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Episode 64  -  intimacy after childbirt
an interview
with dr.rachelollivier

Melany Krangle & Suzie Sheckter

Suzie: Welcome to sharing my truth with Mel and Suzie, the uncensored version where we bear it all.

Mel : We do.

Dr.Rachel Ollivier: 1234.

Suzie: And welcome back to sharing my truth pod. It's Mel and Suzie. And here's a cute little friendly reminder to give this podcast five stars and thumbs up and subscribe rate review subscribe Share hi.

Dr.Rachel Ollivier: Hi, babes.

Mel : Hello, Danny. How are you? I'm fine. Apparently, I'm recording this from Houston, Texas.

Dr.Rachel Ollivier: I know.

Suzie: Well, I thought we'd get a little country in here because I'm feeling like I'm riding a bull, but I wish I was.

Mel : That's just something you do come from the part of Canada that they wear cowboy hats. I know.

Suzie: It's the Texas of Canada.

Mel : It is, isn't it? It is. The Montana of Canada.

Suzie: Politics. It's the, the.

Mel : They've got the whole thing going on. The hats, the boots and the boots. Kind of shaggy like the horses. Horses and the whole.

Suzie: God, I miss Alberta, man, it's like Yellowstone.

Mel : Did you ever watch it?

Suzie: Of course I watch it. Kevin Costner. Oh my God, does he burn my loins?

Mel : I will burn your loins.

Suzie: Tell you, he is pretty hot. I will let you know about that.

Mel : And I'm actually distraught that it's finished and he's left because it's nothing without him.

Suzie: Is it done?

Mel : Yeah. Thinking.

Suzie: Realize. Yeah, Willie.

Mel : Not very relevant.

Suzie: Deserves it for that ****. Anyways, he's got a lot of children.

Mel : He's just got divorced, so maybe you've got a chance.

Suzie: Okay, well, speaking about children, our episode, yes.

Mel : Is about intimacy after birth.

Suzie: Thank you, Mel. Because you're the only one of us who has had a birth or two. Yes, but we actually had the most amazing little guest on Dr.Rachel Olivier. I'm probably butchering her last name.

Mel : Doctor.

Suzie: Excuse me, what? Doctor?

Mel : She literally had a PhD.

Suzie: She's 29. It's wild. I feel like extremely unaccomplished compared. But yeah, she's amazing. She has so much knowledge about sex education, sex in general, just birth mothers, women. You could ask her anything and she has an answer for it. It's amazing.

Mel : Yeah.

Dr.Rachel Ollivier: I don't know.

Mel : Yeah, she does. And I mean, it's great that people are talking about this stuff because they didn't. And I'm not sure how much they are doing at the moment other than I don't know how many Rachel's there are out there. But I don't think it's like anything. When you have a baby, you don't think about all this stuff. It's like anything in life it happens. Then you're like, oh, okay, what does this mean? Where do we go with this? And intimacy and sex after birth is not high up on your list of priorities. No, it's pretty far down.

Suzie: Because obviously I am not a mother. No, but you are not. But except for a doggy mummy practicing my offer, say. But yeah. No, I can't even imagine a ***** inserting my holes after giving birth to a watermelon.

Mel : Yeah.

Suzie: That is insanity.

Mel : My two children were quite big. Eight pounds nine and eight pounds six for my size. But I've had friends who, some of my friends had babies. One of my friends had a ten pound one of my boys and she had a vaginal birth and I had two caesareans. So I didn't have the kind of splitting of the hoohah.

Suzie: The hoohah.

Mel : But a lot of my friends did. And I can't actually even imagine how terrifying it is when it's happening. And then to have it sewn back up. And the reality is, let's be frank, obviously that changes the sensations, the feelings you have down there. Obviously. Let's not put too fine a point on it, Susie. Your whole is so obviously I don't think your partner, if you have a male partner, that's not something that he's thought about. Oh, the feeling for him will also be different. I mean they're actual practical realities. And then the fact that when you've had a baby, you hurt physically. You're not like, oh, let's go and run a marathon type. Yeah. And having a sort of eight hour tantric sex session is not what you want. You can barely have time to have a shower, a cup of tea and something to eat. So sex is far down that. And then you don't sleep. And I'm selling this to you, aren't I?

Suzie: Yeah, I'm absolutely never.

Mel : And then sex, sex and intimacy, it doesn't have to necessarily be sex, but it takes time. It's time out of your day. And if you're tired, I mean, we know just in everyday life, if you're tired, goes flying out the window and if you're annoyed with somebody or you're tired, you're like, oh, just leave me alone.

Suzie: And the hormones in that and the.

Mel : Hormones and the whole thing. And if we talk about men, I think men are not, we're not helping them actually be prepared for how we're going to change because we don't know. So if there was some actual education, like I had classes in the States, I think it's called Lamar's. I don't know what it's called here.

Suzie: I think it's the same thing.

Mel : Yeah. I don't know if they know. They obviously tell you about the way you might feel or they did in my day, like afterwards, and there was a focus on postnatal depression and helping with the baby and blah, blah, blah, but nothing prepares you for it. So having the baby is the shock. The fact that this baby's come out of you is like a mega shock. And then everything. I mean, sex is just far away and it can cause obviously massive problems and it can end marriages, not necessarily at that point, but it can end, or relationships or whatever, it can end them in a very slow, painful way in a sense, because the longer it goes on and you don't talk about it, the worse it gets, the more problems you have.

Suzie: Well, and that's why people like Miss Doctor Rachel exist. And that's exactly what she's researching on and what she's done all of her research and it's amazing how much more help there is and what a brighter future for sex after birth is. And I mean, what I loved about the conversation, and you guys will hear in a moment, is like she talks about masturbation, which I love, and that was a question of mine. Is your ******** even okay after birth? And obviously, do you even get horny? There's just so many things after birth that I'm sure change, but you're a human and obviously you want to be touched still. It's crazy. I just can't imagine.

