As many as one in ten women and possibly more may suffer from this condition. It may start within a month of the birth, or much later, it may last months or years, and it may or, occasionally, may not get better on its own. Doctors and health visitors are aware of it and know what help there is available.

At the time when you want to feel happy and up-beat, you feel ill, have no energy, can't sleep even when you have the chance, lose your appetite, and feel irritable for no good reason. You may think you can't cope with motherhood, and suffer from anxiety and panic attacks. You find you have good days and bad days, which is confusing. On the other hand any new mother might be subject to some of these feelings without having depression.

There are things which make someone more likely to become depressed, for example previous depressions, loss of mother in childhood, lack of support from the father, a sick or difficult baby, but remember that it is treatable, and even without treatment usually gets better.

Therapy and counselling can be very helpful, as can talking to other depressed mothers in a group. Medication which is non addictive, does not affect breastfeeding, and has minimal side effects is a good idea too. Your doctor or health visitor are there to help.

Now there are three of you and you have become a family, many aspects of your relationship are likely to change. Your status within your wider family and friends will be affected, and people who are not parents may find it odd that you seem so preoccupied with your child. This may change your friendships and social life. As you walk in the street with a baby, people like to stop and admire him or her. This can feel very supportive, or at times a bit of a nuisance.

Between you there will be much less private time, and less energy for your relationship. Intimacy may be more difficult, and sex may be on the back burner. The importance of communicating, understanding and accepting what cannot be changed about the situation cannot be stressed enough! At least you can remind yourselves that with a baby everything is "only a phase", as things change so fast.

It is important for the two of you to get private time away from the baby as soon as you can, even if it is only an hour to go for a walk. If the baby sleeps with you at first, make sure that when your child has his or her own room that you teach them about the importance of your privacy, and the meaning of a closed door. Some parents prefer to give the children free and open access to them at all times, and are not concerned for their privacy.

Firstly the fear of another pregnancy may be important, so careful attention to contraception is a must. Fear of causing pain or further damage can affect both partners sexually, even causing erection problems.

There may be "flashbacks" to the scene of the birth, reminding both partners of the difficult, painful or frightening experience, and re- awakening the emotions attached to the events.

It may feel to the mother that her sexual parts have given her so much trouble that she wants nothing more to do with them. Alternatively, she may feel that her sexual parts now belong to the doctors and to the hospital.

It can be very important for a couple to talk through what they remember of events, and share the feelings about it. There may be a sense of loss that they did not have a simple birth like others do, or even a feeling of having failed in some way. A lot of the feelings are very natural, a bit irrational, and need to be talked about and shared.

There seems to be an increased risk of Post Natal Depression after a difficult birth, so extra vigilance and care is needed. Health visitors and general practitioners will help with this, as they are well aware of how awful that can make you feel. Do consult your health visitor if you are at all worried about your mood.

Becoming a Father can take some men by surprise. They may look forward to it and share the pregnancy and birth every step of the way and be fully emotionally part of it. They may be astonished at the emotional depths they experience with this tiny scrap of humanity, and feel a connection with the child from the outset.

Others may be distanced from the process, feeling left out and that it is not really anything to do with them. They may resent the way their life is taken over, and feel jealous of the attention given to the baby. Thay may miss the warmth and closeness from the woman and hate to see it going to the child. They may also feel ashamed of these feelings and try to keep them secret.

For some men the sense of responsibility is very strong and at times unbearable. A nursing mother is vulnerable and emotionally needy, and this may seem unreasonable and unfair. This can give rise to feeling trapped, and a desperate wish to escape.

For some fathers, presence at the birth is difficult to deal with. it can seem physically frightening, even alarming, and a father who decides it is not for him should not be pressurised into being there. It can have an impact on how a man perceives his partner's sexuality, and her sexual parts. He may find it hard to feel sexual towards her in the future.

Sexual changes in the mother
The commonest change is loss of sexual desire. A very large majority of mothers notice it, and it may take up to a year to return to anything like normal. In some women, whilst it comes back to some degree, it does not return to its pre-pregnancy level, and reduces after each child. It may be partly due to the hormone changes that go with childbirth and breast feeding. In some women it is a normal sign of their adjustment from woman to mother.

For some women intercourse is mildly painful, and they have a dull aching sensation which can persist for many months. Provided healing is complete, the pain is not a reason to avoid intercourse and it does not mean that anything is wrong. Things can take a while to settle down.

Another change is slowing down of arousal, possibly because of changes to the layout of the genital area, needing a different type of touch. The vagina may be less tight and give less friction. Fear of pain after stitches may interfere with arousal. Worries about contraception, or fear of another baby too soon will also slow down arousal.

