Destigmatizing Sexual Health & Wellness In Motherhood DAY 6: Explore how the medical system contributes to stigma of maternal sexual health & wellness
The medical system plays a huge role in stigmatizing maternal sexual health and wellness. From skipping conversations about intimacy, libido, and body image to dismissing moms’ concerns, it sends the message that their sexual health doesn’t matter. In this blog, we’ll dive into how these gaps in care contribute to stigma and why it’s time for the system to step up for moms.
Pregnancy
Prenatal care focuses almost entirely on the baby, leaving the mother’s sexual, emotional, and physical health overlooked. Providers rarely discuss how pregnancy impacts libido, comfort, or intimacy, and parents are left to navigate these changes on their own. Whether someone is feeling more sexual desire, less, or none at all, moms often end up blaming themselves for any tension in their relationships.
To make matters worse, healthcare visits are short—often just 10-15 minutes. In a for-profit system fueled by capitalism, providers are forced to cram in as many patients as possible to meet the demands of insurance companies. This doesn’t leave time for education or meaningful conversations about anything, especially not how pregnancy affects someone’s sense of self, their relationships, libido, arousal, pleasure, etc.
Racial and socioeconomic inequities make these issues worse. Black women, for example, are more likely to have their concerns dismissed or ignored by providers, leaving them even less supported during pregnancy. On top of that, the system assumes heterosexual relationships, offering little to no relevant guidance for LGBTQ+ parents.
1 in 5 U.S. Moms report being mistreated by providers during their prenatal and birth care.
Labor & Birth Education & Preparation
When it comes to preparing for labor and birth, discussion about sexual health remains absent. Prenatal classes focus on preparation of the practicalities of labor and birth, caring for baby, lactation, etc. Education does not address how birth can affect their sexual health physically and/or emotionally . Providers, nurses, doulas, and childbirth educators seldom talk about how the labor and birth process can affect body image, sexuality, intimacy, and relationships. Nor do they give any information about sexual health in the postpartum period.
And let’s be real, partners surely aren’t getting much guidance either. Discussions about how to maintain emotional and physical connection during pregnancy and postpartum are basically non-existent. This lack of support creates a perfect storm of stress and miscommunication for couples, leaving moms feeling like the burden is all on them.
Labor and Birth
Labor and birth can be physically and emotionally traumatic, especially when providers don’t prioritize informed consent or shared decision-making. Too often, moms are pressured into interventions they don’t fully understand, and when they express concerns, they’re dismissed.
Birth trauma isn’t just about what happens physically, it's about feeling powerless or unheard during one of the most vulnerable moments of your life. Providers not only often fail to acknowledge or offer support for birth related trauma, they sometimes contribute to trauma. When someone has a difficult or traumatic birth, both the physical and emotional impact on their sexual health is often ignored. This can leave moms feeling dismissed and/or ashamed, and perpetuates stigma. Trauma has a huge impact on sexual health and wellness for moms, and contributes to chronic pelvic pain, avoidance of pelvic exams, increased rate of sexually transmitted infections, and unintended pregnancies.
Even for those who don’t have a traumatic birth, the lack of guidance about postpartum sexual health leaves many moms confused and unprepared. Most sexual health related education after birth is stripped down to “don’t have sex for six weeks,” with no real talk about how childbirth can affect things like body image, comfort, ibido, or intimacy. On top of that, hospitals often push birth control methods, like IUDs, right after delivery, without fully explaining the risks (including how they can affect sexuality).
To be clear, we fully support access to birth control—when it’s offered with full, true informed consent. Unfortunately, this is often not the case. This issue is even worse for Black, Latina, young, and low-income women, who are more likely to have doctors push these methods on them or even refuse to remove an IUD when they ask.
This lack of respect and information takes away control over their own bodies and leaves moms feeling unsupported. Without real conversations or care, postpartum sexual health gets ignored, making moms feel like their struggles don’t matter.
Postpartum
The six-week postpartum visit is the epitome of "let’s do the bare minimum." This visit is often the only postpartum visit a mom/birthing person has after their birth. Just like prenatal visits, this visit is often limited to an insultingly short slot of time that is not long enough to holistically (meaning whole-person, not the conspiracy woo-anon co-opted version of the word holistic) provide the physical and emotional assessment, support, and education needed postpartum people need and deserve. If sex is discussed, it is usually giving “clearance” to resume sexual activity.This clearance usually comes with a strong emphasis (and sometimes coercion) on starting a prescription based birth control ASAP in order to prevent pregnancy. The pregnancy prevention conversation often leaves out the recommendations for optimal pregnancy spacing for better health outcomes for moms and future babies. The omission of this conversation misses a key opportunity to discuss the realistic length of time it takes to truly fully recover from pregnancy and birth (upwards of a year for most people) and how it is normal feel like a stranger in your body and how important it is to be kind and gentle, physically and emotionally to yourself.
