Kate and William have one child and are trying for a second, but William is still traumatised by Kate’s first labour. Their sex life has suffered, and Kate wants to have IVF to get pregnant again.

WILLIAM SAYS “I feel angry, resentful and upset that Kate insisted I was there when our daughter, Sarah, was born. She knows I hate hospitals, but I was made out to be a freak and a wimp unless I was in there. We had agreed that I would go in and out during labour and didn’t have to stay for the birth, but I ended up witnessing every gory detail. Kate was in labour for hours. It was a Saturday night in a busy ward. The monitor she was attached to kept bleeping, and I couldn’t find a midwife to help. It was the most stressful thing I’ve ever encountered. No antenatal classes can prepare you for that. I’d become doctor, midwife and husband rolled into one. I hated seeing her in so much pain.

“All hell broke loose in the early hours of the morning: the baby’s heartbeat began to drop as Kate was pushing it out. Suddenly, the room was full of people and I found myself at the end of the bed, Kate’s legs wide open and everyone telling her to push. Then the head came out and the baby looked blue. I was convinced it was dead.

“Kate kept shouting, ‘I’m tearing, I’m tearing.’ They managed to get the baby out and straight to the recovery machine. I looked and just saw this gaping hole where it had come from, all bloody and torn, like raw meat. The doctor was talking about stitches and all I could think about was the area all sewn up.

“Those early days and months seemed like the aftermath of a car crash. I felt shaken, but didn’t make the connection with what had happened during labour – maybe because I was so thrilled about our baby. Something had shifted between Kate and me, though. I didn’t know why. In the early days, we were both so sleep-deprived that sex was the last thing on our minds. But even as time went on, I was too frightened to go near her, afraid I might hurt her.

“Initially, I had felt relieved that Kate and the baby were okay, but after about six weeks, Kate wanted to have sex. Then, I realised I couldn’t do it. I felt sick. All I could think about was that night at the hospital. I found it hard to get aroused, and the thought of penetrating her left me cold.

“It has caused arguments about me not loving – or fancying – her any more. I think Kate is a lovely mum, great fun and very loyal. I want back what we had, but the closeness isn’t there. The bottom line is, I am frightened of her getting pregnant again.”

KATE SAYS “I feel rejected. I seem to repulse William. We’ve had sex only twice since our daughter was born 18 months ago. I still find it painful – I feel a ridge there when we’ve had sex – even though my gynaecologist says there’s nothing wrong with me. I am tense, and can’t talk to anybody – it’s not exactly dinner-party conversation. I feel completely rejected and unattractive. I’m so insecure, I’ve even accused William of having an affair. I am now so desperate to have a second child that I think IVF is the only way forward.”

ZITA’S ADVICE “You want to find out how to improve your chances of IVF, but your problem is not that simple. Your relationship and emotional issues are impacting on your ability to conceive. At 31, Kate, you are still young, so there is no need to rush into IVF treatment. It would be far better to work on your sex life and see whether that helps first.

“I see many couples whose sex life has changed as the result of having a baby. It is not unusual for women to feel unenthusiastic about sex in the first year or so after giving birth. However, these problems are usually temporary. For you, there are resentments and frustrations on both sides, but by simply voicing your feelings frankly, you are already making progress.

“I suggest you both undergo counselling – both couples and individual sessions – and suggest hypnotherapy for you, William, to help change your mindset and give you strategies to overcome your phobia.

“Kate, I would like you to have a look at your vagina, using a mirror. I am pleased you have been checked by a gynaecologist and know that everything is in order. Sometimes, it simply helps to see for yourself that there is no physical problem. Also, I have to stress that the vaginal muscles are very powerful, and anxiety can cause them to tense, creating the ridge you are experiencing and making penetration more painful.

“Pelvic floor exercises will help to relax the vaginal muscles. This will ease penetration and make sex more pleasurable for both of you. Draw up the muscles that you use to stop the flow of urine, hold for a count of five, then let go gently for a count of five. Repeat five times each day. You should do a series of 10 short, sharp contractions each day.

“As for William feeling obliged to be present at the birth, there are no rights and wrongs about this. It is a matter of personal choice. For someone who feels as squeamish about hospitals as he does, it is perfectly understandable that he may not feel able to witness a birth. Kate, I know you would like him to be there, but you need to understand that his reluctance does not reflect on the way he feels about you. As William is afraid that a second pregnancy will mean a second painful delivery, it may help him to be told categorically that he does not need to watch a second time.

“Your immediate plan of action should be to forget about having sex entirely. This may seem daunting when getting pregnant naturally obviously requires it, but you need to take the pressure off and eliminate your fears.

“It would be a really good idea for the two of you to go out on a date, somewhere that you can talk and get back the closeness you have lost, with no sex at the end of the night. No pressure at all. You can kiss, but leave it at that. Once you have intimacy back in your relationship, you may well find that IVF isn’t necessary.”

— Zita West is a leading holistic pregnancy and fertility guru based in London. She has been a midwife for 25 years and is also a qualified acupuncturist and nutritional therapist. She is the author of several books on fertility;

www.zitawest.com

Times recommends

• Live chat: Thrifty ways to update your winter wardrobe
• Is anybody out there really listening?
• Nutrition Q&A: Will eating late make me fat?