You are currently viewing Let’s talk about sex after delivery – a postnatal care package component we often forget.

Let’s talk about sex after delivery – a postnatal care package component we often forget.

Sex after delivery? – Yes, you’ve read it well. It occurs, yet many women don’t get information about this vital component of postnatal care at discharge. We often indulge ourselves in teaching the mother how to take care of herself and the new-born baby – we forget to tell her how to take care of herself and the husband to avail ample time for her body to heal and recover from the ordeal of childbirth.

Many women in the villages return within six weeks after delivery with gaping episiotomies and perineal tears after following sexual encounters with their husbands: you wonder how to best care for these often-septic wounds. In the urban settings, as well as, many rural areas, women give in to their husbands such that they prevent them from having extramarital affairs, but at what cost.

Today, we talk about sex after delivery; discussing when is the right time should a woman indulge in sexual intercourse following childbirth, and how to handle the whole situation when that time comes. The duty of health care workers is providing such information to the couples at discharge rather than sorting it out themselves.

No stipulated time is right for couples to resume sex after delivery – there’s no one-size-fits-all time. Forget the six weeks after childbirth, it is elusive. Many of us think that the optimal time is six weeks because we’ve learned to believe in it – it coincides with the second postpartum check-up in many parts of the world.

Resuming sex sooner carries the risk of unwanted pregnancies if the couple uses no contraceptive methods after six months postpartum. It also increases the risk of episiotomies and perineal tears gapping. It poses a substantial risk of infection due to vaginal lesions and abrasions sustained during labour and childbirth.

The woman’s desire for sex decreases throughout pregnancy but returns to normal during the postnatal period.

Women experience discharge from the genital tracts following delivery – we call it lochia. For as long as, there’s lochia, the woman isn’t ready for sexual intercourse. In the Islamic doctrine; women in this state are spiritually unclean – they are exempt from conducting daily prayers until lochia stops. After this, they undergo a spiritual birth that prepares them for obligatory prayers. When the woman is in the puerperal period (defined by the time taken for lochia to clear), the Islamic laws prohibit the husband from having sexual intercourse with her. This period varies from 36 days to 60 days.

When the delivery course was uneventful, the healing process is fast. However, when a woman had an operative delivery or sustained perineal tears and underwent repair, the healing process is slow. She must have all the time to recover, and the health care providers should awaken the husband’s awareness, at the time of discharge.

Women experience sexuality problems during the postnatal period that range from vaginal dryness, dyspareunia (painful intercourse), vaginal loosening, loss of sexual desire, difficulty achieving orgasm, bleeding, or irritation.

To reduce such problems, women should seek pain relief, empty the bladder, take a warm birth; use a lubricant to sort vaginal dryness out; set aside time for sex when they are tired or anxious, and experiment how they want to be intimate.

Kegel exercises help the pelvic floor muscles recover their tonicity and strength. Health care providers should teach them.

Health care providers should encourage women to seek medical advice should they continue to struggle with sexuality after delivery and educate them on how to observe for such difficulties. They may be the early warnings of postpartum blues.

In summary, health care providers must enlighten the couple when the ample time to resume sexual intercourse after delivery is, and they should tailor it to the labour and childbirth process of the individual woman. Clinicians should also educate husbands on how to support their women to help them recover from the ordeal of childbirth. A postnatal care package is incomplete without discussing the component of sexuality after delivery.

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MBChB (MUK), Graduate Fellow, Department of Physiology, Makerere University Founder and Content Creator Peer reviewer, Associate Editor

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