keeping up supply and fighting mastitis became my entire life and they were so fragile and vulnerable and too easy to screw up. And about how my husband and I spent over $1,500, between specialist and treatments, just to be able to feed our child from the breast. And about how my nipples were dotted with fat, shiny blisters that ripped my body in pain every time I nursed, or hugged, or showered, and how a week after not breastfeeding at all they still haven’t healed up completely. And about how my breasts didn’t respond well to pumping, and about how when I tried to exclusively pump I got mastitis. And about how my baby’s body would tense up, and how his jaw was so tight, and how his palate was domed, and how he had a gag reflex that prevented him from taking more of the breast. And about how many people helped and supported us to be able to nurse and how thankful.

I want to whine, complain, compare, and tell you just how hard I tried. I want you to believe me. 

But at the end of the day, I made a choice and it was quite simply the right choice for me.

There will be no more milk stains on the floor anymore. But there will also be no more ripping pain, no more infections, no more crying in frustration and pain, for me or my son.

I am proud of having fought so hard to give you the best, my cacahuatito, and also proud that I finally figured out when the best might not be what I imagined.

 

I am mother

I had a list of affirmations for the birth of my child. At the babyshower, people wrote them on big cardstock so I could hang them up as a banner when it was time. But when I got home that evening I found a new affirmation, one that I didn’t write or expect, and that really rattled me: “I am mother.” Nope. Not going on my banner.

I wanted my pregnancy to be low key. People all over the world, across the entire expanse of time we’ve been a species in this world, have had babies and continued their normal lives. That’s what I wanted. I kept going to the gym, eating how I normally ate, doing basically all the same things (except no alcohol and yes prenatal pills). I wanted to feel “normal.” I wanted the transition to feel easy and uneventful.  

With my mom’s Alzheimer’s progressing and the beginning of my own new role as a mother, I felt sandwiched between grief and a need to assert my motherhood as very different than my mom’s. Calls home became fewer and more traumatic; my dad demanded I focus on my mom’s sickness and I refused to talk about my pregnancy but demanded to be treated gently as I was knee-deep into the throngs of its hormone-induced madness. I wanted to pretend everything was fine, nothing to see here: no sick mom, no loss, no fear.

The birth experience was both what I expected and planned for. I thoroughly believed and continue to believe that this is what our bodies are made for but it also left me feeling powerless; not because of anything external, but because the very nature of labor is the loss of control and I resented that. Hypnobirthing helped me work through the opening and effacing. I could see the muscles working, the baby working his way down as he should, the cervix opening and disappearing to make room. I was proud that I was able to manage the waves with focus and strength. What I didn’t expect, and I guess, how could one, was the viscerality and vulnerability of pushing the baby out. Natural, my ass. How did we evolve to push a creature through tissue that isn’t flexible, past bones that can only move a little, ripping, bleeding, burning?

And then he came, my beautiful child. I don’t remember much about this moment with him, because just as he was placed on me, the resident plunged her hands deep inside me again to stop what my midwives called “significant” bleeding and sew me up. It’s all very vivid in my memory. More vivid than the birth. Lots of things were lobbed at me right at this moment: that I was diagnosed with gestational hypertension late during the labor, that my baby was small and was phlegmy, that I ripped a lot, that they used a lot of material in the sutures, that my baby couldn’t latch (later we learned it was because he had several tongue ties). My nature is to focus on the negative and this was no different. Where was the avalanche of “happy hormones” washing over me, making me love everything and everyone? Wasn’t that why I worked so hard for an unmedicated vaginal birth?

The hospital stay was a whirlwind. Every single person that came into our room had totally different advice, different concerns, different bedside manners but everyone pretty much magnified our ineptitud and scared the crap out of us. Every new worry built up from the previous one until it felt like we had entered a new reality filled with dangers and no sleep. Somehow everybody feels it is duty to inform you that you won’t sleep for a while. Each time the effect was to make us feel like we were fucked.

At home, we were zombies. Despite “knowing” what we should do –nurse, change, bounce, skin-to-skin– this little crying baby baffled us. The baby blues, 3 skips into full postpartum depression, got a hold of me. I was consumed with the permanence of this change, the inmensity, the feeling that, despite what my brain was telling me, it would always be this tough and we would always be so bad at it and that it would never improve. Sleep deprivation fucks you up.

One night, I woke up in the middle of the night to a crying baby that I had to feed with my aching boobs. Sitting on the toilet to pee before I set myself up with every pillow in our apartment, I looked down at my right boob, lovingly called Sofia, which was throbbing, and, panicked, I thought the boob was my baby. “I lost my baby’s mouth! I lost his nose! How will he survive!?” It took me a full minute to realize that Sofia was just a boob.

There’s so much I thought I knew about breastfeeding and none of it mattered. I had no idea what supply meant, when my let down happened or how it worked, and how to “stuff the nipple like a sandwich” into the baby’s mouth. I cleaned a good portion of our hardwood floors with my breastmilk, chasing the random droplets on the floor until I realized they were coming from my body. I tried all kinds of positions but it was gamble every time; sometimes it was ok, sometimes it wasn’t. Baby cried a lot a lot, and it turns out that it was because despite spending hours and hours on the boob, he wasn’t getting enough milk. His tongue couldn’t really do the motions. He had a tongue tie.

