A pressing question for new parents in the weeks after childbirth might not be just about diapers and nightly feedings, but also when it is OK to start having sex again.
Most doctors will recommend waiting until after a six-week follow-up visit, but for some women that time frame doesn't work.
Researchers at Purdue University's College of Health and Human Sciences conducted extensive interviews with 70 women ages 19 to 78 years living in South Carolina, part of an oral history project on women's reproductive health experiences including menstruation, contraception, childbirth and sexual violence. The results were recently published in the journal Culture, Health & Sexuality.
They found the women usually relied on their clinician's opinion to wait until after the six-week postpartum visit to resume sex.
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"But we found some women were ready before six weeks due to personal and partner desire, while other women expressed difficulties resuming sex, including pain and exhaustion from caring for a new baby," said Andrea DeMaria, an assistant professor at the university and lead author of the study.
The American College of Obstetrics and Gynecology states postpartum care should be an ongoing process rather than a single appointment, and that all women should have contact with their obstetric care providers within three weeks of delivery.
There is no one-size-fits-all approach. Health care professionals should tell their pregnant and postpartum patients that women have varied experiences with resuming sexual activity after they give birth, the researchers said
Experiences can differ by the type of delivery, as well as with self-confidence and body image, they found.
Florencia Polite, chief of the Division of General Obstetrics & Gynecology at the Perelman School of Medicine, says resuming sex after a birth should not be rushed, and that six-week visit is an important for several reasons.
"We want to make sure everything is OK after childbirth," she said.
Women who had a scheduled c-section may not need the same amount of time as someone who had to push before having the procedure or those who had a vaginal delivery, she said.
The mothers need time for their body to recover, Polite said. The cervix needs to fully close, the vagina needs to heal. If stitches were required, it takes about six weeks for them to dissolve. Plus, women need to be screened for any postpartum depression issues, she said.
"There is a lot we cover in that visit," said Polite.
The majority of partners are ready to resume sex. But she also counsels couples that sex is not just a "yes or no" event. Some will be mentally ready before the new mother is physically ready. In some cases, she said, having sex too soon has meant the woman has had to return to the hospital.
Although patients are told to wait six weeks before having sex, about half don't, Polite said. As a result, doctors talk about contraception before the delivery rather than waiting until that six-week appointment, she said.