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London - Recently, it was revealed that childcare guru Gina Ford has advocated that women force themselves to have sex within four to six weeks of giving birth.
Her new book, The Contented Mother’s Guide, aims to tell women how to stay intimate with the father of their child. One section dedicated to sharing advice from other women even advises “sometimes you may just have to grin and bear it”.
I absolutely disagree with this sentiment and with Gina’s advice, and I think it is dangerous to be dogmatic about something which is so subjective. But I am pleased the topic has been brought up.
At the routine six-week postnatal checks I do in my surgery every week, the tricky subject of resuming sex is something I make sure I discuss with all women because it causes a lot of apprehension and anxiety.
Every woman is different. My message is this: there is no normal. Some women feel ready within weeks, for others it could be months. The main thing is to keep an open dialogue with your partner after ruling out any underlying health problems which may trigger reluctance.
Is it safe to have intercourse four weeks after giving birth?
For many women it is perfectly safe if they feel ready physically and emotionally. However, I would advise caution in women who have had any tear or stitches, a postnatal infection or urinary incontinence. In these cases it is worth waiting for your six-week check so that your GP can examine you and ensure healing has occurred. It is normal to discuss this at your six-week check and for your GP to examine you if there are any concerns.
If Gina is wrong, when should women be ready to resume sex?
You can’t set a timeframe. To do so creates pressure, both physically and emotionally, at a time when a woman’s body and psyche are already under tremendous strain. It is also unnecessary to add to the guilt many women feel anyway after birth, particularly in those who are suffering with “baby blues”. Critically, women who have had any complications in labour or after birth must be careful to listen to their own bodies rather than guidelines on this matter. If you still feel anxious about it three to four months postnatally, it is worth speaking to your GP as apprehension by then would indicate a physical or psychological problem that needs to be overcome.
I can’t imagine ever feeling ready after giving birth. Is that normal?
Absolutely. I find that among my postnatal women, resuming intercourse causes a tremendous amount of anxiety, especially after a natural delivery. The anxiety is also fuelled by sleep deprivation and the changes in relationship which can be characteristic of this time in a couple’s life. Once you feel ready, it is best not to hold off as it should not be painful: the anticipation is worse.
Does the advice change if I have had a caesarean delivery?
I give the same advice to patients who have had a caesarean birth. There is generally no perineal damage after a C-section, but there can still be the discomfort, bleeding or infection postnatally that warrants caution.
Do I need to think about contraception this soon after birth?
Definitely. A woman can ovulate as early as 28 days after delivery, which means she would be fertile again at this time. I have patients who have been pregnant again by the time their baby is three months old, so it does happen. Contraceptive choices will depend on whether the baby is breast-fed or bottle-fed, but there is a huge range available. If you do not want to become pregnant again you cannot rely on breastfeeding as birth control.
Gina’s book says men can sometimes feel “emotionally closed out” by a lack of intimacy following the birth of a baby. What can I do about this?
Maintaining a good relationship is crucial, although difficult after giving birth. I advise my patients to work on getting babies to sleep early in the evening so couples can prioritise each other. If a friend or grandparents offer to look after the child one evening, accept the offer. - Daily Mail
* Follow Dr Cannon on twitter.com/Dr_Ellie