©Pregnancy bliss 2008

Postnatal sex and contraception issues

 

Resuming Sexual Intercourse after delivery

The timing of resuming sexual intercourse after delivery depends on the newly delivered mother's specific concerns. The sweeping answer is, therefore; whenever she is physically and psychologically ready.

 

Risks in resuming sex ‘too soon’ after delivery

There are two main concerns. Firstly, the area around the birth canal is likely to be tender after delivery, making it difficult to have satisfying coitus. It could even be painful.

 

There is also the post­-delivery vaginal discharge (lochia), which may be rather off­-putting. This takes a few weeks to stop completely.

 

From the medical point of view, there is the theoretical risk of precipitating an infection of the raw womb lining, a condition known as endometritis. This is because the bacteria that reside in the vagina may hitch a ride on the sperm, ending up in the womb and even the pelvis. If one has to have intercourse in this early period, the use of condoms is therefore recommended.

 

Issues of postpartum libido

It is true that many women experience low or absent libido in the period after delivery. However, this is not universally the case.

 

A mixture of psychological adjustment to the new role as a mother and the sheer physical exhaustion that this role engenders may place sex low on the list of priorities.

 

It is thought that the role of hormonal changes in this state of affairs is minor. However, it is true that levels of the sex hormone estrogen are low, especially for those who are fully breast-feeding. This may cause relative dryness of the vagina, which may make sex uncomfortable or outright painful. This is easily overcome using an estrogen vaginal cream or a vaginal moisturizer such as Replens MD®.

 

 

Timing of resuming sex after having a baby

This differs widely among different cultures. Surveys in the Western world have consistently shown that most women would have resumed sex by the end of six weeks.

Possibility of conception after having a baby

How soon can a woman conceive following delivery depends on a number of factors. The most important among the natural factors is whether she is breast-feeding or not. A fully breast-feeding woman has a 90% chance of not ovulating and not having a period, at least in the first four to six months.

In developing countries, this has proved to be a fairly reliable form of contraception on its own. However, emphasis has to be put on the fact that it is not 100% reliable and if a breast-feeding woman does not want to conceive, she has to use a supplementary form of contraception.

Significance of frequency of breast-feeding in preventing ovulation

For breast-feeding to be optimally effective in preventing ovulation, intervals between feeds should not exceed four hours, especially during the day and certainly not longer than six hours during the night. This is why breast-feeding is less reliable as the baby grows and starts demanding feeds less frequently and probably sleeps through the night.

Continues next page