Abstract
Objective
We aimed to evaluate factors associated with early resumption of sexual intercourse
after first childbirth and assess whether early intercourse is associated with unprotected
intercourse, subsequent pregnancy, and unintended pregnancy over 6 months.
Methods
This secondary analysis used data from the First Baby Study, a prospective study of
women aged 18–35 years with singleton pregnancies who delivered at 76 hospitals in
Pennsylvania. At 1 and 6 months postpartum, women were asked about intercourse and
the use of birth control since childbirth. We compared women who resumed intercourse
in the first month after childbirth (early resumption) with those who resumed intercourse
later, via multivariable logistic regression models.
Results
In our cohort, 261 of 2,643 women (9.9%) reported first intercourse within the first
postpartum month (7–31 days). Women who resumed intercourse early were less educated,
younger, and less likely to breastfeed, have had a perineal laceration, or have had
an episiotomy than those who resumed intercourse later. In addition, they were more
likely to have unprotected intercourse in at least one of the first 6 months after
first childbirth (adjusted odds ratio [aOR], 2.33; 95% confidence interval [CI], 1.76–3.09);
to be pregnant by 6 months postpartum (aOR, 3.03; 95% CI, 1.48–6.20); and to report
that pregnancy as unintended (aOR, 3.32; 95% CI, 1.50–7.36).
Conclusions
Nearly 10% of women resumed intercourse in the first month after childbirth. Because
early resumption of intercourse was associated with a greater likelihood of unprotected
intercourse and unintended pregnancy within 6 months of first childbirth, clinicians
should focus efforts on comprehensive family planning and contraception counseling
beginning in the prenatal period.
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References
- ACOG Committee Opinion No. 736: Optimizing postpartum care.Obstetrics and Gynecology. 2018; 131: e140-e150
- ACOG Obstetric Care Consensus No. 8: Interpregnancy care.Obstetrics and Gynecology. 2019; 133: e51-e72
- Postpartum contraception: Initiation and effectiveness in a large universal healthcare system.American Journal of Obstetrics and Gynecology. 2017; 217: 55e1-55e9
- Influence of interpregnancy interval on neonatal morbidity.American Journal of Obstetrics and Gynecology. 2015; 212: 386.e1-386.e9
- Postpartum Medicaid coverage and contraceptive use before and after Ohio's Medicaid expansion under the Affordable Care Act.Women’s Health Issues. 2020; 30: 426-435
- Resumption of vaginal intercourse in the early postpartum period: Determinants and considerations for child spacing in a Nigerian population.Journal of Obstetrics and Gynaecology. 2012; 32: 353-356
- Disparities in rates of unintended pregnancy In the United States, 1994 and 2001.Perspectives on Sexual and Reproductive Health. 2006; 38: 90-96
- Declines in unintended pregnancy in the United States, 2008–2011.New England Journal of Medicine. 2016; 374: 843-852
- Short interpregnancy intervals in the United States.Obstetrics and Gynecology. 2013; 122: 64-71
- Factors associated with short interpregnancy interval in women who plan postpartum LARC: A retrospective study.Contraception. 2017; 95: 245-250
- Is effective contraceptive use conceived prenatally in Florida? The association between prenatal contraceptive counseling and postpartum contraceptive use.Maternal and Child Health Journal. 2012; 16: 423-429
- Early resumption of sexual intercourse and its associated factors among postpartum women in Western Ethiopia: A cross-sectional study.International Journal of Women’s Health. 2020; 12: 381-391
- Why lightning strikes twice: Postpartum resumption of sexual activity during adolescence.Journal of Pediatric and Adolescent Gynecology. 2005; 18: 327-335
- Association between mode of first delivery and subsequent fecundity and fertility.JAMA Network Open. 2020; 3: e203076
- Mode of first delivery and women’s intentions for subsequent childbearing: Findings from the First Baby Study.Paediatric and Perinatal Epidemiology. 2013; 27: 62-71
- Sex after childbirth: Postpartum sexual function.Obstetrics and Gynecology. 2012; 119: 647-655
- Sexual function after childbirth by the mode of delivery: A prospective study.Archives of Gynecology and Obstetrics. 2013; 288: 785-792
- Short interpregnancy intervals: Results from the First Baby Study.Women’s Health Issues. 2017; 27: 426-433
- Consultation about sexual health issues in the year after childbirth: A Cohort Study.Birth. 2015; 42: 354-361
- Does method of birth make a difference to when women resume sex after childbirth?.BJOG: An International Journal of Obstetrics and Gynaecology. 2013; 120: 823-830
- Resumption of sex after a second birth: An Australian prospective cohort.Birth. 2019; 46: 173-181
- Breastfeeding and sexuality immediately post partum.Canadian Family Physician Médecin de Famille Canadien. 2005; 51: 1366-1367
- Sexual behavior, satisfaction, and contraceptive use among postpartum women.Journal of Midwifery and Women’s Health. 2016; 61: 158-165
- Experiences with prenatal and postpartum contraceptive services among women with a preterm birth.Women’s Health Issues. 2020; 30: 184-190
- Confidence and readiness to discuss, plan and implement postpartum contraception during prenatal care versus after delivery.Journal of Obstetrics and Gynaecology. 2019; 39: 941-947
- Postpartum contraceptive use among adolescent mothers in seven states.Journal of Adolescent Health. 2013; 52: 278-283
- Associations between immediate postpartum long-acting reversible contraception and short interpregnancy intervals.Contraception. 2020; 102: 409-413
- Contraceptive counseling and postpartum contraceptive use.American Journal of Obstetrics and Gynecology. 2015; 212: 171.e1-171.e8
Biography
Alex J. Knutson, MD, is a resident in the Department of Obstetrics and Gynecology, Penn State Health, and plans to specialize in pelvic floor disorders. His research interests are broad and include gynecological topics, as well as general women's health.
Biography
Sarah S. Boyd, MD, is an Assistant Professor in the Department of Obstetrics and Gynecology, Penn State Health. Her research focuses on optimizing patient outcomes and decreasing adverse events in both surgical and non-surgical management of pelvic floor disorders.
Biography
Jaime B. Long, MD, is an Assistant Professor in the Department of Obstetrics and Gynecology, Penn State Health. Her research focuses on perioperative patient care, including ways to optimize pain control and other postoperative patient experiences.
Biography
Kristen H. Kjerulff, PhD, is a professor, Department of Public Health Sciences, Penn State College of Medicine, and has a secondary appointment in the Department of Obstetrics and Gynecology. Her research focuses on women's health, with a particular focus on reproductive health.
Article info
Publication history
Published online: September 30, 2021
Accepted:
September 2,
2021
Received in revised form:
September 1,
2021
Received:
February 1,
2021
Footnotes
Funding Statement: Supported by grant R01-HD052990 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.
Identification
Copyright
© 2021 Jacobs Institute of Women's Health, George Washington University. Published by Elsevier Inc. All rights reserved.
