A Midwife’s Guide to Sex During Pregnancy, Postpartum, and Menopause with Jessica Diggs

by Jessica Diggs
Aug 20, 2025

A Midwife’s Guide to Sex During Pregnancy, Postpartum, and Menopause

An Honest Intimacy Conversation with licensed midwife Jessica Diggs

Talk Pleasure to Me is our series where we talk to experts on sex, relationships, and caring for your body (& mind) so you can get inspired on your pleasure journey and learn from the best.

Jessica is a licensed midwife practicing at Moxie Birth, a birth center in South Pasadena. She supports people and families through holistic gynecological care, out-of-hospital birth, and conception support. Jessica has a skill and love for making childbirth and reproductive education digestible and accessible for all people. When she’s not talking about birth and bodies, she loves hosting dinner parties, hanging with her chickens, and devouring a good book.

Jessica, can you introduce yourself and share a bit about your background?

I’m a licensed midwife specializing in out-of-hospital birth, gynecological and well-woman care, and fertility support. I love talking about pleasure, sex, postpartum experiences, and normalizing the full spectrum of reproductive health — from puberty to menopause. Midwifery is not just about birth; it’s about creating a trauma-informed, patient- and pleasure-centered experience throughout all life stages.

Many people think midwives are only for pregnancy. Can you clarify what midwives actually do?

Midwives support the entire reproductive journey. Historically, the midwife was the person in your community you’d talk to about your first period or who helped normalize menopause. We’ve always been there across all phases of life, not just birth.

Let’s start with pregnancy. How do the different trimesters affect sex and libido?

First trimester: Hormones surge, causing nausea, fatigue, and breast tenderness. Many experience a dip in libido, though some feel the opposite. Body image shifts can also impact desire.
Second trimester: Libido often spikes. Increased blood flow boosts sensitivity, and most positions are still comfortable. Many couples are surprised by how strong desire can be at this stage.
Third trimester: Bodies are larger, positions can be tricky, and shortness of breath is common. Still, many find orgasms easier due to heightened blood flow. Sometimes sex is even used to help initiate labor.

What sexual positions are most comfortable later in pregnancy?

Because lying flat compresses the lungs, positions like side-lying, being on top, doggy style, or a supported/reclined missionary are more comfortable. Using pillows for support can also help.

What are the best ways for partners to support someone during pregnancy?

Keep it simple and consistent:

Hydration & nourishment: Keep snacks and water on hand.
Physical comfort: Run a bath, give foot rubs, or schedule a massage.
Check-ins: Ask how she’s feeling and act on what she shares.
Extra support: Hire a doula if you need backup.

Think: hydrate her, feed her, provide touch (or pay for it), and support her mental health.

What’s the difference between a midwife and a doula?

Midwives are medical providers — we catch babies, prescribe medications, and handle clinical safety. Doulas are emotional and educational support: labor coaches who provide continuous presence. Both roles are invaluable and complement each other beautifully.

There’s a saying: “What gets the baby in gets the baby out.” How does pleasure play a role in birth?

Oxytocin is the hormone that fuels both orgasm and contractions. In labor, oxytocin flows best when the birthing person feels safe, loved, and supported. Sometimes nipple stimulation or intimacy with a partner can even help restart or progress labor. Birth often looks and feels sensual: movement, sounds, and positions overlap with sex. At its core, it’s a primal, embodied experience.

What should couples expect with postpartum sex?

First 6 weeks: Healing takes priority. Libido varies widely — some feel none, others feel an unexpected surge. Clearance at 6 weeks is arbitrary; readiness depends on healing and comfort.
Hormones: Estrogen drops significantly, leading to dryness and even vaginal atrophy (similar to menopause). This can cause pain or anxiety about resuming sex.
Practical advice:

Use a high-quality lube or glide (I recommend Foria’s Sex Oil).
Expect arousal to take longer — fatigue and stress play a role.
Sex may feel either very spontaneous (“now or never”) or very scheduled.
The birthing parent should set the pace, positions, and timing.

And for partners: the easiest way to support intimacy is by taking care of household tasks. If you want sex, do the dishes, prep dinner, then put the baby down while she puts on Foria’s Awaken Arousal Oil because it works better over time and then you meet in the bedroom and go for it.

How can couples protect their intimacy during the postpartum period?

It’s about supporting the whole family foundation. Miscommunication is common in early parenthood, and sex often reflects that. Normalize talking openly about comfort, healing, and pleasure. Remember: sex isn’t just penetration — there are many ways to connect intimately.

Let’s talk about menopause. What changes can people expect?

Perimenopause is a long process of fluctuating hormones. Lower estrogen leads to vaginal dryness, brain fog, and changes in libido. Lower progesterone can cause anxiety or irritability. Testosterone also drops, reducing sex drive and muscle mass.

What is vaginal atrophy, and how can it be addressed?

Vaginal atrophy is thinning and tightening of vaginal tissues, causing dryness, burning, or pain. It’s common in perimenopause and postpartum. Regular connection with your body — through touch, self-pleasure, or products (like a good vaginal moisturizer) — helps.

Is there truth to the idea of “use it or lose it” with sexual pleasure?

I don’t like that phrase — it’s stressful. Pleasure isn’t just sexual; oxytocin comes from many things: gardening, community, pets, creativity. Staying connected to your body, whether through sex or self-care, helps overall tissue health and wellbeing. And desire can return after long pauses, sometimes in the most unexpected seasons of life.

Any last words of wisdom?

Seek pleasure, talk openly about it, and let it be a guiding light in your life — whether it’s clinical, sensual, or solo. Pleasure doesn’t have to center sex or a partner; it’s about connection to yourself.

Where to Find Jessica:

Instagram: @jessicaadiggs
Substack
In person: Moxie Birth, South Pasadena (full-spectrum gynecological care and birth support)

Wanna be interviewed for this series?

The Foria Practitioner Program is accepting applications from professionals with expertise in women’s health who wish to recommend Foria products to their clients and professional network To be part of the practitioner program, please apply to our affiliate program. Learn more and apply.