Sex After Loss
I was 16 weeks pregnant when blood trickled from my vagina and down my inner thighs. Alone in the bathroom of my dermatologist’s office for a routine appointment, I quickly cleaned up and called my obstetrician. “Did you have sex last night?” No. “Did you exercise this morning?” No. “Come on in and we’ll check things out.” At the appointment, I heard the heartbeat and was told to wait and see. But somehow I already knew: this was the beginning of the end.
If I wipe, I wondered, will there be more blood? Maybe I can just not pee somehow?
Two days later, my body expelled the fetus. Hemorrhaging after cutting the umbilical cord myself, I called my husband, shrieking into the phone. He rushed home and took me to the doctor’s office, where the obstetrician gave me the choice to wait for anesthesiology, which would then include a mandatory blood transfusion, or to go ahead with an emergency unmedicated D&C. I asked what the latter would mean.
“It’ll be about 15 minutes of pulling the rest of the pregnancy out,” my doctor said. “You’ll experience a tugging sensation. The bleeding won’t stop until we do this.”
I opted to just get it over with. Nothing could be worse than what’s already happened, I thought, I can handle anything now. But I’ll never forget the sound of that machine, and the feeling of its tugging. The doctor used it to extract the placenta, a pulsing red mass, then waved smelling salts near my face. A friend took a picture of the fetus, and then the world went dark.
Two weeks later, my doctor called with testing results: There had been an extra chromosome. Approximately 80 percent of miscarriages are a result of this kind of chromosomal defect in the embryo. “This is a normative outcome of pregnancy,” my doctor reiterated. “Your body is working.”
Pregnancy loss is often associated with feelings of body betrayal — a foreboding sense that the body has “failed” or isn’t doing something it’s supposed to do. One common side effect is for women to retreat from sex. As a psychologist who specializes in women’s reproductive and maternal mental health, I saw this for years before experiencing it myself.
Women who’d gone through miscarriage came to me expressing how sex was the last thing they wanted, how feeling like their bodies didn’t work erased the desire for intimacy. Some were afraid sex might lead to another loss, or felt guilty about not being intimate with their partners. Each time, I’d encourage them to trust their body, and their schedule. If you don’t want to have sex, I told them, don’t.
And then I was them. I knew my body worked; I knew there was nothing unnatural or not normal about it. But I was terrified to have sex with my husband.
After all the wreckage, I was afraid penetration might hurt in more ways than one. Would it evoke flashbacks of what had slipped out? Conjure the invasiveness of the D&C, me lying splay-legged on the table? The pregnancy loss had polarized my husband and me, revealing the fundamental differences in our experience — his vaguer sadness and support was something altogether different from my trauma. And so our intimacy came through holding hands, lying chastely side by side. I wanted to be close to my husband, but my sexual appetite was not hungry for him.
When three months had gone by, my doctor gave my body the all-clear. I was still reeling, with no desire for sex — specifically, the kind that could make a baby. But I also knew that if we wanted another child, we had to get a move on.
Reluctantly, we went through the motions. The sex was mechanical. Like everything else back then, it felt like something I simply had to live through. For the first time in my life, orgasming was off the table.
Achieving orgasm during sex had never been a problem for me. When I was 16 or 17, my sister educated me about its importance: “Orgasm is a must, not an option.” I studied my vulva, my breasts, my hips, my lips in the mirror, explored them with my hands. I learned what felt best. I showed my partners what I wanted. I was playful, uninhibited — sex as pure pleasure always came easily.
For a little while, my miscarriage took that from me. I didn’t climax. I’d never had any hang-ups about sex, but now that it was tied so clearly to conception, everything had changed.
Somehow, I felt like experiencing pleasure with the goal of getting pregnant again was a betrayal of the baby we never got to have. It was one thing for me to masturbate in order to fall asleep, and something else to try to replace that loss with another pregnancy.
This was purposeful sex, a means to an end. A chance at creating another life, but also a chance we could lose once again. I wanted to want it, but mostly, I wanted it to be over.
I was lucky: I got pregnant again quickly, on our second try. But throughout the pregnancy, I refrained from sex out of fear. I wasn’t afraid of orgasm, though, and found my pleasure there, alone. Fourteen months after my miscarriage, I gave birth to a healthy baby girl, and in the years that followed, time softened the sharp edges of my grief. Eventually, my husband and I — especially — came back to sex for sex’s sake.
This piece was originally featured on The Cut and republished with permission from Dr. Jessica Zucker.
Dr. Jessica Zucker is a Los Angeles-based licensed clinical psychologist specializing in women’s reproductive and maternal mental health. Jessica primarily works with women struggling with fertility, pregnancy ambivalence, pregnancy loss, during transitions in motherhood, prenatal and postpartum adjustments, perinatal and postpartum mood and anxiety disorders, pregnancy and postpartum body image concerns, and in the midst of relationship challenges after the loss or birth of a child.
Jessica has contributed to myriad publications, including: The New York Times, The Washington Post, New York Magazine, The Guardian, BuzzFeed, TIME, Glamour, Refinery29, Ladies’ Home Journal, Mashable, among others. Dr. Zucker is the creator of the #IHadaMiscarriage campaign. She serves on the Medical Advisory Council of Every Mother Counts, an organization dedicated to maternal health created by Christy Turlington Burns and is a Community Advisor at LOOM. She also contributed to PBS’s This Emotional Life, where she helped create the award-winning Early Childhood Attachment Toolkit distributed to women in hospitals, birth centers, and pediatricians offices across the country. Her research on women’s health culminated in an award-winning dissertation and a book chapter in an anthology. In addition, Jessica has contributed to several books pertaining to the maternal mental health landscape. Dr. Zucker has been featured on Good Morning America, CNN, Inside Edition, and NPR.