Mel : Yeah, but no, it's great that people are having these conversations and I think it leads into all the other conversations in a woman's life. Like the fact that women don't know about enough about later life, like perimenopause, menopause, they don't know enough about birth, they don't know enough about postnatal depression until it's actually happening to you. And I know it's a thing with women is that we actually don't really care and we think, oh, that's a long way away, but actually nothing is really a long way away and you'll get to it and it'll happen and you'll be totally unprepared and you won't know. But the fact that we're having more conversations that we didn't have in the past, obviously, stuff like sex toys and people actually even uttering the word masturbation is much more in the mainstream. It's very helpful for young women and at least they'll know if they're feeling different and they're worried about their partner and that they can talk to somebody and they're not actually going mad. And I think that's really important. And even for the partner, think can be quite isolating, right? Absolutely.

Suzie: Like, they don't know how to help.

Mel : No. And your love transfers. When you have a baby, you've got obviously less time, and it's going into this little human who really, really needs you all the time. So, of course, that shifts everything and maybe a little bit of understanding of that, which, of course, is very difficult to have until you're actually in the position. But, yeah, it's great to have people like Rachel who are studying this, who are interested in this, bringing this to know, talking about this in anything in relation to male and female intimacy or their life or relationships or how they interact with each know. I think it's important in whatever context.

Suzie: No, it definitely is. And here we go.

Mel : Yes. So listen to Rachel. Dr. Rachel Olivier. Here she is. Okay, so.

Suzie: Dr. Rachel Olivier is an actual full time nurse practitioner and women's health scientist, and she's based in BC at the women's Hospital and Health center in Vancouver, BC. So if you are in that area, you can actually go see her and talk to her about your postnatal care in terms of sex. And then she also completed her PhD at Delhose University in 2022. And obviously, her research focused on exploring sexual health after birth using feminist, post structuralism and discourse analysis, which are words that I have not heard in a very long time. So I appreciate that. She's also spoken on lots of podcasts, so we're so lucky to have her. And CTV's the Social, which I love that show so much. But, yeah, her research has yielded many interesting findings, and some of the themes are including body image, relationship to self, and navigating identity as a mother versus as a sexual being, which I find extremely interesting. But thank you. Dr. Rachel darling.

Mel : Here she is.

Suzie: Okay, perfect. Well, Rachel, again, thank you so much for being on here. It's such a pleasure to meet you through voice. It's a real pleasure. I know you're extremely qualified and enthusiastic about what you do, and it's such an incredible, inspiring journey to us when we looked you up, and I know you've been on a lot of podcasts. You've been on the social. It's very cool when people look you up, and if you could, could you just. We'll plug you here and they'll plug.

Mel : You in at the end.

Suzie: So if you just tell us your socials for our audience now so they can look at you up while we talk, and then we can do it at the end as well.

Dr.Rachel Ollivier: Yeah, not a problem. So I do have a twitter accounter now called X. That's at R A. Olivier. So at r a o l l I V I e r. In terms of any other social media, I'm actually not super present on Instagram or TikTok or anything else. So that's the main one. Yes.

Suzie: Mel, you got to get her on the TikTok.

Mel : Oh, yeah. So get you on TikTok.

Suzie: No, I mean, it's not like.

Dr.Rachel Ollivier: You'Re.

Mel : Not missing much, to be fair. Garbage on social media.

Dr.Rachel Ollivier: It's so funny.

Suzie: Well, I would love to start. Thank you for doing that. I would love to start with. Let's just tell us about yourself. What do you specialize in? Because it's extremely important work and it's extremely interesting to us and to our audience. So if you could just tell us a bit about your background and what you're doing currently.

Dr.Rachel Ollivier: Of course. Yeah. So I completed about a decade of university. I completed my PhD in nursing at Delhi's university in 2022, where my research focused on exploring sexual health after birth, which is, of course, our topic today. And did my nurse practitioner program at Queen's University and graduated that program last July. So I'm trained clinically in family practice. Prior to that, I was a registered nurse for seven years, working in various settings, including gynecology and medical surgical settings. I also have completed some nursing rotations in Zambia and Tanzania, and so started the nurse practitioner program and as I said, completed that last year. And I'm now working at the BC Women's Hospital and health center in both the access clinic. So that's generally complex gynecology as well as in a women's heart health clinic, and have that mixed bag clinically and also, fortunately, have some dedicated time each week for leadership and research as well. So lots of hats that I wear. I also lecture in various programs across the country. I'm an adjunct professor at the UBC School of Nursing and I'm also involved with various policy work across BC, in addition to serving on two boards. So for the Canadian association of Perinatal and Women's Health nurses, as well as for options for sexual health.

Suzie: Mean that's. That's quite a. I mean, for someone who deals in all sexual everything and extremely qualified in it, how do you have time for sex?

Dr.Rachel Ollivier: Rachel, it's a very good point. The most common question I get is, when do you sleep? Yeah, when do you sleep and when do you have sex?

Suzie: Those are my two top questions for you, Rachel.

Mel : Very good questions.

Suzie: And you're so young. Sorry, if you don't mind, can you tell us how old you are?

Dr.Rachel Ollivier: Of course. I'm 29 years old. I turn 30 in August. Oh, my God.

Suzie: So obviously in your 20s, you're so young to us. Obviously, anyone who's 17 is like, oh, my God, but you're so young to us. Obviously. That's incredible what you've accomplished already. I'm a little bit intimidated, but it's really amazing. So, obviously, you specialize in sex after birth, which is our topic today. And it's something that's very. Obviously, I'm not a mother. I don't know if you're a mother, Rachel.

