Sex Therapist Carli Blau On postpartum orgasms + sex while pregnant

By Ruthie Friedlander

When it comes to sex, Carli knows a thing or two — or ten. Beaming with personality and pregnant with her second, this sex therapist is a mama who’s sure to give it to you straight.

Here, she dishes on it all: from her pulsating postpartum vagina (yes, you read that correctly), to the realities of pregnancy sex, and learning how to talk to our kids about sex age-appropriately. 


I was really nauseous at the beginning of this pregnancy, but things are getting better now that I’m halfway through. We’re having a boy this time, which is exciting after a girl. Not to mention, he’s so fucking handsome. I saw him on the scan, and he’s a good looking boy. True story.

Path to pregnancy?

I’ve always been someone who wants what I want when I want it, and will do whatever is necessary to get it. For some reason, despite my experience and history with endometriosis and being on oral birth control for 15 years, I approached pregnancy with this same attitude. The reality is, we live in an instant gratification culture, and if we don’t get what we want, it’s easy to become obsessive over it. Unfortunately, I was one of those people. I wanted to be a mother, always had, and I was going to do whatever was in my power to get there. However, it wasn’t as easy as I thought. I went off birth control the night of my wedding, waited three months like the doctors suggested, before trying and tracking my ovulation. Apparently, my LH surges were too long with my body because of my PCOS, and essentially my eggs were “overcooked”. But still, we tried for months to no avail. I lived with this constant feeling of failure with each subsequent negative pregnancy test and felt defeated.

Eventually, after 6 months of trying followed by 8 months of medicated cycles with Clomid and Letrozole, and a miscarriage at 6 weeks, I opted for IVF. I wish someone would have told me honestly that my body needed a year off birth control to get regulate itself. I expected my body to remember how to ovulate after 15 years of NOT ovulating in just a few months. I put so much pressure on myself and looking back, I could have been more gentle. That said, my persistent personality and dream of being a mom helped me through my IVF journey and ultimately to meeting my daughter, Joie. 

This pregnancy was different from the start. I never went back on birth control after I had Joie. Instead, I learned about cervical mucus, ovulation, how to track cycles, and subsequently plan around it. Funny enough, the month we got pregnant was the one month I didn’t want to. I had the most important exam of my licensure, and didn’t want to be pregnant or potentially feel sick during it. But, as fate would have it, we went to a small wedding for a family member, and I looked and felt beautiful. That night we came home and enjoyed each other. It was a sweet night. I’ll tell you, I checked my Flo app before having sex and saw that I wouldn’t be ovulating for another 4 days, but sperm can live up to 5 days! It’s not very likely, but can happen. My cervical mucus didn’t scream ovulation but my drive sure did! That night, I said to my husband, “I’m not ovulating until Thursday; we’re ok, and if we get pregnant, it’s a gift from the universe”.

A month later, in my final training course before my exam, I woke up and just knew. My boobs surged, my discharge was not what it would be pre-period. I took 4 pregnancy tests, all with a faint line. Then I put one in water, and it was weirdly pink. I convinced myself it was nothing but knew otherwise. Later that night, we got the First Response Early Detection kit, and sure enough, I was pregnant. I sound like a psycho, but I have come to believe that there are babies out there waiting for the right time and the right body for their little souls. I knew it would be a boy, I knew he would come around my husband’s birthday, and here we are with a boy due June 12. I don’t know what is coming or how it will pan out, but I know that I’m where I belong, and I’m really grateful to be here.

Cravings much?

It’s funny because this was how I knew I was pregnant. I started craving grilled cheese with spicy honey mustard at 11 pm every night…on the dot! Additionally, I never eat chicken in my non-pregnant life, but now that’s all I want. Give me a spicy chicken sandwich number six combo at Wendy’s, and I’m all yours. Plus, a double cheeseburger combo from McDonald’s at least once every two weeks with large fries, ice cream, Oreos, and coffee all day long! Yes, I’m “that” pregnant girl.

Ok, so have to ask: Are orgasms during birth a thing?

Yes, orgasms can occur during birth but not often. Although, after giving birth to my daughter, my clitoris and vagina were so swollen from pushing that I was having constant clitoral orgasms for days postpartum. Sounds fun, but it was not. I literally couldn’t sit for days because my vagina was throbbing. There’s nothing sexy about sitting in your living room trying to watch Judge Judy with a baby on your boob and your vagina out of control. Or, how about trying to carry on a conversation with visiting family members while orgasming? Like, no, thank you. Finally, as the swelling went down, the orgasms subsided. Also, I found wearing compression, period-like panties plus spandex pants that went over my belly helped keep the throbbing to a minimum. 

Sex during pregnancy?

