Couples are commonly advised that intercourse can resume after the flow of the red­dish uterine discharge, called lochia (LOH-kee-uh), has stopped and after episiot – omy incisions or vaginal tears have healed, usually in about 3-4 weeks. However, the most important factor to consider is when intercourse is physically comfortable for the woman. This depends on the type of birth, the size and presentation of the baby,

Conceiving Children: process and Choice

the extent of episiotomy or lacerations, and the individual woman’s rate of healing. The postpartum decrease in hormones, especially pronounced with breast-feeding, can cause discomfort during intercourse. After a cesarean birth the couple needs to wait until the incision has healed enough for intercourse to occur without discomfort. Other sexual and affectionate relations can be shared while waiting.

A new baby brings significant changes in daily life that can affect sexual intimacy (Botros et al., 2006). Research has found high levels of sexual difficulties after childbirth. Before pregnancy, 38% of the study participants reported experiencing sexual problems, but 80% experienced one or more sexual problems in the first 3 months after delivery. At 6 months, 64% were still having difficulty. The most common concerns were decreased sexual interest, vaginal dryness, and painful intercourse. As would be expected, women who experience postpartum depression often have less sexual arousal, orgasm, and sat­isfaction than nondepressed women (Chivers et al., 2011). A researcher, who has writ­ten books about pregnancy and the first year of motherhood, warns women and their partners to be prepared for their sex lives to be "downright crummy" for up to a year: "Mother Nature is using her entire arsenal of tricks, from hormones to humility, to keep you focused on your baby and not on getting pregnant again" (Iovine, 1997, p. 158). Women and their partners, whose sexual activity has been disrupted by pregnancy and birth, may feel out of practice in their sexual relationship. It is often helpful to resume sexual activity in an unhurried, exploratory manner.

Summary

CHAPTER 11

Conceiving Children: Process and Choice