Dr.Rachel Ollivier: I'm not, no.

Suzie: Okay. So obviously, Mel is the only mother among us, but, I mean, I have no idea about. Right. Like, all I can imagine is just right. Like, that's where my mind goes, is, like, sex after having a child, after a literal watermelon comes out of your ******. *****. That is terrifying to me. Like, if we can just be full sharing our truth right now. Terrifying. So what do you say to the people who, when you're like, don't be so scared. It's okay. It's okay to get yourself and take your time. What is the first thing you say to that?

Dr.Rachel Ollivier: Yeah, and you bring up a great point, because, as you said, I think there is so much we hear out there, both positive and negative, about sexual health after birth. There are a lot of myths. It's very taboo. So I think it's also what can be part of that fear is just simply having a lack of reliable information about what to expect, what normal changes are, and how there really is such a spectrum within normal, which is kind of part of where my work comes in. But I think in terms of education and preparation, care, it's really nice when we have those sorts of resources available in terms of having not only education on what to expect, but supports during that time. So whether that's pelvic floor physiotherapy or counseling, and, again, visits with your primary care provider, whatever it may be, if and when concerns or questions come up regarding sexual health after birth. So it's difficult to say what people might be or what they might experience because it's so different, individual to individual. But of course, there are kind of some common issues that people can also have as well. But no, I think a lot of it also comes from just like, okay, where do I even find out what I might expect? Yeah.

Mel : And what do you think the percentage is of women that have issues? Because it's not something. I mean, certainly when I had. I've got two teenage girls, and it's not something that anybody talked about, but I know a lot of my friends suffered from issues with intimacy after birth on both a psychological and physical level, but nobody talked about it. And I wonder what the statistics are.

Dr.Rachel Ollivier: And it's a great question. So there are a few studies that have been done. Again, this area tends to be underresearched, but there was a review paper published in 2020 that was kind of amalgamation of various studies that had been done on this issue. And so rates of sexual dysfunction or sexual issues postpartum can range from 41% to 83% at the two to three month mark postpartum, and are at about 64% at six months postpartum. But the thing is with this is that even between studies and when I was doing my doctoral work, really looking into what we know about this topic is it varies even between study to study and the context of where the study might have been done, all these other factors. So statistically, it's kind of all over the board. But we know that generally, sexual health issues do tend to increase in prevalence compared to pre pregnancy. Yeah. So, no, definitely. I think something that's on people's minds at that point and something that people are wanting to know about or have kind of their experience normalized in some way when they are having issues, 100%.

Mel : I mean, just to sort of jump in, because obviously, I can really relate to this in terms of having had children and your body just. I mean, everything goes through so many changes. And my big question really would be, men are not aware of this at all, certainly. I mean, men of my generation, I'm 51, so they find out, literally, while it's, if you like, not happening, that this is going to be an issue, it doesn't cross anybody's mind that it is actually very hard, once you have children, for women to compartmentalize. Being a mother, being a sexual being, being a partner. It's actually quite hard because motherhood is all consuming, physically and psychologically. And, of course, there's no education for men. So I wonder if that's changed. Is that changing? Is that something that you do or you look into, if that makes sense?

Suzie: And absolutely.

Dr.Rachel Ollivier: I mean, it's something that is so relevant for not only the person who recently gave birth, but their partners as well, so I think involving them in those conversations or those educational sessions or whatever it may be, is critical in terms of helping kind of that understanding on both parts. We are seeing more research come out that is looking at couples in the postpartum context specifically. And a lot of that research, I think, is important, but often tends to focus on sexual activities in particular, which is one component of sexual health that is, of course, important. But really, with my research, I wanted to delve into what is the actual postpartum woman experiencing, not only in relation to partnered sexual activities, but the physical components, emotional, relational, social, and even sexual activities, again, that are unpurn. So that was really kind of the gap that I was seeking to fill with my work, was delving into what is that experience like, how do people create meaning within their experiences? How do they define their sexual health after birth? But no, I mean, there's, again, a lot of work that's needed in several aspects of a sexual health postpartum. So whether that research involves couples or not, I think it's all great work that can contribute to care and to hopefully helping people feel supported during that time.

Mel : Okay. Yeah.

Dr.Rachel Ollivier: Interesting.

Suzie: No, that's really great. I think that's the one big thing that we always kind of, and we're talking about it more now, but where it's like, women, as mothers, we're just like, you got this, girl. And a lot of women are like.

Mel : I don't got this.

Suzie: I really don't got this. I need support, but we don't know how to give support as communities, as partners. So what is the biggest thing for support postpartum women?

Dr.Rachel Ollivier: There are a few things that came up in my research and that have kind of been relevant in clinical care as well. But I think having those conversations early and having them be brought up in any healthcare interactions is helpful even to just starting the conversation. So, in terms of support, it's helpful to have kind of that tailored approach in terms of, as I said, knowing what to expect, but also helping with the physical recovery as well. So, pelvic floor physiotherapy is something that the participants in my research found really helpful if and when they sought it. But it isn't necessarily accessible across the board here in Canada because it's not universally covered. And so people do have to pay out of pocket. It can be quite costly. So there are still barriers to care in that sense, but in terms of also kind of understanding things and the changes related to your body, there were some postpartum women that I interviewed in my research that had kind of their second birth and so were a bit more aware of what they needed in terms of supporting their sexual health. So whether that was an estrogen cream to help a little bit with vaginal tissue health or vaginal dryness, they knew to ask for that or knew that it existed. But I think that is kind of the thing with a lot of these things postpartum is that people aren't even aware that they are out there. And so if you don't know, you don't necessarily know who or what to ask. So that's, I think, kind of the main thing that I found for people who did have that knowledge of that previous experience, they could kind of draw on that a little bit. But, yeah, it really, as I said, is multifaceted as well. So that emotional support from not only their partners, but other moms, as well as someone who can kind of relate to things or that they can talk to about some things that, again, are not really part of normal conversation.

