veNTIlATIoN - Green Cross Publishing

levels of ill health to white women.
The women surveyed were aged 16 or over and from all
ethnic groups. They had had their babies at least 12 months
before the survey began and all had a live baby with no
congenital abnormalities at the time of survey.
“Our research has raised a number of issues,” says Amanda
Williams. “For example, it has highlighted concerns about the
long-term health effects resulting from forceps deliveries and
the variations in ill health between white and Asian women.
Both these areas could benefit from further research.”
“It’s also important to point out that while women who had
had caesareans reported fewer problems with the health issues
covered by this study, this delivery method is associated with
other problems that have a negative effect on women’s quality
of life, such as adhesions and wound infections.”
“We believe that our study points to the need for health
professionals to provide ongoing support for women who have
given birth, focusing on issues such as perineal problems and
sensitive health problems. This coupled with greater public
awareness of these issues, will hopefully make it easier for
women to get help for both short-term and long-term health
problems,” says Amanda Williams.
Factors influencing women’s emotions post childbirth
• Episiotomy or a repaired vaginal tear may take several
months to heal completely. Even without an episiotomy or a
tear, the perineal area (between the vagina and the anus) can
feel bruised and sensitive for some time.
• Vagina may lack natural lubrication due to low levels of
oestrogen following childbirth.
• Oestrogen levels may also remain low when breast-feeding.
• Trauma: having a baby pass through the vagina can be a
in practice
traumatic process for some women. Difficult or complicated
births can cause severe trauma.
• Vaginal discharge that smells unpleasant could indicate an
infection that requires medical attention.
• Low libido: many women say that their libido is low at this
time — they just don’t feel sexy.
• Hormonal changes.
• Body image — a woman’s body may feel so significantly
changed by the processes of pregnancy and childbirth
leading to a feeling that she needs time to recover and feel
like herself again.
• The shape and sensitivity of the vagina may have changed.
• Anxiety about her new baby and the new world of
motherhood.
• Distractions, such a a crying or unsettled baby.
• Life is different: even with an uncomplicated birth of a muchwanted
child, life is much more demanding for everyone in
the household, especially the new mother. Tiredness is an
overwhelming factor.
Looking after a baby 24 hours a day is exhausting physically
and emotionally, so when the mother gets into bed she may
just want to sleep. This is clearly what nature demands — it
ensures that the baby is well looked after. It takes priority and
may not leave much time for the mother or her partner.
role of the practice nurse
• Raise awareness
• Give information
• Normalising
There is a vital educational component here. Factual
information can be very helpful and very empowering for
women and their partners. It also serves to debunk some myths
and preconceptions e.g. that everything returns to normal
after the mother has had her six weeks postnatal check-up and
sexual relations may resume as normal. This kind of information
is as important as the other routine health information that she
will be given post childbirth.
It is most important to help ‘normalise’ what women
are experiencing and to make them feel listened to and
understood.
• All mothers and their partners need information about sex
after childbirth.
• Both partners should be aware of, and know how to cope
with, vaginal changes.
• Both partners need to know and understand the reasons why
intercourse may be uncomfortable.
• Both partners should be aware that there are no hard and
fast rules about when desire and comfort for sex will return
or when to resume sexual relations. It varies significantly for
each woman.
The parents should be encouraged to look at other ways
to show their love for each other. Lubricants such as K–y Jelly,
Liquid Silk or Pjur may help to overcome vaginal dryness.
It’s important to advise couples that it’s not recommended
that the man perform oral sex on the woman for the first two or
three months after chilbirth, for the following reasons:
• If she hasn’t healed completely (internally and externally),
there is a risk that it could introduce infection into the vagina
and womb.
• It rarely happens but it can lead to death. Air blown into the
vagina can easily get into the blood vessels of the newly
delivered womb and cause a fatal-illness called ‘air embolism.
Not long ago one such death was reported in the British
press.
With commonsense advice, a loving couple can usually get
things sorted out — though it may take some months. New
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