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28 July 2014

UK: Contraceptive needs of new mothers

A quarter of new mothers resume sex by 6 weeks, research by British Pregnancy Advisory Service shows.

A quarter of new mothers (23%) start having sex again by 6 weeks after having a baby, while more than one in ten wait longer than 6 months, according to a survey carried out for British Pregnancy Advisory Service (bpas). Pain and exhaustion are among the principle barriers to resuming sex, but sadly body image anxieties among new mothers are also widespread.

Tearing or episiotomies (surgical cut to the perineum) with a vaginal delivery and having an emergency caesarean section have the greatest impact on when a woman resumes sex. The survey shows that the majority of women delivering vaginally will have some perineal trauma (72%) - and nearly 9 out of 10 first time mothers.

The survey of more than 1,300 members of the Bounty parenting club suggests women are waiting longer than in previous generations to resume sex after childbirth. Research from the 1970s indicated many women started having sex again between the 2nd and 4th week after birth.

Women who have had vaginal deliveries without tearing/episiotomy followed by those who have undergone planned caesarean sections are most likely to resume sex by 6 weeks (35% and 25%), while those who have experienced tearing/episiotomy or undergone an emergency caesarean section wait longer (20% and 13% by 6 weeks). By 3 months, 60% have resumed sex, and by 6 months nearly 90%.

This research provides the first recent data on the resumption of sex after childbirth in the UK and shows there is a wide timetable, which many new mothers may find reassuring.  It also found that:

- Nearly half of women say feeling uncomfortable about their body after having a baby put them off resuming sex (45%). This follows on from previous research by the Royal College of Midwives in which the majority of mothers said “celebrity culture” increased the pressure on them to regain their pre-pregnancy shape

- A quarter of women (23%) are worried about contraception and becoming pregnant again

- Nearly half of women (48%) say they would have felt unable to confide in a healthcare professional about any concerns over resuming sex if they had needed to

Fertility can return within a month of childbirth. The survey indicates many new mothers will need access to contraception before the 6-8 week postnatal check when it is usually discussed, and fewer than a quarter of mothers said they found it “easy” to get their chosen contraceptive.  There are several effective contraceptive methods which can be used while exclusively or partially breastfeeding, including the mini-pill, coil and implant and emergency contraception (the Levonelle morning-after-pill).  However knowledge about the safety of these methods is poor, with most mothers believing only condoms can safely be used.

BPAS has produced a guide to contraception after a baby, which provides information on the return of fertility and which contraception can be used whether women are breast or bottlefeeding. With the welcome support of Bounty, the guide will now be included in the Bounty pack distributed to over 800,000 new mothers in maternity units across the UK.

Clare Murphy of BPAS said: “There is no set time to start having sex again after having a baby - all that should matter for women is that it feels right for them and that they have access to the contraception best suited to their needs if they wish to avoid another pregnancy straightaway. We regularly see women experiencing unplanned pregnancy in the year after giving birth, sometimes because of confusing information about breastfeeding and contraception.

“The sexual health needs of new mothers will be diverse and we need to find innovative ways to support them. This may mean ensuring more information is provided antenatally, enabling those women who want to leave hospital with contraception to do so - including with an advance supply of the morning-after-pill if she wishes. Contraception and sexual health clinics dedicated to the needs of women with young children would be welcome.”

Cathy Warwick, chief executive of the Royal College of Midwives, said: “In the interests of the long term health of women, it is really important that midwives are able to devote time to these discussions. Opportunities should be found in both the antenatal and postnatal period to provide the support and information that women want and need.”

Lisa Penney of Bounty said: “The findings from the Bounty survey amongst new mums have shown just how important it is that mothers are provided with this vital information.  For 55 years, we have worked in partnership with the NHS to provide information to new mums and we are proud to be supporting bpas, mums and midwives by distributing this guide in the Newborn packs we give out in hospital maternity wards across the UK.”

Read the full report here:

Sex and contraception after childbirth: Supporting women’s choices in the postnatal period. BPAS, July 2014

A quarter of new mothers resume sex by 6 weeks. bpas, 28 July 2014

Morning-after pill should be handed out in maternity wards – BPAS. Call for new mothers to be given emergency contraception in advance to help prevent unwanted pregnancies shortly after giving birth. Daily Telegraph, 23 July 2014