Mel : Yeah.

Dr.Rachel Ollivier: And then having that support and resource through their healthcare providers who, right now aren't necessarily trained on how to care for sexual health after birth. And that's also part of the teaching that I do in various nurse practitioner and MD programs across Canada, is helping facilitate that knowledge so that if and when people do come forward with concerns, they know what to do in terms of perhaps medications that we can offer or other resources down to. Okay, what are some things in terms of sexual activities that can be tried to help ease pain or whatever it may be? So there's kind of a knowledge gap on both fronts as well.

Suzie: Okay, so what are the best sex positions after postpartum?

Dr.Rachel Ollivier: It's a good question. So kind of some of the recommendations I often have is related to perennial sensitivity or perennial tearing that people might have had during the delivery itself is exactly between the vaginal opening and the.

Suzie: People who don't know.

Mel : I didn't have it. I had two caesareans, but I hear it was a lot of fun. Oh, God. And the last thing you're thinking about when you have that is anything coming anywhere near you.

Dr.Rachel Ollivier: Exactly. So in terms of that, often rear facing your hand and knee positions can be helpful in terms of taking some of that contact off. The perennium. Water and silicone based lubricants are also, I think, very helpful, especially for folks who are breastfeeding or nursing their babies, because some of the hormones involved in that can cause vaginal dryness. So it is quite a common issue postpartum. So I always encourage the use of lubricant, especially in that sort of context of being newly postpartum. And then, as well, there are things like vaginal moisturizers, an estrogen cream that can be prescribed by your healthcare provider to support some of that vulvar tissue health and help make things more comfortable. Another thing is perennial massage. So sometimes kind of massaging the vulvar area or the perennial area prior to any penetrative sexual intercourse can be helpful in just helping things to relax, because I find one of the common myths that's out there is, and I hate to use the word, but things are kind of loose after birth, quote unquote, when in fact, it can be the opposite. So with those pelvic floor muscles that are supporting the pelvic organs, like the uterus, like the bladder, they're skeletal muscles. So it's the same type of tissue as you would see in your bicep or your tricep. And after birth, because of the trauma that those pelvic floor muscles have often experienced, postpartum women can often actually have tension in that area. And so when I talked to a few people in my research, some of them were having pain with even inserting a finger or a tampon into their ****** because of that tension. And so that's another thing that I think people often have a misconception about. So relaxing those muscles is also something that can be helpful.

Suzie: But are women even, and obviously, you can say this, but are women even horny after they give birth? How long does it take until you're like, I want to have sex again? I feel like, for me, because birth is just such a crazy concept to me as someone who's not a mother, but just, like, I would just feel so one self conscious and just not sexy. But that's also just me. I don't know, how long does it usually take for these women to be like, let's do it again?

Dr.Rachel Ollivier: Great question. And with this, it can really vary, I think, individual to individual, because, as you said, you're juggling new responsibilities as a parent. You're fatigued. You're really prioritizing baby and baby's care. A lot of the time you've had these physical changes, all these things kind of coming together. So it is quite common, and we see this in the research as well, for people to experience a decrease in their sexual desire after birth. And some of those issues can last up to kind of 18 to 24 months postpartum. And it's kind of one of those things that I always frame as kind of an evolution of sexuality throughout the lifespan. So it can be something that ebbs and flows. There isn't necessarily this time point where you might be feeling, okay, I'm ready to return. That time may come, and then it may also kind of go away again. So there is a lot of kind of up and down, but I think in terms of also that piece of sexual desire, as you mentioned, there's the physical piece, and this was shown in my research of kind of having a bit of a different meaning ascribed to your body or certain body parts postpartum. So for a lot of people, seeing their ****** or their ***** as something that's sexual, again, can be a bit of a journey because it's sort of like, okay, this is what birthed the baby. This is what's now healing. You might not want anything being touched down there for quite some time or have fear of pain. And then also the ******* as well. The meaning of and the use of your ******* in terms of now you might be nursing a child, might have tenderness there or nipple dryness or whatever it may be. So in my research, it really was shown that people do kind of define their bodies differently. And then there's also really that social piece that the participants in this research illuminated in terms of identity as a mother, as kind of being constructed as being in opposition to sexual identity and kind of how they're navigating that. And we see that in society more generally, how oftentimes, again, motherhood is viewed as being in opposition to being a sexual being or having a sexual identity. So navigating that is also, I think, something that is really relevant for postpartum women in terms of kind of redefining not only their relationship if they have a partner, but also kind of how they see themselves sexually and as kind of a sexual being. So, yeah, lots of changes, for sure, going on.

Mel : Yeah. I mean, from my personal experience and, like, my friends and we have talked about it, and it's been sort of very different across the board. I think one of the personally, obviously, and this is zero medical training. This is just my personal observation, is that it's really about you and your partner, and the partner, whomever that is, has to be kind of patient. And I think that is a very difficult piece, actually, because it's not something we talk about. It's not something you're prepared for. Nothing in the world prepares you for a baby. I mean, you think you're prepared. You have the baby, and, yeah, it's a whole different thing. And I don't think the piece of getting the partner more involved, understanding that this may take you some time, like you're talking about, to actually sort of come back to yourself, because it's not just physically. You don't feel that great about yourself. I mean, most women just. You don't. I mean, unless you pop right back into shape, you genuinely just don't feel great about yourself. You don't have the time to spend on yourself. That's not really a priority. And you would even feel guilty about making sex a priority while you had a little baby, if you know what I mean. So I don't know if that's part of it, but I think that that's a big piece, that it's not just the woman. The woman has to feel supported by her partner, but also they have to have the best word. I can come up with a sense of patience that you will get back there, but it's going to be a journey because it's going to a different place. It's going to become a different thing. Right?

