The Role of Culture in Maintaining Post-Partum Sexual Abstinence of Swazi Women

'Feeling Ready': A Feminist Poststructural Analysis of Postpartum Sexual Health

There exists a lack of literature surrounding how postpartum individuals define feeling 'ready' to resume sexual activities after childbirth. Many factors may influence feelings of desire or readiness for sexual activities, such as breastfeeding. Therefore, it is important to understand why and how postpartum individuals understand and make meaning of their experiences surrounding postpartum sexual activities, as well as how those experiences are influenced or negotiated through relations of power. This study was guided by feminist poststructuralism and discourse analysis. Eleven participants who were between 1 and 6 months postpartum and living in Nova Scotia, Canada, were interviewed using semi-structured interviews. Participants challenged certain discourses surrounding sexual activities postpartum, including the social discourse that positions sexual activities as a requirement within romantic relationships and the discourse that positions health care providers as the authority on postpartum sexual health. 'Feeling ready' centered on four main issues: (1) navigating physical recovery; (2) personal knowing and emotional readiness; (3) the 6-week check; and (4) redefining intimacy. This article describes one branch of the findings within the overall study. Choosing to resume sexual activities postpartum, or feeling ready to do so, is individual, fluid, and complex. This research has important implications for practice and policy, specifically as it pertains to postpartum care.

Multilevel analysis of early resumption of sexual intercourse among postpartum women in sub-Saharan Africa: evidence from Demographic and Health Survey Data

BACKGROUND

Resuming sexual activity early after childbirth can cause reproductive health problems such as unwanted pregnancy, unsafe abortion, and short birth intervals, especially if contraception is not used. However, it is uncommon for healthcare providers to discuss postpartum sexual practices during prenatal and postnatal care. Therefore, this study aimed to assess early resumption of sexual intercourse and associated factors among postpartum women in sub-Saharan Africa.

METHODS

Secondary data analysis from the most recent Demographic and Health Surveys data from the period of 2014 to 2019/2020 of 23 countries in sub-Saharan Africa were used. A total weighted sample of 118,371 women who gave birth in the three years before the surveys were used. We analyzed the data using Stata version 14. A multilevel mixed-effect logistic regression model was fitted to identify factors associated with early resumption of sexual intercourse. Variables with a p-value < 0.05 in the multilevel mixed-effect logistic regression model were declared significant factors associated with the outcome variables.

RESULTS

The magnitude of early resumption of sexual intercourse among postpartum women was 67.97% (95% CI: 67.60, 68.34). Urban resident (AOR = 1.91; 95% CI: 1.83, 2.06), women with primary education 1.11 (AOR = 1.11; 95% CI: 1.07 to 1.31) and secondary education and above level 1.17 (AOR = 1.17; 95% CI: 1.09 to 1.29), husbands with primary education 1.32 (AOR = 1.32; 95% CI: 1.27, 1.38) and secondary education and above level 1.15 (AOR = 1.15; 95% CI: 1.11 to 1.25), family planning use (AOR = 95%; CI: 1.77, 1.91), fertility intention wanted then 1.24 (AOR = 1.24; 95%; CI: 1.19, 1.32) and wanted later 1.27 (AOR = 1.27; 95%; CI: 1.22, 1.46), religion (AOR = 2.08; 95%CI: 1.97, 2.17), and place of delivery (AOR = 1.51; 95%CI = 1.36, 1.65) were significantly associated with early resumption of sexual intercourse.

CONCLUSION

The study revealed that more than two-thirds of the women had resumed sexual intercourse early after childbirth. Hence, the concerned bodies should strengthen the integration of postpartum education on sexual resumption with maternal, neonatal, and child health care services to reduce the early resumption of sexual intercourse. In addition, healthcare providers providing counseling on the resumption of postpartum sexual intercourse should focus on these factors to ensure a more effective outcome.

Predictors of early resumption of post-partum sexual intercourse among post-partum period women in Ethiopia: A multilevel analysis based on Ethiopian demographic and health survey 2016

Background

Early resumption of post-partum sexual intercourse has an adverse outcome on the health of women and indirectly unintended pregnancy might happen and affects both the health of women and the delivered baby. There is limited evidence that shows predictors at the individual and community level from the Ethiopian demographic and health survey. Therefore, the aim of this study was to assess predictors of early resumption of post-partum sexual intercourse among post-partum period women in Ethiopia: a multilevel analysis based on Ethiopian demographic and health survey 2016.