Depression hit me hard between week 1 and 2. My sister Tere held me softly as I cried and cried, sorrowful tears of loss and fear and… was it despair? I know that doesn’t match up with what was expected of me. I should be joyful. I should be thankful. I should feel magical, lucid love. But I didn’t. When Elkin returned from the gym one day, he found me gripped with such an immense depression that we both got really scared. This was not normal. I stopped taking my placenta pills. I made an appointment for acupuncture the next day. I am still immensely thankful that Elkin was willing to stay with our son, alone, for my hour-long visits to the community clinic.

Postpartum surprised me. Like breastfeeding, it is built on perfect scenarios that at least for me were basically impossible to meet. You have to be nailing the breastfeeding for one, and somehow be able to do it lying down so as to not put pressure on your hoo-ha. Nope. Your partner has to know how to care for the baby with an expertise they never had before and which is nearly impossible to acquire alone. So, nope. You have to eat “right” and drink tons and tons of water when you barely know what day it is, who you are, or how to get food, not just how to get it into your home but how to get it into your belly –we barely had time to physically get the food into our mouths and in a world of competing priorities, sleep was significantly more important than food. Another no. You have to somehow be able to rest when there are way too many things to do (many, many more than your partner can do) and your mind is going a mile a minute trying to grapple with everything that’s happening with the baby and to you. And you’re supposed to stay at home even though the most import element of your depression self-care is to get sunshine and fresh air, and to exercise. And then there is the bleeding; for weeks on end – where is all this damn blood coming from? You are told that if you don’t rest completely, which it’s already clear is simply not possible for you, you will have incontinence and get mastitis. You get mastitis, mostly because you do not understand breastfeeding; possibly because you didn’t rest enough. Nope. Nope. Nope.

Then things did start to improve. Improve in some way and become more challenging in others. I always laugh when people say it gets better at x weeks; and then you get to x weeks and it isn’t better and then they say, “it gets better at x months.” Always later and later until you realize, it doesn’t quite get better because “better” is actually just “different.”

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But the most important shift to make things better for me was in fact already taking place. I realized that while I expected motherhood to be epic and life-changing, I actually believed that things would go back to normal; that I would go back to normal; that I would go back to being Miri, Miri plus, now as a mother, but still very much myself. And the truth is, there is no such thing. There is no going back, there is only moving forward into a new identity, alongside this new person who I am getting to know and love. I grieved that change because that is just how I relate to the world, in constant grief. And because the feedback loop with my child, my very sensitive, vocal child, isn’t there yet; he doesn’t yet hangout or laugh. But the end of the day, as my sense of self shifts, becoming both larger and smaller than my previous identities, I am, rather slowly, embracing this new one: I am mother. I am mother. I am mother.

 

A planned surprise: Pregnancy!

I misread the pregnancy test.

The 2nd line was so faint that I assumed it was an error: the test had expired a couple of years earlier (my older sister gave it to me); I peed in the afternoon instead of in the am, when it is recommended; I thought I was infertile.

So out we went for margaritas.

In wee hours of the night I woke up with a thought: could that faint line mean something? I dug up the test from the trash and got googling. It turns out, lots of women misread their pregnancy tests. Not only, as you might assume, because we are dimwits, but also because it takes time for pregnancy hormones to show up on a test, and you might not be expecting the news, and tests do sometimes fail. So I jostled my poor husband awake and told him the news–he was groggy and confused but supportive, and patted me sweetly on the belly before going back to sleep. I proceeded to stare at the ceiling in terror.

Oh.my.god.

When I was 15, a respected–and expensive–gynecologists in my hometown in Mexico told me, point blank: “You are infertile.” He based his “expert” opinion on the fact that my period wasn’t regular (which is common in teenagers, as you would assume), I had polycystic syndrome (which does cause fertility issues but is treatable), and my uterus was slightly tilted (which is a common variance that has no effect on conception). I have no faith in Mexican doctors, and was on birth control most of my adult life, clearly believing it was necessary, yet I still harbored the idea that pregnancy wouldn’t be possible for me.

When my husband and I decided I would go off the pill, it was under the belief that it would take a year to get pregnant, if it was possible. I even transferred into his health insurance plan because, unlike my work one, it offered infertility coverage. We didn’t check what it covered for labor and delivery.

As luck would have it, I got pregnant the very first month we tried.

There’s an expression in Spanish that really conveys how I felt and continue to feel: “sentimientos encontrados.” The comparable expression in English would be “mixed feelings,” but to me, the English expression means feelings are all jumbled together, bleeding into each other, fighting, conflicted. The Spanish expression is more like these feelings all meet up in the middle, cramped into a tiny space right at the mouth of the gut, and are looking at each other in shock. Glee, sadness, fear, love, panic, excitement, confusion.

How did we get here?