Dr.Rachel Ollivier: Absolutely. And kind of with that, I think, yes, that communication piece can be difficult to kind of bring up or touch base with in terms of expectations on both ends of, okay, how are we feeling? How are things? I certainly agree that patience is absolutely important for the partner and also being patient with ourselves postpartum, too. But one thing that I think also participants talked about kind of in relation to that, was redefining intimacy within their relationship based on what their needs were at that time. So pre pregnancy, perhaps, sexual intimacy was part of their relationship in whatever way that was. And postpartum, kind of reshaping that, of still having that emotional connection, which was, I think, really important for people, but also finding ways to prioritize each other. So whether that was making time to have just some time at the end of the day to chat on the couch uninterrupted or to cuddle or cooking together, flirting, still letting each other know that they were attracted to one another or that they really appreciated one another. It was kind of a bit of a different way of expressing intimacy and expressing affection that didn't necessarily need to include sexual intimacy. It could, but it was kind of part of how they redefined what intimacy looked like in their relationship, based on, again, everything that they were both juggling and being new parents and still having that caring and that connection. So for some, it wasn't necessarily a date night out, like it might have been pre pregnancy, postpartum. It was sort of like having that support and say, having their partner take care of their baby so they could go have a shower or just things like that that still really showed that affection and that caring and helping them to navigate parenthood. But it wasn't necessarily. Yes. What we would define as quote unquote sexy.

Mel : Yeah, I think that's important. Can I ask you what brought you to this? Because, like you said, you're not a mother at the moment, but it's like, what brought you to being interested in this?

Dr.Rachel Ollivier: A lot of it came, I think, from my previous work in sexual health and sort of a combination and merging of my interests in maternal health as well. I volunteered as a clinic assistant at options for sexual health BC in Kelowna during my undergraduate degree, and that was my first exposure to sexual health care. And once I started my master's at Dalhousie, I was thinking of a topic for my research and knew I had interest in maternal health and global health, in sexual health, and sort of thought, hey, okay, a combination here might be talking about or looking into postpartum sexual health. And so I, of course, delved into the literature and found that, of course, there were gaps on this topic. And from there, I think, really found it was a fit and great combination of not only my research interest, but my clinical experience as well, having worked as a nurse on a gynecology unit at the IWK Health center during my doctorate. And, yeah, Noah is certainly, I think, a passion of mine because it's something that isn't talked about enough, as you will know, and something that really is, I think, important to postpartum well being. Ovary.

Suzie: Yeah. And this is, I mean, relevant to Mel as well, even though she had a caesarean? Two caesareans. Pardon me, but do you find that the postpartum sexual health is different from caesareans to natural births, as they would call it? Do you know what I mean? Just because obviously, maybe your perennium is intact, like Mel. It's perfectly perennium.

Mel : You're hurting at a different place.

Suzie: You're hurting at a different place, obviously. So have you seen different, maybe sexual issues with the two types?

Dr.Rachel Ollivier: And this is a question I actually get probably most often from family physicians when I present to them. So, again, wonderful question. And in terms of the research that's out there, there have been several studies that have compared outcomes in terms of sexual health between folks who have had a vaginal birth and folks who've had a caesarean section and really have found no significant difference between those two populations. However, we do know that some other risk factors for issues for sexual health after birth include more so use of forceps or an apesiotomy during birth. So sometimes the assisted deliveries can have more sexual issues after birth. But in terms of spontaneous vaginal delivery versus caesarean, it's about equal on both ends. Again, it can vary slightly, study to study, but the overall consensus is that they're about equal.

Mel : Interesting. I mean, that makes sense to me because I had one emergency caesarean, so I actually had to do all the pushing. And so it actually does damage down there, if you like. But then at the very end, had to have a caesarean. And then in my second tutorial, in my second birth, I had an elective caesarean. But it's seen as like, that's the easy way out, having a caesarean. It certainly was when I had caesareans, and there were lots of comments about it, about, you got off easy, basically. It is actually a different kind of pain because obviously it's horrible. Your pain is in a different place and in your core. Right. It's not obviously where you're penetratively where you're going to have sex, but it does hurt a great deal, and it creates, well, in my experience, a lot of self esteem issues, too, having a caesarean, because then you also have a sort of most layer of fat there because especially if you've had several caesareans, because it doesn't really go away. The muffin top, it's sort of almost worse. So that does make you quite self conscious. So I think there's different kinds of issues. Obviously, you don't have the issues of having damage. Well, down there, for the lack of a better word, and tearing, which many of my friends had, which sounds beyond horrendous. And at the end of the day, the last thing you're going to want to do is have sex and trying to communicate that with your partner so they're not upset, because that can be another thing that your partner doesn't know what the hell's going on, that you're feeling very fragile, very vulnerable about that area of your life and finding it extremely difficult to communicate because it's embarrassing, it's a weird sensation. But if there are professionals like you out there who can actually bridge that gap, who can help women to talk, to say, no, it's okay, we can talk about this. We really can. It is important. It is an important subject because I think it's sort of diminished somewhat.

