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A new Mother is expected to adjust into her new life as soon as she has delivered the child. As if the adjustments to a new way of life are not in consequence at all. And what is she to think? A well–supported mother will bond better, love more deeply, and be better able to distinguish the needs of her child from her own. Good care frees her to develop as an individual, it gives her a healthy foundation on which to base her social interactions and contributions. Her child reaps the benefits of security and respect for its own process of growth. Yes, care of new mothers assures survival of the species, but more than that, it positively affects a culture’s quality of life.

When a woman is neglected and not taken care of during this period the effects are long term and can reflect in the future. Even though we have noted oxytocin’s ability to buffer stress, there are definitely limits. If a woman is forced out of bed or back to work too soon, overproduction of adrenaline will severely inhibit recovery. Women are not intended to give birth in the bushes and jump back on their horses. The notoriously high incidence of postpartum depression in the United States has frustrated biological needs at its root. Without adequate rest, recuperation is grueling and prolonged, and sex is the last thing on a woman’s mind.

On a practical level, she will experience a loss of income if she takes maternity leave, with a probable drop in her standard of living. More significantly, her temporary loss of energy and resourcefulness may seem all but permanent unless she receives assistance. Chronic fatigue–really very common postpartum– may link to other losses and lead to depression. Women in this phase are fragile, vulnerable, impressionable, and still quite sensitive from giving birth. Well–meaning but misguided advice sinks deep, criticism is not easily forgotten.

Yet another aspect in a woman’s recovery has to do with how well she has bonded to her baby. Animals thus separated respond in classic ways: the newborn creature will bond with whatever is available (even another species, or something mechanical), and the mother will reject her young if later reintroduced. This is powerful genetic programming meant to ensure survival. If a new mom happens to have someone who cares for the baby, changes his diapers, bathes him, and plays with him, she loses out on the entire experience of bonding with the baby.

So now back to the question of “Does a woman feel the need for sex at the postpartum period?” At the most basic level, the key to sexual health and happiness in this phase has to do with the mother recognizing her new self, working out her birth experience, accepting her changed role, and then deepening her attachment to her baby. If she is able to do all this, she will generally return to her partner with great enthusiasm. There are certain practical considerations regarding sex at this time, but ultimately, sex postpartum is not about timing and technique any more than it is at any other phase of a woman’s life.


Motherhood
Practicalities of Postpartum Sex
Women during this time are very concerned about their internal healing. Their vulnerability and susceptibility comes to the fore during this time. If the woman has had complications or undergone stitches she has a fear set in her mind. This might make it difficult for her to perform, and thus sensitivity and patience are the key words to be kept in mind not only for her partner but the entire family. Most doctors have women return for a checkup around six weeks postpartum to determine degree of recovery, readiness for intercourse, and appropriate contraception. But many women are told little or nothing of how to care for the perineum in the interim.

Why is there a time limit on sex? There is a six week ban on sex which most practitioners advice but a woman can have sex if she chooses to. Then again, the experience may be so fraught with anxiety and not a little pain that it is both worrisome and disappointing. Ordinarily, it takes about ten days for the uterus to return to normal size and the cervix to close securely. Sex during this time is correlated to bleeding beyond the normal postpartum flow. There may also be some risk of uterine infection. Stitches are a major contraindication, they take a week or so to dissolve and at least two more to heal. A woman who has had a repair should really have herself checked before intercourse, even if it means scheduling an appointment earlier than her practitioner expects or recommends.

Some women are so anxious about “The first time” that even the official all–clear is not enough. In this case, self–massage can help, particularly in areas with scar tissue. When scarring is particularly extensive, evening primrose oil (found in health–food stores) can make a noticeable difference. Due to a decrease in estrogen postpartum, lack of vaginal lubrication poses a definite problem during sex. Water–based lubricating jelly is best for intercourse, as excess oil can clog delicate vaginal tissues and glands.

Estrogen production will increase spontaneously if a mother stops nursing, or may resume gradually as she introduces solid foods and the baby nurses less often. There are exceptions, though. Some women nurse their babies (or even toddlers) just once or twice a day and still do not resume their normal cycles. Others may nurse exclusively and have milk in abundance, yet start menstruating as early as six weeks postpartum. The reasons for this discrepancy are uncertain.

In India, however, women are a lot more conscious and inhibited to seek approval of even talk about sex and the problems they face during intercourse. A woman had been suffering for seven months with pain and bleeding during intercourse. She had been back to see her doctor, who offered little advice or assistance. Unfortunately, he was also a relative, so she hesitated to seek a second opinion lest word get back to him. As suspected, she had been sewn up too tightly (the so–called “Husband’s stitch”). Even with gentle pressure to the area, drops of blood appeared as the skin tore ever so slightly apart. She and her partner were quite frustrated and miserable. Ultimately, she had to have reconstructive surgery.

Bleeding without pain is normal for up to six weeks but should be fairly light from about the third week on. It may increase temporarily with intense physical activity, indicating the need for more rest. The first intercourse may also cause a bit more bleeding, this is perfectly normal. But if bleeding persists past six weeks, placental fragments may be retained or the endometrium may be over–proliferating. If there is any doubt, it’s best to see a doctor.
Andrologist   Gynaecologist and Obstetrician   Sexologist   Postpartum Sex