February 4, 2019

Let’s talk about sex … after childbirth

Study shows generally accepted standard of six weeks may not be enough

WEST LAFAYETTE, Ind. — Some feedback from doctors seemed almost appalling.

One woman remembers her gynecologist stating, “Well, girl, you better, because if you don't, somebody else will.”

Another said, “My doctor was really excited to tell [my partner] at six weeks that I was ready to go.”

Yes, we’re talking sex. After childbirth.

Beginning sexual activity after pregnancy isn’t always like riding a bike, especially for mothers experiencing postpartum pain, fatigue and stress. Yet, many couples are led to believe there is a hard-and-fast point at which they can resume sexual intercourse, according to 70 in-depth interviews with women in South Carolina.

The findings were recently published online in the journal Culture, Health & Sexuality.

Andrea DeMaria Andrea DeMaria, an assistant professor in Purdue University’s College of Health and Human Sciences, recently led a study of 70 women regarding their postpartum sexual experiences. (Purdue University photo) Download image

“Among participants, the most frequent recommendation from health providers was to resume sex after the six-week postpartum visit,” said Andrea DeMaria, an assistant professor in Purdue University’s College of Health and Human Sciences who led the study. “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.”

The American College of Obstetrics and Gynecology recently revised its recommendations on postpartum care, stating it “should be an ongoing process, rather than a single encounter, and that all women have contact with their ob-gyns or other obstetric care providers within the first three weeks postpartum,” according to a news release issued by the professional organization.

Although the recommendation was designed to reduce maternal morbidity and mortality, the move represents a departure from the current “one-size-fits-all” approach to postpartum care, DeMaria said.

“Providers should communicate to their patients pre- and postpartum that women have varied experiences with resuming sexual activity after birth, and there is not one strict recommendation or guideline that applies to everyone,” she said.

The in-depth interviews reinforced previous findings that individual women significantly differ in how they experience postpartum sexual desires and pleasures, which are often influenced physically by delivery mode and psychologically by self-confidence and body image. The study also highlighted the need for candid conversations about the subject among mothers, partners and doctors, even at the prenatal stage.

“If health care providers can bring this up and normalize these different experiences, then women and partners will be more aware of what they should be on the lookout for, that these feelings they’re experiencing are normal,” said Stephanie Meier, a doctoral student at Purdue and co-author of the paper. “Those conversations should continue throughout prenatal and postpartum.”

The study is part of a larger oral histories project recording women’s reproductive health experiences across generations, including menstruation, contraception, childbirth and sexual violence. The recordings will be archived for future reference, Meier said.

“Researchers and people who are interested in the history of South Carolina and the community can go back and listen to these recordings so those stories aren’t lost,” she said.

New mothers seeking advice on postpartum health should contact their personal health care provider, DeMaria said. Women also can reference postpartum toolkits provided by the American College of Obstetrics and Gynecology or contact Indiana’s Office of Women’s Health.

The work aligns with Purdue's Giant Leaps celebration, acknowledging the university’s global advancements made in health, longevity and quality of life as part of Purdue’s 150th anniversary. This is one of the four themes of the yearlong celebration’s Ideas Festival, designed to showcase Purdue as an intellectual center solving real-world issues. 

Writer: Joseph Paul, 765-494-9541, paul102@purdue.edu

Sources: Andrea DeMaria, 765-494-8300, ademaria@purdue.edu

Stephanie Meier, meier11@purdue.edu

Note to Journalists: Journalists interested in a copy of the paper should contact Joe Paul, Purdue News Service, 765-494-9541, paul102@purdue.edu

Abstract-Understanding women’s postpartum sexual experiences

Abstract-Andrea L. DeMaria, Cara Delay, Beth Sundstrom, Audrey L. Wakefield,

Angel Avina and Stephanie Meier

Abstract-This study aimed to understand women’s sexual health experiences, specifically knowledge, attitudes and norms related to sexual behaviour resumption during the postpartum period. Semi-structured, reproductive health-focused interviews (N1⁄470) were conducted among women aged 18 years or older (range: 19–78) residing in South Carolina. Findings demonstrated that women identified clinicians as most influential concerning when they should and could resume sexual activity. Some women noted returning to sex earlier than anticipated due to personal and partner desire and indicated achieving considerable sexual satisfaction during the postpartum period. However, other participants noted difficulties resuming sexual activity, including pain and exhaustion from caring for a new baby. Findings provide practical recommendations for health professionals to further develop tailored, timely health messaging related to safe and healthy postpartum sexual behaviours. We discuss recommendations for health professionals to bring further awareness to varied postpartum sexual experiences.

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