Dr.Rachel Ollivier: Absolutely. I think especially postpartum, there are so many things going on. There's often an overload of information for new parents. And so it's something that I think kind of gets put on the back burner, especially related to infant health. Oftentimes, a lot of the support and those visits or whatever it may be, you're very focused on things like breastfeeding and infant care. And of course, those are all important. But then sometimes, yeah, you can forget about the postpartum piece and how that's affecting things as well. So I think it's important to have those conversations, as you mentioned, and be able to also explore that a little bit. I think one thing that people mentioned in my research in terms of navigating things was kind of using masturbation or self touch to just get a sense of how things were feeling without having to worry about pain or having to kind of communicate in the moment with a partner. It was kind of something that I think was really empowering in terms of understanding. Okay, what are actually the changes that have happened to my body? How am I responding to touch those sorts of things? So I think that's also another piece that isn't necessarily normalized, but I think can be really helpful during that postcardum period in particular, whether masturbation was something you engaged in prior to pregnancy or not. It's, again, another tool to have in your toolkit. Right?

Suzie: Yeah, I was actually just going to ask about masturbation because I was like, is that something. Obviously, you just answered it. But does the ******** ever get. Because obviously we're learning now that the ******** is larger than just a little pea on, pea size thing on near your *****. Does the ******** ever get damaged when it comes to childbirth, or is it usually, well, intact, if you will?

Dr.Rachel Ollivier: So generally with birth, the actual ******** itself is not particularly damaged. However, people can experience nerve and sensation changes in their ***** and ****** as well. And that can be related largely to pelvic floor injury that was sustained during childbirth or during pregnancy. So we do often hear from folks, especially who are in kind of those first six months and still physically recovering from the birth, that there are altered sensations down there, and that can be related also to tension, to blood flow, to the area. So absolutely, stimulation of the ********, people can have a different response than they did prior to pregnancy with that. And there is a length of time for recovery that varies depending on the individual. But, yeah, it can absolutely be an issue in relation to arousal or their response, either emotionally or physically, to stimulation in that area.

Suzie: Wow. I don't know if you have any experience in this, but do you have any sex toys that might be best for. Really? Have you seen these sex toys? Recommendations for postpartum? Is it vibrators that are bad or are they good? What is probably the easiest kind of to put on your ********? Postpartum?

Mel : Absolutely.

Dr.Rachel Ollivier: I think it can vary depending on the person. Something that I think for throughout life, we find what works or what doesn't work for us. So I think exploring with or without sexual toys is a great way to kind of understand how things are feeling and kind of also, just as I said, to get that awareness a little bit of, okay, what are things feeling like now? Because that fear of pain, I think, is very real for a lot of people and very fair. But in terms of toys, really, it depends on the individual and how they respond and exploring that. So I've had a few friends, colleagues, things like that, who have purchased new toys that they perhaps didn't use prior to pregnancy and found that they've been very beneficial or positive in terms of their sexual relationship and sexual satisfaction overall. But, yeah, in terms of particular toys, I say knowledge is power. So getting out there and trying things, whatever that looks like for the individual, I encourage, because it is. It's important to explore that and be aware of your body. I think it's really powerful in terms of helping to ease that change and that transition postcardum as well.

Suzie: Amazing. And remember to use lube.

Mel : Yeah. I think it's so interesting that you talk about that, because if I think myself that somebody had talked to me after birth about masturbation or sex toys 20 years ago, you'd have been like, what? It just would not have been a conversation. And the main focus when I had my kids was postnatal depression. So that was really coming into a little bit more understanding, a little bit more caring about it, and really making sure that you were okay or on the right road mentally. But anybody asking you about helping you in an intimate area of real life, absolutely no way. And I think the fact that now sex toys are much more mainstream, really, that is great for women, makes that conversation a lot easier. People are going to be like, no, I can have this conversation. Sorry, a question. Do you actually go into GPS or obstetrician gynecology? Do they call you? How does that work? How do you get referred and talk to people? Because you mentioned that doctors do call on you, so how does that work with the patient?

Dr.Rachel Ollivier: Yeah. Interaction in terms of sharing knowledge with healthcare providers is often in the setting of providing a guest lecture or kind of in service for information. So I've done it with public health nurses, with midwives, physicians, you name it. Just kind of discussing some tools. Again, in terms of my actual clinical practice right now, I certainly care for a range of gynecological concerns, do not work specifically with postpartum patients. However, know, I think, certainly tried to help our educational curriculum in Canada incorporate more information on sexual health after birth so that healthcare providers feel more prepared to have those discussions and offer resources and support if and when needed. So, yeah, slowly but surely working on it, for sure. But usually, as I said, it's through a guest lecturer presentation with various healthcare providers.

Mel : Well, I have to say, I think it's amazing. I mean, I'm definitely not having any more children, but for all the women out there, I mean, thank God there are professionals like you. I mean, honestly, it's about time. It really is. Women need it. There needs to be more conversation, more education, more understanding, more caring. When you have a baby, it is a humongous thing. It is a big shift in your life, and it changes absolutely everything, and you're not prepared for it. So, thank goodness there are people like you with your experience and your education and your knowledge. Yeah, I'm flawed. I don't know what to say. I think, thank God, my daughters, when they have babies, they'll have people like you to consult with, to talk to, to not feel alone. It's huge. It's a huge thing.

Suzie: I have a question. Sometimes you hear about these people who, they have children. Their children are literally like nine months apart or something like that, right? Where they're like, they have a baby and then they get pregnant right away. And I'm like, how are you having sex right away? Or are they having sex right before they gave birth and then you're having that baby. How does that work? Please explain if you have an explanation.

Dr.Rachel Ollivier: Absolutely. So, spacing, I think, in terms of family planning, is something that I think is also important to talk about. Generally, we recommend spacing children at least 18 months apart in terms of date of delivery, to date of delivery for the next child. But of course, everyone's different. People have different choices or circumstances. And so, of course, that isn't always an exact science, so to speak. So I think with that, talking about contraception, all those things, if anything comes up about sexual health, postpartum or during that six week check, it's often related to that. But then that's sort of the only thing that gets talked about related to sexual health. But no, of course, it is possible to get pregnant anytime after birth. Whether or not your mensis have returned. So it is something I always remind people about. Of course, after birth, there is that period of bleeding, or what's called locia for a couple of weeks after birth. But if people are sexually active during that time, I always encourage the use of a reliable method of contraception. So whether that's condom use or having some people immediately have an IUD inserted immediately after birth. So we do hear of that. We do see it happen, as you said.

