Sex after delivery
Is there a universally agreed ‘back to sex by’ date?
No hard and fast rules Even though there are no hard and fast rules as to when or how a couple should resume sex, central to all opinions, though, is a common agreement that intercourse should not take place immediately a mother is discharged from the labour ward. Usually, after the physical processes of pregnancy and birth, it is true that a woman may not have the urge to have sex due to exhaustion, if nothing else. Having the baby pass through the vagina during delivery makes it strained, tender and sometimes torn. At such a time sex would be difficult, uncomfortable, painful and repulsive.
Review at six weeks
In general, and traditionally, doctors have advised couples to consider sex only after six to eight weeks after delivery (a period known as the pueperium), when a postnatal review is undertaken. In this review the physical condition of the mother and her baby is assessed. Of course there are those (men or women) who want to have sex as soon as practically possible, and there may be instances where couples work to resume a sex life much earlier than six week, but this is the exception rather than the norm. Even then, for those familiar with what a woman goes through after childbirth, six weeks is a very short period and must not be treated as a deadline. In fact, there are no deadlines! On the other hand, it would be unusual for a couple not to have resumed sex between three to six months.
Demands of a newborn
Sometimes it is difficult for women to engage in sexual intercourse because of the demanding needs of the new born. At this time the baby is endlessly or regularly crying and needs to be breastfed, touched and rocked quite often. This certainly makes it difficult for couples to fully focus on sex. However, when the mother’s physical and emotional conditions and environment stabilize, and the baby’s feeding and sleeping habits become predictable or manageable, sex can comfortably take place.
Doctor’s permission is not a court order
Consulting a doctor on when to resume sex is advisable, especially if you’ve had a C-section or an episiotomy. However, it needs to be borne in mind that the doctor only advises on your physical readiness to engage in intercourse. There are many other factors that will determine your decision on the exact timing of your resumption to an active sex life. A man may feel that because the doctor has ‘ruled’ that his wife is ‘ready’ to get back to a sex life, she has an obligation to oblige. Some may even display a sense of entitlement. It makes sense for both husband and wife to recognize that the doctor’s advice is simply safe counsel, not a court order!
What makes sex after delivery difficult for a woman?
Risks of early sex
There are many risks associated with attempts to have sex after pregnancy before the woman is physically ready. These include the possible rupture of an episiotomy or C-section stitches and pain due to lack of lubrication in the absence of adequate stimulation. Painful intercourse after a vaginal delivery is actually common. Another physical factor is the preparedness of a woman’s vaginal muscles, which are elastic and will have been stretched by the baby’s exit.
Episiotomy
This is an incision made on the perineum (thin area between the vaginal and anal canals) to enlarge the vaginal exit, thereby easing the baby’s exit. It is not a must for one to be cut and stitched, and some recent initiatives have discouraged routine episiotomies. An episiotomy takes between two to three weeks to heal, but one may continue feeling sore or sensitive for a while. Exerting pressure or stretching an episiotomy wound can be painful and can cause further injury. Even after sexual intercourse is resumed, care should be taken not to initially exert too much pressure on the scar.
Hormonal effects
Sudden changes in hormones after delivery may lead to a dry vaginal canal, and consequently painful sexual intercourse. This may persist for upto twelve weeks or more, improving gradually. Mothers who breastfeed exclusively are believed to stay drier for longer. Other reasons for dryness include postnatal depression, worriers, anxiety, emotional stress and a busy baby care schedule, all of which take interest away from sex.
Low vaginal muscle tone
The feeling that the vagina is less tight after delivery is a fact. It is the result of pressure exerted by the head of the baby on exit. Even though the muscles are elastic and do return to their pre-pregnancy state with time, that process can take several months. Certain exercises are commonly recommended to aid in tightening these muscles. A simple and practical one is to regularly hold the flow of urine long enough to count 1 to 5.
The art of stimulation
Before pregnancy, a man’s territory and options for stimulation of his wife is vast and unrestricted. After delivery however, he is faced with major obstructions, and he has to be innovative if he is to succeed in foreplay. First, for many women touching of the breasts is a no-no. High tenderness of the nipples combined with reduced breast sensitivity means that where there was pleasure there may now be irritation or nil impact. Engorged breasts and cracked nipples are just examples of what can make matters worse. Second, vaginal and abdominal caresses may be another no-no, depending on whether one had an episiotomy or a C-section. The woman’s fatigue and weakness also means that most foreplay must happen with the man keeping his weight to himself.
What steps can a couple take to make Sex after delivery easy?
The role of frank discussions
Childbirth results in new changes of a physical and emotional nature. A couple who talk frequently, openly and responsibly about their feelings will therefore find themselves on a better track to recovery than those who keep feelings and opinions to themselves. You may be surprised at how understanding your partner may become once they know what you think and how you feel, because it helps to manage their expectations.
Coming to terms with the situation
There is no automatic switch between the healing of a wound and sexual drive. A woman has to first get to terms with herself and comfortable with her privates before she can entertain ‘intrusion’ by her lover. For some women, accepting the scars on their bodies and feeling beautiful once again can take a while. This is a natural healing process and it must be nurtured to completion with the help of the husband.
The importance of foreplay
It needs not be overemphasized that a woman cannot enjoy sex if she is dry. Lots of foreplay and patient romance can help her get ready for sex. If repeated attempts do not work but she feels ready for it, she can use recommended lubricants to aid the situation. In such cases it is advisable to consult a doctor first as some lubricants may cause irritation.
Emotional changes
Your wife is a new parent, with all the demands and responsibilities on the queue. Her sleep (and sometimes yours too) will be interrupted and some meals will get skipped. She will be concerned about weight, stretch marks, a sagging tummy, healing wounds, etc. All the ingredients for loss of self-esteem will be in the offing. Unless her husband can step in and help her both physically-by sharing baby care duties and household chores-and emotionally by talking, talking and talking; gently and constructively, with her, it may be a long while before she ‘gets back that kick’.
Fear of pregnancy
Some couples may delay resumption of sex because they fear getting pregnant again so soon. True, unless one is prepared for back-to-hack pregnancies, it makes sense to decide early on the post-delivery birth control methods you will use. Ordinarily a breastfeeding mother has less chances of getting pregnant, but that does not mean she cannot conceive. Fertility of a woman is restored just six weeks after delivery, and it is therefore better to play it safe than sorry.
END: PG 11/52-53