Methods

This study used an in-depth secondary data analysis of the survey using the 2016 main EDHS. A total weighted sample of 6447 post-partum women who have children aged 0 to 36 months (about 3 years) was included for the analysis. Multilevel binary logistic regression analysis was conducted considering the hierarchical nature of the EDHS data. Intra-class Correlation Coefficient (ICC), and deviance [-2 Log-Likelihood Ratio (LRR)] were used for model comparison and for assessing model fitness. In a multivariable analysis adjusted OR with a 95% CI (Confidence Interval) was reported with a p-value <0.05 was used to declare a significant association between the explanatory and the outcome variables.

Results

The proportion of early resumption of post-partum sexual intercourse was found to be 60.41% [95% CI 59.19–61.63]. Women with age group of 25–28 (AOR = 0.8; 95% CI 0.67–0.96), 29–32 (AOR = 0.79; 95% CI 0.63–0.98), and 33–49 (AOR = 0.67; 95% CI 0.53–0.85), women with sex of child female (AOR = 0.82; 95% CI 0.73–0.92), women whose child is alive (AOR = 0.52; 95% CI 0.38–0.69), women who delivered by cesarean section(AOR = 0.34; 95% CI 0.23–0.49), women with primary educational level (AOR = 1.27; 95% CI 1.09–1.48), women with secondary educational level (AOR = 1.61; 95% CI 1.19–2.17) and women with higher educational level (AOR = 1.6; 95% CI 1.05–2.45), Para 3–4 women (AOR = 1.45; 95% CI 1.21–1.73) and women with grand multi parity (AOR = 1.61; 95% CI 1.29–2), women with fertility desire wanted latter (AOR = 0.81; 95% CI 0.69–0.94), women with fertility desire wanted no more (AOR = 0.81; 95% CI 0.66–1.01), women who are on family planning use (AOR = 1.2; 95% CI 1.05–1.38) and participant with currently on working (AOR = 0.79; 95% CI 0.69–0.91) were significantly associated with early resumption of post-partum sexual intercourse.

Conclusions

The magnitude of early resumption of post-partum sexual intercourse was found to be high. Giving emphasis to the age groups of 25–28, 29–32, and 33–49 women, women with the sex of child female, women who delivered by cesarean section, currently working, the child is live, fertility desire wanted later and no more were suggested to reduce early resumption of post-partum sexual intercourse. On the other hand, improved educational attainments of women, women with parity 3–4, and >5, and family planning use were variables to increase early resumption of post-partum sexual intercourse. Therefore, the health care providers and program managers should act on early resumption of post-partum sexual intercourse through health education and promotion considering the significant factors.

Sexual abstinence as a reproductive health-promoting behavior for women: A perspective

This article is intended to provide an appropriate context for adopting sexual abstinence from a health-promoting behavioral perspective that can be applied to women of reproductive age worldwide to improve reproductive health, maintain well-being, and prevent health problems in women. The topics related to women's health status, sexual abstinence definitions, benefits, and application, as well as sexual autonomy and efficacy, including family collaboration, are discussed. This article will provide health care providers, especially nurses and midwives, with new ideas for integrating sexual abstinence into nursing and midwifery practice.

Return of Sexual Activity Within Six Weeks of Childbirth Among Married Women Attending Postpartum Clinic of a Teaching Hospital in Ethiopia

Introduction:

Postpartum sexual health gets very little attention compared to pregnancy and childbirth, even though most maternal deaths and disabilities occur during this time. Therefore, the study aimed to assess return of sexual activity within 6 weeks of childbirth among married women attending postpartum clinic of a teaching hospital in Ethiopia, 2021.

Methods

The hospital-based cross-sectional study design was implemented from September to October 2021. Eligible postpartum women were sampled by systematic random sampling technique. The data was entered into EPI-info and exported to SPSS version 24 for further analysis. All variables with a p-value < 0.05 in multivariable analyses were taken as associated factors with the return to sexual activity before 6 weeks of childbirth.