Mel : Right. Okay.

Suzie: Because, yeah, I mean, it's a lot, but just even, like, the fact that they're having sex right after they just gave birth, that is wild to me.

Mel : And like, well, there's lots of emotion. You're very hormonal. And some people do have a sort of euphoric sense of. And I think lots and lots of people who should know better think that you can't get pregnant just after you've had a baby. Right? I have no idea. They don't know. I don't know. The idea of having two babies that close together is all too much for me to process, to be honest. But, yeah.

Suzie: Anyway, that's wild.

Mel : It is wild. It is wild.

Suzie: Even giving birth once, but, like, giving birth nine months after again.

Mel : But it could have been just that one night. That's the thing. It probably just was the one night. And then people think, oh, no, I can't get pregnant.

Suzie: But this is also the thing. Just ridiculous. So you're just having the baby. You have sex on the night you just had a baby and then.

Mel : Could.

Suzie: You get pregnant on that night that you had sex and then you have that baby?

Mel : You thought about that? Because it's terrifying wondering how quickly afterwards. Yeah, like, quickly afterwards you get pregnant.

Suzie: While you're pregnant, even though you're just giving birth that day. Does that make sense?

Dr.Rachel Ollivier: I think so.

Mel : You're asking trouble, right?

Dr.Rachel Ollivier: Usually beta leak postpartum. Again, having ovulation occur. It can occur anytime after birth. Technically. Usually it takes about a month for people's mensies to return, but kind of during that first month, in terms of when exactly you will ovulate, there isn't any exact way to know. And so that's why, again, we always caution people in terms of their sexual activity during that immediate postpartum period because they can get pregnant and have ovulated without knowing it. So hypothetically, if it were to occur immediately after the birth, I don't think that would. It's quite unlikely, but not impossible, just in terms of kind of the hormones shifting and returning to ovulation. And then of course men's use as well.

Suzie: This is also the problem where it's like, I don't know these answers. I'm a woman, you'd think that I should know about birth first and foremost. Something that I can either hopefully, like in Canada, you could choose to do it or not do. Just it's something that seems still so foreign to me. And is that something that's because of me or is it because of our education? Or like why is it still seems so foreign? Because I'm an open person sexually. But why is birth seemed like so scary and far away? Maybe that's too psychological.

Dr.Rachel Ollivier: There is a lack of information, I think, on several women's health topics, labor and delivery, postpartum, all being some of them. But yeah, it's really, I think about having these conversations be not only normalized, but when we do normalize these topics, we also kind of, I think have a better idea of just the variance that's within normal. So rather than having kind of these mainstream ways of viewing sexual health after birth or viewing pelvic pain or whatever it is, it's something that the more we get it out there, the more we also normalize other experiences and can hopefully help people feel supported. So you bring up a great point in terms of our education more generally about these topics. And it's something I'm happy to lecture about and present about in the community. And one of the ways I do that is through dress for success Vancouver having these lectures on different methods for contraception, how to access medical or surgical abortion in the province, talking about costs of care, things like that, community resources to be aware of. As you said, these conversations are not common. And if and when people are searching for that information, it's often kind of leading to the Google rabbit hole, which can be a scary place to be.

Mel : Definitely.

Dr.Rachel Ollivier: So I think we're seeing more know in terms of having reliable sources of information. So whether that's for example through perinatal services of BC or through other reliable means of accurate health information and connection to healthcare. Yeah, I agree. Absolutely. Always ways to improve and I'm happy to see that. I think we're moving that way.

Mel : That's very good news.

Suzie: This is a little off topic, but have you seen and I'm sure I don't know if you have because you're so in the industry, but Alberta just passed this thing about their sex education where they now have to have parents opt in instead of opt out. I don't know if you've heard of that, yes. How do you think that's going to affect, I mean, Alberta, but also Canada as a whole with that? I don't know if you've heard of that, Mel.

Mel : Yeah, well, Susie's from. She's very aware. Yeah.

Dr.Rachel Ollivier: Yes and no. I think in terms of eliminating those barriers, what's important is that people have access to accurate, unbiased information so that they have the resources and tools available to care for their sexual health in whatever way that is. And I think especially that comes down to education and access in our educational systems. When people are in childhood, in adolescence, all of that education, I think it's important for it to start early. So whether that's related to consensual touch and what that means, it doesn't even necessarily mean discussing sex in particular, but learning about our bodies, all those sorts of things. So, yeah, I think in terms of access to care, especially for folks who might be experiencing marginalization, who might identify as part of the two S LGBTQ plus community, I think it's especially important for those folks to have access to care and access to education. So in terms of the changes in Alberta, we've heard, I think, a lot of very vocal advocates arguing against it because we don't necessarily know what people's context is in terms of their relationship with their family or their parents or with their social networks and things like that. And we can't always assume that's necessarily supportive. And so I think, again, eliminating those barriers for anyone but young people in particular is important so that they feel that they have somewhere where they can feel supported in navigating their sexual health, their gender identity, whatever that may be. So, yeah, I mean, really what it comes down to, I think for me, no matter the context, is eliminating barriers to care and to information. And we all, I think, have a role to play in that as healthcare providers, as educators or whatever it may be.

