Is 6 Weeks Postpartum Too Late for Contraceptive Counseling in the U.S.? A Look into the Timing of Postpartum...

Healthcare providers in the United States typically recommend that postpartum people wait 6 weeks before resuming vaginal sex to ensure time to recover from childbirth. Guidelines recommend that postpartum patients attend a 6-week postpartum visit, and this visit typically includes contraception provision and counseling. We analyzed data from a clinical trial of immediate postpartum use of injectable contraception on lactation, which followed patients from delivery through the first postpartum year. We calculated the prevalence of early resumption of vaginal sex, defined as having vaginal sex before 6 weeks postpartum. We also used bivariable and multivariable models to identify correlates of early resumption. Among the sample of 137 adult postpartum patients, 18.4% reported early resumption of vaginal sex; among this subgroup, the mean time to resumption was 3.9 weeks (standard deviation, 0.9 weeks). The sole factor evaluated that appeared to be correlated with early resumption of vaginal sex was education; college graduates had 70% lower adjusted odds of reporting early vaginal intercourse compared with those who had less education (p = .04). Our study findings suggest that resuming sex before 6 weeks postpartum is not rare and could place people at risk of a rapid repeat pregnancy.