Intimacy and Postpartum Depression After an Ectopic Pregnancy

The first thing you're told when you're pregnant, or after you've delivered a baby (alive or deceased, vaginally or via cesarean section) is that you can't be intimate with your partner for at least 6 weeks. It takes your body that much time to heal into a semi-functional, reliable place where having sex is both safe and pleasurable.

I've had 2 very different experiences with this across my 3 pregnancies, and intuition tells me that it's due to the way the pregnancies ended, but that’s never been confirmed by a professional.

Intimacy after pregnancy and giving birth

After my living daughter was born at 35 weeks and 5 days gestation, my whole life and my entire body became hers. Between breastfeeding and pumping and snuggling, I was almost always in physical contact with her. However, my husband did as much as he could, and watching him become this engaged, tender, loving father made him even more attractive to me.

To be honest, we broke the 6-week recommendation by about a week – but it all ended up fine. And for a few months, we had the best intimate connection of our relationship because it was illuminated and tied to the most amazing thing we'd ever done – create, grow, deliver, and begin to raise our daughter.

The impact of trauma and postpartum depression

After that season, I experienced several additional rounds of IVF and two early miscarriages before getting pregnant with twins. Devastatingly, I delivered those twins alone at home in my bathroom at just 11 weeks gestation, and that changed me for good.

I had no desire to be touched, I was afraid to be intimate, and I couldn't get it out of my mind that death had just come out of my body. I did not under any circumstances want to put anything back in there.

My husband and I worked for a long time to move through this phase and we did get to the other side, until I experienced an extremely surprising ectopic pregnancy earlier this year. Now, we've found ourselves back to the challenge of struggling with postpartum depression, the death of our baby, and quite frankly, the missing sense of connection and intimacy plaguing our relationship.

Open communication through postpartum depression

We are very lucky to be in a relationship that comes with open and honest conversation and understanding, and by now we've talked through so much of this, but I wanted to share some strategies that might help you and your partner realign while living with postpartum depression, again, regardless of when or how your baby(ies) left your body.

6 strategies for approaching intimacy

1. Of course, prioritize physical healing. The 6-week rule is a little different for pregnancy loss or an ectopic pregnancy – but regardless, there is a significant amount of time and energy the body requires to heal. Both partners need to identify and respect that.
2. The emotional impact on the birthing person is sometimes even bigger than the physical impact. This is critical for both parents to understand – the grief, fear, and sadness that may become attached to sex are things that will have to be worked through before physical intimacy feels pleasurable or even desirable.
3. Maintain open communication. lying or skating around the truth doesn't help you or your partner or your attempt to bond. If you're not ready, or if things that used to feel good don't feel good anymore, it's essential to talk about them.
4. Utilize resources – books, support groups, therapists, couples therapists, sex therapists, pelvic floor therapists. Draw on external parties who understand not only how an ectopic pregnancy affects the body and the ability and desire for intimacy, but how important re-establishing connection afterwards truly is.
5. Ease your way back into intimacy. For my partner and I, this has meant a lot of making out and cuddling on the couch. Those things feel safe to me, and come with a sense of intimacy, but don't push any of my boundaries (or even require me to take off my clothes and see my body - the thing that just betrayed me the most).
6. Ensure to block off quality time to spend with your partner, even in non-intimate ways. Go to the grocery store together. Go for a walk. Sit in a coffee shop with journals or your favorite books. Be patient with yourself and each other, and understand that in many ways, you're being asked to re-establish the intimacy you began growing at the very beginning of your relationship.

Intimacy challenges with postpartum depression

I'll be honest here – coming back to intimacy while struggling with postpartum depression after my ectopic pregnancy has been one of the biggest obstacles within my marriage. My husband has been extremely patient, but the complexity of emotions I’ve experienced need much gentle support, hand holding, honest conversation, time and patience.

If you've managed a postpartum mood or anxiety disorder after an ectopic pregnancy or pregnancy loss, how have you worked your way back to intimacy with your partner? I encourage you to share your own story.