The first people I told about my pregnancy were people who I knew could and would recognize, accept, reflect, and support the complexity of what I was feeling rather than oversimplify it. I am also lucky to have as friends so many of my co-workers, and to work in an organization that develops many incredibly useful, and women-centered materials on reproductive health, pregnancy, and birth; they were all supportive, helpful, and compassionate. Both the people, and the books.

As an existentialist, nothing would catapult me deeper into a crisis than knowing I was having a boy. In addition to all the common fears–money, where to live, daycare, a body that didn’t feel mine anymore, labor, romance and sex now and after birth, family, global warming, health insurance, chemicals, virulent anti-facts movement, racism, name–suddenly I now had to worry about machismo, male role models, challenges towards equal fatherhood, rape culture, the Principito complex, toxic masculinity, violence, emotional maturity and language, Latino homophobia and misogyny, penises…

I was taught. and have taught my nieces, to fight the system. But, could I help create a new one by raising a feminist son, alongside my husband, in a toxic male-dominated society?

Perhaps what scares me the most is ceasing to exist to others as myself and now existing solely as a mother, in relation to another being. It is similar to why being introduced as someone’s wife also annoys me. As a fetus grows inside of me, I am now a vessel, solely responsible for everything that happens to it, seen as a bad mother for accidentally walking into cigarette smoke without noticing or because I drank when I didn’t yet know I was pregnant or because I really, really want an ice-cold michelada or 2 right now, and because I am now supposed to think and pray and worry only about it, and then me, but only in relation to it.

When I was getting a couple’s massage with my husband last week, one of the masseuses asked us to breathe into the part of the body that was most ailing us. My lower back was rocking me–I have 2 herniated discs on one side and sciatica on the other–but before I could send my sweet, sweet breath there, now bunching up, impatient, in my belly, the masseuse said to me, “you, send your breath to your baby.” It took me by surprise, but I sent it to where I was hurting anyways.

I am also deeply annoyed at people’s beliefs about pregnancy and the utter, fantastical mythology and misconceptions many hold, an obvious and emblematic symptom of deeply entrenched misogyny, particularly in Latino culture. For an experience that every human goes through (we are all birthed), and which such a large percentage of humanity endures (women make up 50% of the population and many will be pregnant at least once), it is shocking how little we know and how easily we believe in crap and repeat things that cannot logically happen to every woman everywhere. I’ve been in circles of mothers who shout out absolutes: “All first borns come late!” “All boys make round bellies!” “Fat women don’t show early!” “All of this kind of food is good/bad!” “If you do this/if you don’t do this, you will have a painless labor!” while in their very next breath they share something from their own personal experience that completely negates what they just said. All I keep repeating is: the one constant is that everybody is different.

With a “geriatric pregnancy” and as an “obese” woman I also have to deal with a bunch of other stigmas, many, coming directly from my doctor’s office. I was told I shouldn’t gain more than 11 pounds (5 kg), but wasn’t told why this was going to be such a carefully measured and guilt-inducing metric (though thanks to Emily Oster’s Expecting Better, I understand the debate a bit more). While we all can agree that gaining 50 lbs, pregnancy or not, isn’t healthy, and there is some data showing that staying within the the Institute of Medicine’s recommended ranges (11-20 lbs for my BMI)–though there is still lots of debate–has the best outcomes for mom and baby, the best approach would be to focus on helping pregnant women figure out how to increase nutrition-dense foods, water intake, and exercise,  rather than emphasize a number on the scale or pushing women to count calories, as my OBGYN recommended for me. The whole medical system should be better adept at providing support and guidance that reflects knowledge and compassion of the person’s habits, reality, capabilities, and desires–not a blanket, one-size-fits-all recommendation.

I am also convinced the scale at the hospital is off, so I am keeping a photo and journal record of my weight gain. Every time I’ve been weighed at my doctor’s office, I am 2-3 pounds heavier than what I recorded just the day before at the gym (and I wear my lightest clothing and shoes when I go to the doctor). Body and weight-shaming rarely work to promote healthy weight and can actually harm pregnant women’s sense of well-being and esteem. Harm all people, really.

While many will judge me for choosing to refer to the product of this pregnancy as a fetus (which it is, factually-speaking) or because I am not tripping over words like “blessing” and “my all” and “god’s gift,” the reality is that pregnancy, labor, and parenthood, and all the feelings, thoughts, and expectations associated with it–in addition to the irrefutable reality of how it plays out for us–is a unique and individual experience, while also one of the most central to our humanity. There are smug mothers, and mothers with a certain economic and social status that will tell you how it should be done; there are ones that read all the books and ones that don’t; there are ones that collapse inward and others that reach out to connect to the collective experience; there are ones that dreamed of being at this stage and ones that never imagine it.  There is no right way, no single way, no perfect way to experience this.

As a sense of fierce determination begins to develop inside of me, born from a gamut of what I can only call “pregger harassment,” I welcome the supportive, compassionate, and loving and I reject the unhelpful, butting, uninformed, ill-informed, judge-y, sexist, unkind, and unaware.

For now, let me get back to my grapefruit and rockaleta cravings.