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42. Postnatal sex and contraception

Introduction
How soon after delivery a woman resumes an active sex life differs quite widely among individuals. This is because of varying circumstances which may be cultural, her physical state (is there a healing episiotomy or tear?), her psychological state (relaxed, very stressed or with postnatal depression), her home situation (is there a partner? is he supportive?) and many others.

Even though the advice postnatal contraception: there are many optionsin the older teaching was that intercourse should not occur until at least six weeks have elapsed after delivery, the majority of women ignored it.

Six weeks is the accepted puerperal period but this advice was always ill-founded because it does not have any scientific basis.

Since many couples virtually cease to have sex in the final weeks of pregnancy, to impose an arbitrary moratorium after the birth is seen by many to be unacceptable and with good reason.

However, any couples resuming sexual intercourse in the postnatal period have issues to consider, one of which is the possibility of pregnancy. This is particularly crucial for bottle­-feeding mothers (the majority in the Western world). This and the other issues related to sex and contraception in this period are clarified in this section.

By Dr Joe Kabyemela, MD

Postnatal sex Implanon 'Mini-pill' Injection Natural methods Contraception options Sterilisation 'Coil' (IUCD)