Results

A total of 421 postpartum women participated in the study. The prevalence of women who return to sexual activity 6 weeks after childbirth was 31.6%. The study revealed that monogamy (Adjusted Odds Ratio (AOR) = 4.4, 95% Confidence Interval (CI) (2.1, 9.4)), parity (AOR= 0.11, 95% CI (0.02–0.81)) and (AOR = 0.1, 95% CI (0.015–0.72)), postnatal care (AOR= 1.8, 95% CI (1.01–3)) and infants feeding status (AOR=2.3, 95% CI (1.3–4)) were significantly associated with return of sexual activity before 6 weeks of childbirth.

Conclusion

The findings of this study suggested that, nearly one-third of postpartum women engaged to sexual activity within 6 weeks of childbirth. Return of sexual activity within 6 weeks of childbirth associated with monogamy type of marriage, parity, postnatal care, and child feeding status. Strengthening postpartum counseling regarding the appropriate time to resume sexual activity is crucial. Regular postpartum visits following deliveries should also be encouraged by health care providers.

A scoping review on women’s sexual health in the postpartum period: opportunities for research and practice within low-and middle-income countries

Background

Women’s sexual health is generally defined and explored solely in relation to reproductive capacity, and often omits elements of sexual function and/or dysfunction. Concerted focus is given to women’s health during pregnancy; however, women’s sexual health is largely neglected after childbirth. This scoping review explored how the sexual health of postpartum women has been defined, measured, and researched in low- and middle-income countries (LMICs).

Methods

Articles eligible for review were those that investigated women’s sexual health during the first 12 months postpartum and were conducted among women aged 15–49 in LMICs. Eligibility was further restricted to studies that were published within the last 20 years (2001–2021). The initial PubMed search identified 812 articles, but upon further eligibility review, 97 remained. At this time, the decision was made to focus this review only on articles addressing sexual function and/or dysfunction, which yielded 46 articles. Key article characteristics were described and analyzed by outcome.

Results

Of the final included articles, five studies focused on positive sexual health, 13 on negative sexual health, and the remaining 28 on both positive and negative sexual health or without specified directionality. The most common outcome examined was resumption of sex after childbirth. Most studies occurred within sub-Saharan Africa (n = 27), with geographic spread throughout the Middle East (n = 10), Asia (n = 5), North Africa (n = 3), and cross-geography (n = 1); notably, all five studies on positive sexual health were conducted in Iran. Negative sexual health outcomes included vaginismus, dyspareunia, episiotomy, perineal tears, prolapse, infection, obstetric fistula, female genital cutting, postnatal pain, uterine prolapse, coercion to resume sex, sexual violence, and loss of sexual desire/arousal. Most studies were quantitative, though eight qualitative studies elucidated the difficulties women endured in receiving information specific to sexual health and hesitance in seeking help for sexual morbidities in the postpartum period.

Conclusions

Overall, the evidence base surrounding women’s sexual health in the postpartum period within LMICs remains limited, with most studies focusing solely on the timing of resumption of sex. Integration of sexual health counseling into postnatal care and nonjudgmental service provision can help women navigate these bodily changes and ultimately improve their sexual health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12978-022-01399-6.

Women’s sexual health is often studied in relation to reproductive health and childbearing. While reproductive health during pregnancy and immediately after is well documented, it remains unclear how women’s sexual health is addressed, particularly within low- and middle-income countries. The aim of this review is to understand how researchers have measured, defined, and examined postpartum sexual health. In October 2021, we searched PubMed database with the following criteria: published in the last 20 years; conducted in a low- or middle-income context; examined sexual function and/or dysfunction among women aged 15–49 within 1 year after childbirth. From this inclusion criteria, we identified 46 relevant articles. Most studies were conducted in sub-Saharan Africa. Only five studies focused exclusively on positive sexual health, and the majority of studies examined the resumption of sex after childbirth. Multiple qualitative studies described women’s reluctance to seek help for postpartum sexual health issues and highlighted the difficulties they faced in receiving information specific to sexual health. Overall, the evidence base surrounding women’s sexual health after childbirth within low- and middle-income contexts is limited. Future research should examine sexual health beyond resumption of sex after childbirth and explore barriers to help-seeking for women experiencing sexual health issues. Further exploration of positive sexual health is needed across contexts.

