How healthy is sex after childbirth?

Many people believe that sex during pregnancy is ‘forbidden’, while some dislike it even after childbirth. Medical experts however say there is nothing wrong with having sex after childbirth and it is not also time or season-bound for couples, reports Sade Oguntola

Childbirth could be a traumatic process or experience for a woman. Having a baby pass through a birth canal, that is, vagina, is almost like having a small explosion inside. The delicate vaginal tissues are inevitably strained, bruised and torn and may take some weeks for these injuries to heal up.

Also, childbirth involves very considerable hormonal changes as well as emotional stress. Therefore, some women may not regain their sexual feelings for some time after delivery and the reasons for this are many. The major reasons however include soreness of the vagina and the stitches. Being extremely tired could also be a factor, especially in new mothers that are yet to adjust to the life of having a new baby around to take care of in the house.

Meanwhile, different mothers will give different reasons for the time it would take them to start having sex again after giving birth. “For me, I can only allow my husband to have sex with me only after weaning my child,” was the opinion of Mrs. Fecilicia John, a trader at a popular market in Ibadan. But for Mrs. Afolabi Ojikutu, a businessperson, she said, “I can have sex with my husband after 41 days when I would have started my monthly period (menstruation).” Mrs. Gloria Chukwudi, another business woman stated that she would only resume sex with her husband after she had stopped breastfeeding her child, which could be one to two years in order to prevent another pregnancy.

“After childbirth, having sex with a woman is not an easy task. When my wife gave birth to our first child, I could not go near her for the first four months because of the fear of hurting her or opening the wounds in her vagina,” stated Mr. Poju Onigbinde, a legal practitioner. New parents often wonder when it is okay to resume having sex after having a baby. In fact, it is common for new mothers to have problems getting in the mood for lovemaking. Sometimes, it is as simple as being tired or feeling unappreciated. It can be hormone-related or can be symptoms of postpartum depression. However, medical experts assured that there is really no fixed time to start having sexual intercourse after delivery.

“There is really no hard and fast rule as to when a woman could start having sex after a child birth. Both partners only need to be ready for it,” said Dr. Adekanmbi, a chief medical consultant, Adeoyo Maternity Hospital, Ibadan. Speaking further, the doctor said, "the only exceptions are if the woman had an episiotomy that is yet to heal, had a birth injury or a or if she had caesarian section operation (CS) to deliver the new baby.” According to him, “With stitches and the opening of vagina with sore that is yet to fully heal, there may be pain. Mind you, sex between two partners should not make any of them uncomfortable."

Given that the delivery of a baby per se is not a disease, but another physiological change that the body went through, Dr. Adekanmbi said provided that the two partners are keen, they can go ahead to have sex even with the after birth blood or fluid associated with delivery. “Just as there are no laws saying that there cannot be sex during a menstrual period as long as there are no infections on both sides, so there is no law that prevents a man from having sex with his wife that has just put to bed so long they both agree," Dr. Adekanmbi said.

The doctor described as untrue, the notion that having sex before six weeks after having a baby can lead to infections affecting the cervix and the mouth of the womb, adding that, this cannot be substantiated scientifically. Even then, the woman may not feel ready to ‘go all the way’ Since pain is subjective and what two persons may classify as pain varies, he counseled that it is important for both partners to realize that lovemaking may not be comfortable or enjoyable in the first six months or so after delivery. Even when both partners are ready to have intercourse after the birth, it should begin gently. If possible, they may have to find a time of the day when both are not tired.

After child birth, there may be some discharges that some may find unhygienic, but Dr. Oladapo Olayemi, a consultant obstetrics and gynaecologist at the University College Hospital (UCH), Ibadan, however said, as far as medicine is concerned, “it is okay for a woman to start having sex any time after having a baby, provided it is with her husband as this puts are at a reduced risk of infections."

According to him, women that had episiotomy may have pain, but by the second week, she could commence sex. Also there is no rigid rule about when a woman should start having sex after having a baby. In a recent but unpublished study, Dr. Olayemi said, “by the second week, most women have commenced sex. From the study, by the second week, 38 per cent had commenced sex and by the fourth week, the number had jumped to 82 per cent. However, those that had caesarian delivery commenced sex much earlier than those that had normal delivery because their vargina was not affected, nor bruised.

So, it is advisable to have sex. In fact, it is something many women do for several reasons. Some women may not like it, it may be a turn off for some partners, which has no physical link with ability to have sex. It may even be a psychological response of the woman to her partner,” he stressed. Another doctor, David Delvin, a family planning specialist however said childbirth will definitely affect a couple’s sex life, adding that couples should not expect that everything will instantly return to normal. A lot of men, he said, are particularly likely to believe this and may want to have intercourse as soon as their partner gets home from hospital. However, considering the fact that childbirth is a traumatic process for a woman and that it involves very considerable hormone changes as well as emotional stress, very few women would not feel like having sex until a long time after they have given birth.

Dr. Delvin then suggested that a woman wait until after her postnatal check-up. This examination usually takes place about six weeks after delivery. According to him, if you’re in any doubt about whether to resume sex, ask the doctor who does your postnatal examination for advice, particularly about using additional lubrication.” Typically, by four weeks, most women that had caesarean section would have resumed nearly normal activity, including sexual intercourse. However, you still may have some discomfort from surgery and this may prevent you from engaging in sexual intercourse. Generally, no sexual activity should occur until the uterus is back to its pre-pregnancy size. This helps to reduce discomfort and the incidence of infections. But physicians will let the patient know when it is safe to resume sex,” he emphasised.

Furthermore, Dr. Delvin said some women do not regain their interest in sex even afterwards. This he said is quite common and may be a symptom of postnatal depression (PND). Such a woman he advised may need to see her doctor for help or counseling from an expert in sexual problems. Many women experience some moodiness, sadness and anxiety in the days following delivery (the so-called “baby blues”) but this normally improves within a couple weeks.