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these notions. I’ve talked to so many women about this, because, as you can see, it is layered and intensely complex.

For some, sex stops being a bonding point or a way to experience pleasure, and starts becoming rote, or even unpleasant. This happened to one member of my Instagram community, Yael, who messaged me when I asked for stories about this issue. “I didn’t really want to have sex. We only did it to try to conceive. I used to like sex a lot—we had a really great sex life. But when we were trying to get pregnant again after the loss, it just became a task. I didn’t even physically enjoy it anymore. I think my fear got in the way.” This is not an uncommon reaction.

Pregnancy loss has the power to affect the way some women feel in and about their bodies, and how they want to share (and not share) them sexually.

I remember talking to Jade, one of my patients who experienced this shift in her sexual desire—and the many ways in which it impacted her relationship—after she lost a pregnancy at nine weeks along. “Some days things feel totally copacetic between us, and others it feels like we’re on different planets. He’s just so 
 unchanged,” she said. “Making it through to the end of a day feels like a feat in itself, emotionally speaking. So when it comes time to go to bed, all I want to do is sleep. Not cuddle, not talk, not kiss. I just want the day to end so my grief can finally take a beat. And yet time after time, Ben will crawl in next to me and press his body against mine.” She continued, “It’s a loving act, I know, he just wants to reconnect physically—to bond—and 
 it’s just too soon. It’s the last thing on earth I want to do right now.”

Later in our session, Jade articulated feeling badly about her lack of interest in returning to sexual intimacy. She worried that her lack of interest was hurting her partner somehow, but her primal need to retreat took precedence. As it sometimes must.

My patients and the people in my communities continually reflect on the fact that among the grieving, there exists a recurrent theme: for so many, sexuality shifts, increases, gets lost, or, at the very least, is mired in the weeds of reproductive complications. Its meaning changes. Desire contorts. Some divest in physical connection altogether. I’ve heard stories of people retreating from their partners, burying their sexuality deep beneath their grief, oftentimes feeling undeserving of or wholly disinterested in pleasure. I’ve also heard stories of women wanting more than their partners can provide; of new fantasies taking hold and of the desire to experience more than one sexual partner—a want often rooted in the need to feel in control of the body and the ways in which it can be used.

These potential outcomes exist partially because there are so many conflicting thoughts firing simultaneously in the mind, affecting the body. Some berate their bodies, others divorce them, some are tender and loving to them. Those who come to pregnancy loss with an already complex relationship with their bodies can find a newfound appreciation for the way their bodies work; burying themselves in the science of it all and becoming fixated on the statistics, the medicine, the intricate cogs of procreation. And others take that troubled relationship and, in the wake of a miscarriage, destroy any fragile appreciation they had for their body entirely.

This happened to Yael too. “I generally dislike my body. I’m very self-conscious, but usually my husband makes me feel really good about my body,” she said. “After my loss, I hated my body all the more. Despised it. And now it wasn’t about how it looked, but the fact that it failed. He couldn’t help me with that.” Her feelings spiraled. “I hated my body so much. It was hard to want to experience pleasure, because I didn’t even want to look at myself, touch myself, be touched. I was so angry at my body because it wasn’t doing what it was supposed to do. ‘Why is this happening? What is wrong with me? What is wrong with my body?’ It was a whole-new realm of body loathing that I still haven’t really gotten over. These feelings trumped my negative feelings about my body image, but I constantly felt like it was failing me. And in turn, it was failing everyone I touched. I thought, ‘Look at how many people my defective body is impacting. Look at how my body is causing grief for others.’”

In sessions, women wondered how they’d pick up the pieces of their now-fractured lives, including how they’d return to sex. “How can I even think about having sex right now?” This question would float around with regularity, the women asking themselves just as much as they were posing the question to me. Women who’d gone through miscarriage, stillbirth, and infant loss would come to me expressing how sex was the last thing they wanted—how their desire for intimacy had tuckered out. “I don’t feel it. It’s lost, and I don’t even know if I want to find it again,” they’d say, inadvertently turning their backs on the basic concept of sensuality. As with Yael, their sex drives may have existed healthily before their trauma—thrived, even—but post-loss, the idea of being sexual felt invasive, sometimes disloyal, scary, offensive. Entertaining the idea of personal sexual arousal, let alone pleasuring another, felt like a confusing betrayal—a lewd form of disrespect to the pressing issue at hand: their grief. This is, of course, common in many individuals in the throes of mourning a death or a loss. But the difference with pregnancy loss specifically is that the body—the sex organs—is the physical site of the grief. “My vagina was a constant reminder of the loss,” came a response from Sasha, another member of my online community. “Because this place was a site

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