A 2013 study from Australia, reported in the online edition of the British Journal of Obstetrics and Gynaecology, looked at the timing of resumption of vaginal intercourse after first birth and whether mode of birth (vaginal birth with intact perineum, vaginal birth with episiotomy or perineal tear with suturing, operative vaginal delivery, or cesarean birth) affected that timing.  The study authors looked at responses to questionnaires provided from 1507 nulliparous women who were recruited at 24 weeks of pregnancy as well as data from hospital records.  They found that women tended to resume other sexual activity earlier than vaginal sex.  Forty-one percent had attempted vaginal sex by six weeks postpartum; 65% by eight weeks, 78% by twelve weeks, and 94% by six months.  Women who experienced a vaginal birth with intact perineum were likely to resume vaginal intercourse earlier than women who had a vaginal birth with episiotomy or perineal laceration or an operative vaginal birth (with forceps or vacuum extractor). Women who had a cesarean birth were, on average, the last to reinitiate vaginal intercourse.

As one might guess, there were factors other than mode of delivery affecting resumption of sexual activity.  These included age at delivery – younger women resumed sexual activity sooner than older women. Women with less education (not having completed high school) were also more likely to resume sexual activity sooner. Breastfeeding and extreme tiredness as well as single, separated, or divorced status were associated with later resumption of sex.

As the authors state, “the most important finding of this study is the wide time interval over which women resume vaginal sex after a first birth.”  The common assumption among many care providers that most women will resume sex by six weeks postpartum is incorrect, and may lead to mistaken conclusions about the normalcy of women who delay sex for longer.

Reference: EA McDonald, SJ Brown. Does method of birth make a difference to when women resume sex after childbirth?  Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Melbourne, Australia. Accepted 20 November 2012. Published Online 27 February 2013.

Keywords Method of birth, perineal trauma, pregnancy cohort, resumption of sex.