Is a loaded question. For me, I was ravenous and super horny with my first pregnancy and wanted to have sex three days a week until birth. With this one, not as much, or nearly at all. Point is it changes for everyone and per pregnancy.

Plus, desire aside, the vagina is going to look, taste, feel, and smell different when you’re pregnant thanks to extreme hormonal shifts in pH levels. So, if your partner doesn’t want to have sex, it doesn’t mean they don’t love you, but they just may not want to go down on you right now. In contrast, if you’re in a heterosexual relationship and suddenly your partner’s penis started to smell different, are you going to want to put it in your mouth? Probably not. Same goes for the vagina. Navigating this change, can be tricky and unfortunately can manifest in a variety of ways, from shame to confusion for the pregnant woman: why doesn’t he or she want me? But, it’s more complicated. And, not for nothing, but there’s something sexy about being able to look your partner in the eyes when going down on them, and when you get past the six-month mark of pregnancy, looking up at your stomach instead of into your eyes may change the mood for them.

All this to say, much of this can be navigated through communication. Talk to each other openly and ask questions like: Do I taste different? Do I smell different? Do you like still going down? And, if they don’t right now, know that it’s okay and you can get back there. 

How did you come to work as a sex trherapist?

I’ll give you the Reader’s Digest version. I became a sex therapist because I had an unhealthy, sexually active relationship when I was a teenager. While I grew up in a loving, wonderful home, my mom didn’t know she needed to talk to me about sex at 13/14 years old. Therefore, I became fascinated with understanding what was going on with my body. I had a friend whose parents had a library in their house with sex textbooks, and I read them all. I became “that girl” among my friends whom everyone asked about sex; I always had answers based on my textbook learnings. If you’ve seen Sex Education on Netflix, I was essentially Otis before there was Otis.

As I got older, I dated a lot of assholes who didn’t really value me. And while I’m a confident and bubbly person, I lacked self-love and self-respect. But I did the work on myself. I healed and I practice what I preach. And, this is where the therapy part came into play. I realized that if I had the tendency to be in unhealthy relationships, even though I cam from a loving home, I could only imagine what other young adults that came from less loving homes must be going through and how alone they must feel. I wanted to be able to guide them. 

My work as a sex therapist focuses a lot on women’s health issues like pelvic floor dysfunction, endometriosis, and infertility counseling. The joke now is: ‘I know how to get people pregnant.’ In fact, I just had my third couple tell me they’re pregnant! Additionally, an important part of my practice is about helping women and men come to love themselves. I see therapy as though each of my patients is essentially a bird with a broken wing and the intention is for you to fly off on your own again, not to be dependent on me. In my office, you do the work, you heal, you have a safe space to explore yourself and be supported. Then, as your wing heals, you fly off on your own again, and if you need me, I’m here. But the idea is to empower people, not to make them dependent. With me, you’re not in therapy forever. 

That’s interesting, how do we learn to talk to our kids about sex?

As a parent, I’m a firm believer we need to get educated on how to provide age-appropriate sexual facts to our kids. They only know what we, as adults or their peers, teach them. And when children start to ask questions, we should be prepared with answers for each age. We mustn’t rush our children, and yet, at the same time, we must provide them with adequate information. A colleague of mine, Jennifer Litner of Embrace Sexual Wellness, has created a fantastic curriculum for parents to teach their children about sex and answer questions based on age appropriateness: Building Ease Talking About the Birds and the Bees 

One hope?

My hope for the next generation is that we don’t forget the power of physical and emotional connection. In today’s society, I feel we’re becoming increasingly insecure with some only having the courage to speak out from behind a screen. The quality of relationships, both for adults and children, are dwindling. Recently, I saw a kid on Tik Tok tell another child that she couldn’t be in her video! When we were kids, we’d choreograph dances together for hours in front of the mirror; sadly it feels as though this doesn’t happen anymore. My hope is that we become more open-minded and accepting as a society and that my children grow up to value physical and emotional vulnerability with other people.

Any advice?

Give yourself a break. You’re a human being and there’s only so much that you’re capable of. Plus, when your child comes into the world, recognize there’s a reason they say it takes a village to raise a child. No woman can do it on her own. You will not get an award or any notoriety for doing it by yourself. And quite frankly, you should not have to. Mothers are not meant to be mothers alone. It doesn’t mean we have to have a romantic partner; it only means we need to ask for help from friends, family or therapists, because this is an arduous journey. I suffered from postpartum depression and anxiety because I thought I had to do it all by myself. Finally, I surrendered when I realized that I couldn’t, and that had nothing to do with me being a strong woman or not. In the end, I gained my strength when I admitted I couldn’t do it by myself. The day I asked for help was the day I became an even better woman.