Postpartum Resumption of Sexual Activity, Sexual Morbidity and use of Modern Contraceptives Among Nigerian Women in Jos

Background: Postpartum sexual abstinence until when the child is weaned from breast milk is deeply rooted in most cultures in Nigeria. Aim: The study aimed at describing the current sexual practices of postpartum women, sexual morbidity, contraceptive prevalence and predictive factors for early postpartum sexual intercourse and associated sexual problems in our setting. Subjects and Methods: This cross-sectional study was conducted among consecutive 340 women at a child welfare clinic 14 weeks after childbirth. Questionnaires were administered between January 2012 and June 2012 to ascertain their socio-demographic and obstetric features, sexual activity, time to coital resumption, reasons for resumption and non-resumption of intercourse, sexual problems encountered and contraceptive usage. Statistical analysis was performed using the SPSS version 16 for windows (SPSS Inc., Chicago, IL, USA). Results: Sexual intercourse was resumed by 67.6% (230/340) of women with a mean time to resuming intercourse of 8.2 (2.9) weeks postpartum and a median time of 8.0 weeks. About 3.5% (8/230) did so within the puerperium. Sexual intercourse was initiated mainly (77.4% [178/230]) by their husbands and only 19.1% (44/230) of them were using modern contraceptives. About 62.6% (144/230) of women experienced sexual morbidities including vaginal dryness/insufficient lubrication, dyspareunia and vaginal discharge. Socio-demographic and obstetric features, menstrual and breastfeeding status were not predictive of early resumption of coitus. Vaginal delivery (OR: 3.6, 95% CI: 1.3-10.0, P = 0.01,) and previous episiotomy (OR: 2.4, 95% CI: 2.0-6.1, P = 0.04,) were predictive of sexual morbidity. Conclusion: Women in our setting resume sexual intercourse early after childbirth without the use of contraception and often with associated sexual morbidity. Emphasis on sexual and contraceptive education during the immediate postpartum period is therefore imperative.