Most first-time mothers wait until after 6 weeks postpartum to resume vaginal sex following childbirth and women who have an operative vaginal birth, caesarean section, perineal tear or episiotomy appear to wait longer, suggests a new study published today (27 February) in BJOG: An International Journal of Obstetrics and Gynaecology.

The study, conducted by the Murdoch Childrens Research Institute, Australia, used data from the Maternal Health Study, a large prospective pregnancy cohort in which data were collected from self-administered questionnaires in early pregnancy and at 3, 6 and 12 months postpartum. The study used a sample of 1507 first-time mother to investigate the timing of resumption of vaginal sex and assess associations with methods of birth, perineal trauma and other obstetric and social factors.

Results show that 41% of women attempted vaginal sex by 6 weeks postpartum, 65% by 8 weeks, and 78% by 12 weeks, with this figure increasing to 94% by 6 months postpartum.

The study also found that sexual activity was resumed earlier than vaginal sex, with 53% resuming sexual activity by 6 weeks postpartum.

Furthermore, women aged 30-34 years were significantly less likely to have resumed vaginal sex compared with younger women, aged 18-24 years, by 6 weeks post partum (40% compared with 63%).

Women who had a caesarean section, a birth assisted with forceps and those who had an episiotomy or sutured tear were also less likely to have resumed vaginal sex by 6 weeks postpartum compared with women who had had a spontaneous vaginal birth and intact perineum. The results show that 45% of women who had a caesarean section, 32% who had a forceps-assisted birth, 32% who had an episiotomy and 35% who had a sutured tear had resumed vaginal sex by 6 weeks, compared with 60% who had a spontaneous vaginal birth with intact perineum.

The paper states that only around 10% of women having a first baby will achieve a vaginal birth with an intact perineum. Hence, for the vast majority of women and their partners, it is reasonable to anticipate a delay in resuming vaginal sex related to the events of labour and birth, say the authors.

Associate Professor Stephanie Brown from the Murdoch Childrens Research Institute, Victoria, Australia and lead author of the study said:

“The most important finding from the study is the wide time interval over which couples resume sex after childbirth. Most couples do not resume sex until after 6-8 weeks postpartum, and many delay much longer than this.

“This is useful information for couples to know before their baby is born, and may help reduce feelings of anxiety and guilt about not resuming sexual activity sooner.”

Ellie McDonald, from the Murdoch Childrens Research Institute and co-author of the research said:

“The study findings provide evidence that both method of birth and degree of perineal trauma play a role in the resumption of sex after childbirth.

“It is possible that some couples delay resumption of sex until after the 6-week check-up on the grounds of waiting to check that everything is back to normal. This may explain the relatively large number of women that resume vaginal sex at 7-8 weeks postpartum.”

John Thorp, BJOG Deputy-Editor-in-Chief added:

“It is very common for women and their partners to want information about when sexual activity may be safely and comfortably resumed, and what to expect in relation to the impact of childbirth on their relationship.

“Having reliable information to guide clinical practice can dispel common myths about what is normal during the postnatal period as well as enabling clinicians to tailor information to a woman’s individual circumstances.

“This study provides important new evidence to guide information given to women and their partners about what to expect after childbirth. However, it is important to remember that these decisions are down to the individual couple and when it feels right for them.”

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Rebecca Jones
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Wiley