Here are a few tips for dealing with your post-pregnancy body and keeping the spark alive:

• Review your expectations. If you were under the impression that you'd slip right back into your hippest pair of jeans right after the baby was born, you may need to accept that for most women, this just isn't realistic. Sure, there are the lucky few who can be seen lounging poolside in sexy bikinis three or four weeks post-baby, but if you're reading this, you are probably not among them.

Remember, it takes time and effort to get that body back. And a few extra pounds, plus a stretch mark or three (and a varicose vein), shouldn't stop you from getting it on with your partner, especially if you're in the mood. Some of these changes will fade or disappear altogether, but others may be here to stay, so you'll have to get used to them. Chances are your partner will be so excited to get a little action, he won't care about the changes you're obsessing about.

• Give yourself a break. You've just been through a tremendous event that has taken an inevitable toll on your body. You should feel beautiful and proud, not embarrassed or self-conscious. That body of yours is a magnificent organism which has just produced a baby. What a great gift it has given you. Love yourself from the inside out, and give yourself the time and emotional space to gradually get back into shape.

• Keep in mind: Sex doesn't necessarily correlate with pounds. Among my mommy friends, the woman with the most active sex life was the one who was the last to lose her extra pounds.

• Dim the lights. As basic as this tip sounds, the advice can go a long way. Turning down the lights can actually make you feel more comfortable. You won't need to worry that your partner is taking notice of all of your imperfections. You can just focus on making each other feel desired! To make it more romantic, light a scented candle and play some mood music.

• If you're breastfeeding, stop worrying about leakage. Some women worry that their breasts will leak during sexual activity -- so much that the anxiety gets in the way of their libido. Wearing a nursing bra with pads can do the trick, both because it solves the problem and because it reduces anxiety about the problem.

Low Sex Drive

He looks at you across the dinner table on your first night out since the baby was born. He's flirting, you think, but you hardly notice because you've been secretly checking your watch under the table, counting the minutes until you can get home to make sure your babysitter hasn't dropped the baby.

He reaches for your hand; you're still thinking about the baby. You hear something in the background which sounds like a baby and your breasts fill up with milk. He tells you how much he loves you and you start to leak. He is definitely trying to set the stage for a romantic and intimate evening and you, on the other hand, have to excuse yourself to change your breast pad in the bathroom.

How can he think about sex when sex is the furthest thing from your mind? You haven't thought about sex for, well, it's been about four months. Last night, he told you that he misses being with you. You start to feel bad. But then you check your watch again; only fifteen more minutes, you think, and then you can go home and be with the baby.

How come you're not in the mood (at all)?

There are so many explanations for why new moms aren't in the mood to have sex after the baby comes. A low sex drive can be frustrating for both you and your partner. But don't despair; it's a normal part of the picture. Reasons for a decreased libido include:

• Fluctuating hormone levels. After the baby is born, estrogen and progesterone levels drop, which can contribute to a decrease in your sex drive. If you are breastfeeding, a hormone called prolactin becomes elevated, which can further suppress the other hormone levels, and with them, your sexual desire. It can take months for your hormone levels to go back to their prepregnancy levels.

• Fatigue. I don't need to tell you that new moms frequently suffer from exhaustion. But fatigue and exhaustion can wreak more havoc on your body than you may realize. Studies have shown that disrupted sleep, night after night, can contribute to stress, moodiness, poor decision-making, a decreased immune response, and lowered sex drive.

• Concern about the way your body looks. As discussed above, many women are self-conscious about the changes in their bodies during the postpartum period and anxious about whether their partners will still find their bodies attractive. While these feelings are normal, they can get in the way of the desire to be intimate with your partner.

• Pain. Depending on the type of delivery you experienced, you may have incisions that have not yet healed and are still quite painful. Even if there is no episiotomy or Cesarean scar, the perineum, or area between the vaginal and rectal openings, has been stretched (beyond belief) and is most likely pretty sore. For many women, the thought of putting anything even close to that area can evoke fear and anxiety, which in turn can dramatically lessen sexual desire.

• Lack of vaginal lubrication. In breastfeeding women, elevated prolactin levels and lowered estrogen and progesterone levels can result in vaginal dryness. Without proper lubrication, sex can hurt, and as a result, women may steer away from relations with their partners, especially while breastfeeding.

It's been six weeks and I'm definitely not ready to have sex. Is something wrong with me? Are most women ready at this point?

No, nothing is wrong with you. Some women just take longer than others to be ready. I can't stress enough how individualized this all is. The decision to have sex after the baby comes is definitely not a one-size-fits-all milestone. Everyone is different. I knew women who had sex again right at the six-week mark and others who didn't have sex until the baby's first birthday!

Doctors recommend waiting six weeks because it gives the body a chance to heal. At this point, for most women, postpartum bleeding will have stopped, tears, sutures, and lacerations will be healed, and the cervix will have closed. But that doesn't necessarily mean you feel ready. Many womem complain of pain and soreness well after the six week mark. Other women deal with some of the issues we've already discussed. The decision to resume relations with your partner is entirely up to you. Don't let the six-week timeline -- or pressure from your partner -- dictate your decision; you need to feel comfortable, both mentally and physically.

The above excerpt is a digitally scanned reproduction of text from print. Although this excerpt has been proofread, occasional errors may appear due to the scanning process. Please refer to the finished book for accuracy.

The above is an excerpt from the book The New Mom's Survival Guide
by Jennifer Wider, M.D.
Published by Bantam Books; June 2008;$15.00US/$17.00CAN; 978-0-553-80503-1
Copyright © 2008 Jennifer Wider, M.D.

Author Bio
Jennifer Wider, MD, is a doctor, author, and radio personality who specializes in women's health issues. She is the medical advisor to the Society for Women's Health Research in Washington, D.C. Dr. Wider is a regular contributor to Cosmopolitan magazine and hosts a weekly segment on Cosmo Radio for Sirius Satellite. She has appeared as a health expert on The Today Show, CBS News, Good Day NY, Fox News, and a variety of cable channels. She lives with her physician husband, and their daughter and son, in Fairfield County, Connecticut.