Biomarkers of pneumonia disease in under five children in "grill culture"

OBJECTIVE

Based on data WHO in 2018, almost 802,200 cases of pneumonia occur in children. Indonesia data on Riskesdas in 2018, the increase in pneumonia with the prevalence of pneumonia based on the age group 1-4 years was 5.0. This study aims to obtain more information about biomarkers of the clinical assessment on patient cases and prevention management and then whether postpartum culture contributed to the increase in pneumonia.

METHODS

The method used is a Literature review. Search for scientific articles collected through Scopus indexed journals through Science Direct, Pubmed, Elsevier, MDPI, WHO, Riskesdas, Google Scholar.

RESULT

From the literature articles we read, it shows that the incidence of pneumonia increases from year to year and is the leading cause of death. So it needs prevention from use biomarkers as markers and examined the association of Grill Culture with pneumonia in children under five.

CONCLUSION

The results of the biomarker examination are a marker of the case and prevention management will be carried out using existing cultural approaches.

Factors associated with early resumption of sexual intercourse among women during extended postpartum period in Northwest Ethiopia: a cross sectional study

BACKGROUND

Postpartum sexual health and practice need to be integrated in the current maternal healthcare services to address sexual health problems. However, postpartum sexual practice has received little attention, and was not often discussed by healthcare providers during prenatal and postnatal care. Thus, this study was aimed to assess early resumption of sexual intercourse and associated factors among postpartum women in Gondar city, Northwest Ethiopia.

METHODS

A community based cross-sectional study was conducted from January 20 to February 20, 2020. A systematic random sampling technique was used to select 634 postpartum women. A pretested, structured and interviewer-administered questionnaire was used to collect data. Data were entered into Epi Info 7.2.2 and exported to SPSS version 20 for analysis. Bivariable and multivariable logistic regressions analysis were done. Variables with p- value of < 0.05 were considered as statistically significant.

RESULTS

The magnitude of early resumption of sexual intercourse after childbirth was found to be 26.9% (95% CI: 23.2, 30.8). Urban resident (AOR = 6.12, 95% CI: 2.41, 15.66), parity of one (AOR = 2.26, 95% CI: 1.66, 7.78), husband demand (AOR = 2.66, 95% CI: 1.72, 4.11), postnatal care (AOR = 1.45, 95% CI: 1.06, 2.18) and use of family planning (AOR = 2.72, 95% CI: 1.51, 3.43) were factors significantly associated with early resumption of sexual intercourse.

CONCLUSION

The study found that more than one fourth of women had resumed sexual intercourse within six weeks of following childbirth. The finding of this study suggests the need of integrating discussions of postpartum sexual activity into routine prenatal, intrapartum and postnatal care with collaborative effort of policy makers, program planners, health care providers and other stakeholders. Moreover, spousal communication on postpartum sexual activity should be encouraged.

Postpartum sex taboos and child growth in Tanzania: Implications for child care

The social context and cultural meaning systems shape caregivers' perceptions about child growth and inform their attention to episodes of poor growth. Thus, understanding community members' beliefs about the aetiology of poor child growth is important for effective responses to child malnutrition. We present an analysis of caregivers' narratives on the risks surrounding child growth during postpartum period and highlight how the meanings attached to these risks shape child care practices. We collected data using 19 focus group discussions, 30 in‐depth interviews and five key informant interviews with caregivers of under‐five children in south‐eastern Tanzania. Parental non‐adherence to postpartum sexual abstinence norms was a dominant cultural explanation for poor growth and development in a child, including different forms of malnutrition. In case sexual abstinence is not maintained or when a mother conceives while still lactating, caregivers would wean their infants abruptly and completely to prevent poor growth. Mothers whose babies were growing poorly were often stigmatized for breaking sex taboos by the community and by health care workers. The stigma that mothers face reduced their self‐esteem and deterred them from taking their children to the child health clinics. Traditional rather than biomedical care was often sought to remedy growth problems in children, particularly when violation of sexual abstinence was suspected. When designing culturally sensitive interventions aimed at promoting healthy child growth and effective breastfeeding in the community, it is important to recognize and address people's existing misconceptions about early resumption of sexual intercourse and a new pregnancy during lactation period.