Orgasm may be delayed, partly due to any of the above, and also due to changes in the way the clitoris is positioned. Changes of sexual position or angle may help with this.

Emotional changes in the new mother
After the emotional high of delivering your baby, the anxieties and tiredness begin to be felt. Actually caring for the tiny helpless creature can make you feel emotionally raw, and because the baby's feelings are so strong and uncontainable, they can have the effect of making the mother a bit babyish in her own feelings. This may show in a need for reassurance from her partner, unexplained tearfulness, or emotional instability. She may feel the urgent need to have her own mother around.

Another emotional change is the shift from woman to mother. Suddenly there is 24 hour demand, and she has to meet it or see that somebody else does! The responsibility can seem to change her attitudes and values. "You're no fun any more" is a common cry!

Exhaustion can make it hard to know exactly what you do feel, and exhaustion is a very common part of adjusting to parenthood. After a while, many couple with one child find life can carry on quite a bit as before, but after the second baby, they really notice the difference.

Finding any emotional energy left for lovemaking is a major change for some women. After being at the baby's command, a request for intimacy of any kind can feel impossible to meet.

Firstly, the changes which are most obvious are to the body shape. Post natal exercises will help improve muscle tone and repair the stretching to the pelvic floor. A return to the normal exercise regime when possible should restore the outline to something approaching the pre-pregnancy shape, but few women retain their waist measurement precisely, so expect to increase by a few centimetres with each baby.

Less obvious changes are those which happen in the genital area, both within the vagina, and the other sexual parts. The clitoris may be in a different place relative to the vagina. This can mean you have to adjust your position to get an orgasm.

Some women find intercourse causes a dull aching sensation for a few months, and even as long as a year. Provided healing has occured there is no reason to stop making love if you want to. Imagine all the changes to the muscle structure, and it is clear that recovery from that may take time.

Inside the vagina there may be little crevices and crannies which are new. They are normal, and you may find after a bath that a little water is retained so drying is important. Also, the vagina may feel less tight than before, so the amount of friction for each partner may be less. This could mean the time taken to have an orgasm may be longer.

Childbirth has several profound and sometimes disturbing effects on the sexual life of both parents, and on their relationship generally. Whilst parenthood classes give excellent information about infant care, and what to expect, it is hard to find good advice and information about sex, and what to expect.

For some new parents, the arrival of the baby does not seem to affect their sex life much, but they are a small minority. Most mothers and a large number of fathers are affected in a variety of ways, all of which are normal, and all of them can pass with time and patience.

Provided a couple can talk to each other about what is going on, and are able to understand each other's feelings, there will be a good adjustment. Where a couple are unable to talk, having a child can make their relationship quite difficult. Misunderstandings and loss of intimacy are the main dangers.

The most common effects of childbirth on sex are the following:

• Physical changes in the mother's body after childbirth.
• Emotional changes in the new mother.
• Sexual changes in the mother after childbirth.
• Impact of Fatherhood.
• Emotional effects of a difficult birth.
• How childbirth changes a couple's relationship.

The Association of British Introduction Agencies
Tel: 020 7937 2800
Can provide a list of local commercial agencies nationwide.

Dates for the Disabled
36 Park Grove Edgware Middlesex HA8 7SJ
Tel: 020 8958 9657

Disability Now
6 Market Road London N7 9PW
Tel: 020 7619 7323
A monthly newspaper with a "Find a Friend" column.

Handidate
Wellington Centre
The Association of British Introduction Agencies
Tel: 020 7937 2800
Can provide a list of local commercial agencies nationwide.

Mutual Essential Links
1 Weir Street Northwich Cheshire CW9 5HL
Tel: 01606 49093

The Outsiders' Club
Box 4ZB London W1A 4ZB
Provides list of members, literature and social outlets for mature men and women who are looking for friendship and mutual help.

Sex is never talked about, disabled people are not seen as sexual beings.
This is why it is so important for people with disabilites to make sure the general public recognises that sex is for anybody who wants it (within reasonable social limits!)

Social skills are important, everyone just assumes you've got them.
This goes for everybody, but those who move about easily in society are much more likely to develop them. Social skills can be learned on courses and within groups. You could put out a call on the internet for someone to facilitate a group? Or be taught one to one, but that would be costly.

Expectations of others and yourself can put you under unbearable pressure.
This is a problem for almost everybody. It probably means you have to explain what it is reasonable for others to expect of you, and not to try to be what you are not meant to be. Setting realistic standards, rather than very high ones, can make the difference between feeling good, and feeling like a failure.