Breastfeeding and sexuality immediately post partum

To examine the relationship between breastfeeding and resumption of vaginal intercourse; to determine the association between these behaviours and age, parity, marital status, mode of delivery, and contraceptive use; and to identify factors associated with resumption of intercourse among Canadian women in the early postpartum period.

Prospective survey.

Eleven obstetricians' offices in three Ontario communities between August and December 2002.

Women attending their first postpartum visit.

Resumption of vaginal intercourse.

Of 316 respondents, 181 (57.3%) were currently breastfeeding, and 167 (52.8%) had not yet resumed vaginal intercourse. Mean age of the mothers was 28.7 +/- 5.3 years; mean age of their babies was 6.5 +/- 1.1 weeks. This was a first child for 50.3% and a second child for 32.6%. Most women (72.8%) were married; another 19.3% were in common-law relationships. Married women were more likely to breastfeed (P = .001), as were those with higher parity (P = .008). Multivariable logistic regression identified five variables significantly associated with resumption of intercourse by 6 weeks post partum. The two most statistically significant variables were breastfeeding (exclusively or supplementing with bottle) and baby's age in weeks (P < .001 for both). Mode of delivery (vaginal delivery with no tearing, compared with cesarean section or vaginal delivery with tearing) was also a highly significant predictor (P = .003), as was higher parity (P = .003). Older maternal age was weakly associated with resumption of intercourse (P = .049). The 167 women who had not resumed intercourse were asked to indicate their main reasons: 161 responded, citing a total of 215 reasons (54 cited more than one reason). The most common reasons were lack of interest (18.6%), being too tired (16.8%), being afraid of intercourse being painful (16.8%), physician told them not to (15.6%), and thinking they should wait 6 weeks (14.4%).

Breastfeeding women who delay resumption of intercourse during the postpartum period might benefit from open discussion of breastfeeding, sexuality, and contraception immediately post partum.