Leading maternal health experts say women who delivered their babies through caesarean section can resume sex 40 days after the procedure to allow the incision to heal. The gynecologists said it’s usually safe to have sex when the incision site has healed properly and postpartum bleeding has stopped.
They, however, advised the women to be mindful of the sex position and avoid partner-on-top positions like the missionary position, which they said might put too much pressure on the incision, especially if it’s still tender.
The maternal health specialists, in separate exclusive interviews with PUNCH Healthwise, allayed the fears that having sex after CS could cause injury to the incision site, among other untold myths.
According to Johns Hopkins Medicine, Caesarean Section or C-Section is the surgical delivery of a baby through a cut made in the mother’s abdomen and uterus (womb).
The World Health Organisation stated that CS is one of the most commonly performed surgical operations globally.
A study by Osayande et al on the “Prevalence, indications and complications of cesarean section in health facilities across Nigeria: a systematic review” shows that the overall prevalence of CS in health facilities across Nigeria was 17.63 percent.
Of this percentage, 24.27 percent were elective (opted and planned for CS) while emergency CS was 75.93 percent.
The study further established that previous scar, pregnancy-related hypertensive disorders, and anemia were the most reported indicators for CS.
According to the WHO, Nigeria has the third highest maternal mortality rate globally, with 1047 deaths per 100,000 live births.
Although the fear of undergoing CS by women seems to be dwindling as some pregnant women now request the procedure, there are still some uncertainties and underlying fears of the resumption of normal sexual activity in Nigeria.
Some studies have also found that women with both CS and vaginal births have sexual challenges within the first three months after giving birth.
A fertility specialist and Professor of Obstetrics and Gynaecology at the Usmanu Danfodiyo University, Sokoto State, Abubakar Panti, stated that women who had undergone CS can resume sexual activity after 40 days.
The gynaecologist explained that women who delivered their babies through CS had the same six weeks or 40 days recovery time to begin sexual activity as those who had a vaginal delivery.
Panti said, “Under normal circumstances, we discharge patients on the second or third day after CS. So the moment a woman has spent 40 days after CS, why can’t she have sex? The same way a woman who has vaginal delivery most of the time waits for 40 days before having sex. For some of them, if the bleeding stops on time, then they can resume sex. It is the same way if a woman has CS and the bleeding stops, you can resume gentle sex, there is nothing wrong with that.
“CS is not a terrible operation that reduces one’s capacity. With the advancements in CS, compared with what was obtained in the past where it takes two to three days before the woman can eat, now one can eat after a few hours.
“In the past, it took time before you started walking around, now you can start walking in six hours. So, there is so much improvement in technology and medical techniques.
“You are just waiting for the site to heal and usually two weeks is enough for the wound to heal but for it to heal completely, it can take months. So, after 40 days, the woman can have sex and nothing would happen.”
He further noted that the woman can assume any sexual position desired and style taken before the CS.
The don added, “She can take charge, it is safer for her. There is a sexual position where the woman is in control, that is she is in control and on top. And she can assume the conventional style. There is no need to fear that the man would lie on her stomach and cause an injury to the incision site.”
He, however, noted that individual body variations, as to the healing process, should be taken into consideration.
Panti asserted, “As long as it is a straightforward CS, without any complication, after six weeks, the woman can begin what she wants to do.
“ When a woman undergoes CS, they are asked to come back in two weeks for reassessment and after that another one-month appointment which would complete the six weeks. Within 40 days, if there is no problem, the doctor can okay the woman to commence her normal activity and this includes sex. In other climes, the doctors can recommend shorter days than the 40 days.”
On her part, a Consultant Obstetrician and Gynaecologist at the Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Dr Ebiye Tekenah, noted that such women were advised to resume sex when they feel comfortable.
She added that once the wound of the incision site is healed and the vaginal discharge that comes out after birth, Lochia, is stopped, sexual activity can resume.
Lochia is the vaginal discharge you have after giving birth. It contains a mix of blood, mucus, and uterine tissue.
The gynaecologist explained, “There is no medical cut-off, we just say when you feel comfortable; your wound has healed and don’t feel pain at the site of the incision site, you can go ahead (and resume sex) but they have to be aware that as early as a month after delivery, you can still get pregnant because you can start ovulating and pregnancy can occur.
“ So, a woman who is not on any contraception can get pregnant but for the sex, it is when she feels comfortable and that is when the wound has healed, she doesn’t feel pain and the Lochia has stopped. Many women won’t feel comfortable if they are still having discharge from their private parts, so they wait till that is completely dried up,” Tekenah said.
The physician also stated that there was no particular sexual style that should be assumed, noting that the husband should be gentle.
The gynaecologist further stated that although some might advise waiting until 42 days after delivery, which is when the pregnancy changes and returns back to the pre-pregnancy state, it was not a compulsory rule.
The expert added, “I have heard of people who have sex less than two weeks after CS but two weeks is quite early because it is likely the wound wouldn’t have properly healed though it might have healed on the outside, the inside which we can’t see might not be healed. But if the woman says she is not feeling pain and the man is very gentle, they can achieve it.”