Suzie: I love that. And is there some kind of all Canadian website? Maybe it's not even government funded, but is there, like a Canadian website where you can go to that can explain more of what we need in terms of sex education, no matter your age? And it's not ****. Like, what is that canadian websitE? And does it exist?

Dr.Rachel Ollivier: There are a few fantastic websites that are out there, yes. So one of them is it'saplan CA and sexualityandu CA. Those are both run by the Society of Obstetricians and Gynecologists of Canada and have a lot of information about a variety of topics, including contraception. So I always refer people to those resources, options for sexual health. BC is another great organization, and really, to believe that I am obviously a part of it, but they really do do fantastic work. So that's another website that really is a great resource for reliable information, is pro choice, is queer friendly. So it's a great kind of way not only to have information, but connection, if they need more information, through the sex sense line, where they can ask anonymous questions either by email or by phone, and have a trained healthcare professional reply to them or connect them to.

Suzie: God, I love that.

Dr.Rachel Ollivier: Yeah, no, there are some great ones here in BC and across Canada as know. It is nice to have that. And just now it's having people be aware that they exist and therefore able to reach out and connect if and when needed.

Mel : And we need you on TikTok, definitely.

Suzie: There needs to be more positivity than sexual health and in terms of feminism on TikTok.

Mel : Yeah. And more understanding for women and young women. Young girls, that the changes you go through as a woman, there's a huge evolution. Obviously, you're talking know, obviously starting with periods and then babies and then more. At my end of things, perimenopause, menopause, and women just don't know about this stuff. I mean, Susie's talking about not knowing about birth, but women of my age who don't know about the perimenopause or mean, it just. It doesn't matter along the line where you are, there isn't enough information. And I think if there was more information and better education, I think in the schools, I didn't experience it being great for my girls. I don't think they concentrated personally on the right things or the things that the children could really grasp, then there would be less fear. I think, if there was just more openness and more education, particularly for women and the hormonal changes and the changes they'll go through throughout their life, and not seeing everything as a faraway thing that's going to happen, because unfortunately it will happen. Well, you might not have a baby.

Suzie: I'm never ******* doing.

Mel : But anyway, education is absolutely key, so it's good that something's being done anyway. Yes.

Suzie: We have one last question.

Dr.Rachel Ollivier: Yes.

Mel : Okay, good.

Suzie: Sorry, I wasn't. No, we have one last question, which we ask all of our guests on this pod, and it is in the spirit of sharing truths. What is one truth you would share to your younger self?

Dr.Rachel Ollivier: I think I'm talking today about women's health topics or women's health issues. I think really, as we move through life and thinking of myself as a younger girl and then teen and all those things, I think really redefining normal, as I've said throughout this podcast and kind of relating it to my life as well, I think it's so important to understand that there's so much variance in normal. I think, especially in our young lives when we're teenagers, that you have very, I guess, biased information sometimes depending on your social network or on social media or whatever it may be, but understanding that there is so much that falls under normal and what even is normal, it's a question we often ask ourselves and often ask in health care as well, because there's never one size fits all, whether it's related to sexual health after birth or experience of what your periods are like or what sex is like, what menopause is like. All those things are so individual. So I think looking on my younger self, having a deeper understanding of that and appreciation for that, I think, yeah, would have been, I think, a great thing. So, as you said, we're seeing more changes happen each day in terms of access to information and things like that. But I think, yeah, there certainly are those periods where we're especially experiencing kind of a change or a transition. So whether that's adolescence or postpartum perimenopause, I think those are kind of some of the main ones that women go through in their lives, and as you said, happen to kind of be the topics that are not very talked about. Yeah. So, no, I think it's a message for my past self and present self and future self. So there you go.

Mel : I like it. That's very good.

Suzie: We got to keep changing. We got to keep morphing, keep educating.

Dr.Rachel Ollivier: Keep talking the evolution, right.

Suzie: I love that. Well, let's plug you again. What's your x? And then we'll get you on TikTok.

Dr.Rachel Ollivier: Sounds good. So my ex is at R A, Olivier. So that's @raollivier  on x and otherwise, any publications or things like that can be found on my researchgate profile. Again, that's the more academic side of things. But if people are interested in looking more into the research that's available there.

Suzie: Amazing. You're incredible. You are so inspirational, and just like, what you have accomplished in your young life is so truly amazing. And I think it will really inspire a lot of our listeners to just keep learning, keep educating. We're always changing. There's always something to learn. So you've really, really inspired me to just learn more about my ***** and ******. So I hope that.

Mel : Very good.

Suzie: Yes, it's been great.

Mel : Thank you. Thank you very much for your time. And like I said before, amazing that there are professionals like you out there. For women, for young women especially, having babies and going through a difficult or an unknown time to be able to have contact with professionals like yourself. Amazing.

Suzie: Yes.

Mel : I'm quite jealous. I wish I had that.

Dr.Rachel Ollivier: No wonder. Yes.

Mel : Thank you.

Suzie: And hopefully we'll have you on the pod again. If we have questions from our listeners about sex after birth, maybe we'll have a story or something that a listener will share too. We'll have you back on the pod and you can answer that for them as well.

Dr.Rachel Ollivier: Absolutely. That sounds wonderful.

Suzie: Okay. Amazing. Rachel, you have been so incredible, and we can't wait to talk to you again soon. Thank you so much again for taking the time.

Mel : Thank you so much for your time, Rachel.

Dr.Rachel Ollivier: All right. Thank you both.

Mel : Thank you.

Dr.Rachel Ollivier: Bye.

Mel : Thanks so much for listening. Please rate and review this podcast and follow us on social at sharingmytruthpod and leave us a voicemail on our sharingmytruth.com, to share your stories and experiences with us. We'll see you next time.

Suzie: Bye bye.

Dr.Rachel Ollivier: Three, two, one. Yeah, I.

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