Also not mentioned in the ‘clearance’ is any guidance that addresses pain, pelvic floor issues, emotional readiness, how hormones affect libido and arousal, how lactation can also affect your sex life, etc. This lack of discussion on postpartum sexual health can leave moms feeling unsupported, ashamed, and embarrassed to seek help, especially when their sex life doesn’t go back to what it was pre-pregnancy (fyi, it almost NEVER does!).
83% of postpartum women experience sexual dysfunction, yet most don’t receive the care they need.
Matrescence and Motherhood
Matrescence, the process of becoming a mother, changes everything—your body, emotions, relationships, and identity. Just as adolescence is a developmental stage of transition, matrescence is the developmental stage of becoming a mother. But the medical system doesn’t acknowledge it. Most providers have never even heard of the term matrescence, let alone understand its impact on mental health and sexual health and wellness.
Motherhood, in general, is a time of immense pressure, with unrealistic expectations to be and do everything for everyone. Moms carry 60-70% of the mental load in their households. This invisible labor drains energy, leads to poor sleep, stress, burnout, and poor physical and mental health. Societal pressure to “bounce back” adds to the shame, leaving moms feeling like they’re failing when their bodies and sex life don’t return to pre-baby norms. Of course all of this has an effect on maternal sexual health and wellness. When healthcare providers who regularly see women who are mothers, such as GYN providers, PCPs, pelvic floor PTs, mental health providers, etc., do not fully understand how matrescence and motherhood can impact maternal sexual health and wellness, it is a HUGE disservice to moms. Visits with these types of providers are missing key opportunities for discussion and education about maternal sexual health and wellness.
Obviously the blame is not solely on providers. Our Insurance-driven ‘health’care system is not designed to provide the space and time for the support that mothers deserve. The rushed visits with healthcare providers leave no time to discuss how matrescence and motherhood affect intimacy, body image, libido, sexuality, etc. Without these conversations, moms feel unsupported and assume something is wrong with them, or that their struggles are unimportant, reinforcing stigma around maternal sexuality. Society’s unrealistic expectations for moms only deepen this shame, making it even harder to ask for help.
Systemic Failures: Training, Bias, and Inequities
Let’s address the underlying issue: maternal sexual health is not a priority in our healthcare system, and moms are paying the price. Most providers aren’t trained to address sexual health beyond contraception and disease prevention. Without proper education it is no surprise that OBGYN providers are not adequately (if at all) discussing changes in intimacy, libido, or body image. This silence on sexual health leaves moms feeling lost, unsupported, and ashamed, reinforcing the stigma that their sexual health isn’t important.
Formal sexual health programs are only required in 50% of med schools.
Systemic bias in healthcare makes the stigma around maternal sexual health even worse. Black and brown mothers are more likely to have their concerns dismissed, especially when it comes to issues like sexual pain, changes in libido, and intimacy struggles. Meanwhile, LGBTQ+ parents are often excluded from the conversation entirely because providers assume all families are heterosexual. This lack of inclusive, culturally competent care not only ignores moms’ sexual health but also alienates entire communities, leaving parents without the support they need.
We can’t reiterate enough the role of insurance companies. In a for-profit healthcare system, rushed visits leave no room for providers to explore vulnerable topics like sexual health. Even when moms want specialized care, insurance often denies access to pelvic floor therapy, sexual health experts, or mental health providers who understand the intersection of matrescence and intimacy. Moms are left fighting for services and supprt that should be basic standard of care.
And now, with reproductive freedoms under attack more than ever, the situation is growing worse. Governments are making it harder for people to access basic healthcare, from contraception to abortion, further stigmatizing moms’ autonomy and sexual health. Project 2025 takes this even further by aiming to classify basic sexual health education as “pornography” while pushing to make pornography illegal. This dangerous agenda not only restricts access to essential health education but also deepens the shame and barriers moms face when seeking help for maternal sexual health challenges.
Final Thoughts
The medical system has failed moms by ignoring their sexual health and wellness, but it doesn’t have to stay this way. From pregnancy to postpartum and beyond, moms deserve care that values their whole well-being, including their intimacy, libido, and body image. To break the stigma, we need better provider training, inclusive care, and systemic reforms that prioritize moms’ needs, not just profits. Your sexual health matters, and by demanding better care and having these conversations, we can start creating the change moms deserve.
