Sexuality Following Childbirth
There is less agreement in the findings of research on the resumption of sexual activity following childbirth (Reamy &. White, 1987). The in consistency across studies is likely due to both variations in sampling meth ods, and variations in the number of weeks postpartum when respondents are interviewed. Kenny (1973), in a study of 33 women, found that at four weeks postpartum 75% reported that their sexual activity had returned to pre-pregnancy levels. Masters and Johnson (1966) reported that all 101 women they studied had resumed coitus 6 to 8 weeks after delivery. In most other studies, however, researchers have found a much slower return of sexual functioning following birth. For example, Grudzinskas and Atkinson (1984) interviewed 328 women at 5 to 7 weeks postpartum and reported that only 50% had resumed intercourse.
Kumar, Brant, and Robson (1981) reported results from the most in tensive longitudinal study to date. They recruited 147 women who were in the first 14 weeks of pregnancy. The women were interviewed three times during the pregnancy, at 12, 24, and 36 weeks. They also were in terviewed at about 1, 12, 26, and 52 weeks after delivery. During the preg nancy, frequency of intercourse declined slightly from 12 to 24 weeks, and more substantially from 24 to 36 weeks. In contrast, reported sexual plea sure increased from 12 to 24 weeks and then declined. Ninety-five percent of the women had resumed intercourse 12 weeks after delivery, but coitus was less frequent at one year postpartum than it was prior to the pregnancy. Reported level of enjoyment at 12 weeks postpartum was similar to levels reported at 12 weeks of pregnancy.
Numerous reasons have been suggested for delaying resumption of vaginal intercourse after childbirth (Reamy & White, 1987). The principal ones are pain and tenderness related to an episiotomy, vaginal bleeding and discharge, fatigue, and discomfort related to inadequate vaginal lubri cation. According to Williams Obstetrics, “coitus should not be resumed prior to 2 weeks postpartum” in order to reduce the risk of hemorrhage, infection, and pain. Beyond 2 weeks, “coitus may be resumed based upon the patient’s desire and comfort” (Cunningham et al., 1993, p. 470).
Several studies indicate that women’s sexual patterns are influenced by breastfeeding. In a study of 91 women, Alder and Bancroft (1988) found that breast-feeding (BF) women (n = 60) were less likely to have resumed intercourse 3 months postpartum than non-breast-feeding (NBF) women, and BF women reported less sexual interest and enjoyment than before the pregnancy. By 6 months the differences between BF and NBF women had disappeared. Forster and colleagues studied 19 women before and after weaning; after weaning, an increase in frequency of intercourse occurred (Forster, Abraham, Taylor, & Llewellyn-Jones, 1994). In another study Alder (1989) found no relationship between breastfeeding and resumption of intercourse. As we noted elsewhere in this chapter, the Masters and Johnson research is an outlier; they reported that the 24 nursing mothers in their sample of 101 reported the highest level of sexual interest in the 3 months following delivery (Masters & Johnson, 1966).