ABSTRACT

Despite being a key component to be addressed during postnatal period, sexuality has long been a subject of secrecy and taboo in Africa. Resumption of sexual intercourse after giving birth has been shown to reduce extramarital affairs and consequently reduce risk of sexually transmitted infections like HIV/AIDS. Consequences of early resumption of sexual intercourse include unwanted pregnancy, genital trauma and puerperal infection. The objective of the study was to evaluate nursing mother’s knowledge on the practice of sexual intercourse during lactation in the Tiko Water Tank community.in order to achieved the study objective, a cross sectional survey was carried out using a sample of 40 breast feeding mothers by the help of a structure questionnaire mothers were sampled randomly, using purposive and convenience sampling techniques. Collected data was analyse using SPSS 21.0, where descriptive statistics such as frequency and percentage distribution of variables was obtained, chi-square test of significant was also calculated. Results shows that 44.0% of the mothers had resumed sexual intercourse during breast feeding. 11.0% of the mothers had resumed sexual intercourse in less than 4 weeks after delivery. Top reasons for sexual resumption were due to demands from partner (77.14%) and also due to cultural demands (11.43%). Major challenges encounter by mothers as a results of sexual intercourse during breast feeding were, pains/bruises (45.8%), bleeding (16.7%) and abdominal pains (35.7%).  Occupation of the mother, parity, level of education, time from delivery and use of family planning were the significant determinants of early resumption of sexual intercourse after child birth.

CHAPTER ONE

INTRODUCTION

1.1 INTRODUCTION

Women health has been an important agenda in the development of the nation. Improvement in women’s health is one of the indicators for national health status. Many programmes have been developed nationally to ensure improvement in women’s health is achieved which in turn will influence the formation of productive communities and health of the nation. An important element that has been identified in women’s healthcare is sexual practice during the postpartum period

 

1.1 BACKGROUND OF THE STUDY

Recurrent pregnancy with close child spacing can result from early resumption of sexual intercourse during the postpartum period. This would expose mothers to complications such as unsafe abortion, postpartum depression and premature birth. The aim of this study is to identify the factors associated with early resumption of sexual intercourse among postpartum mothers.

Despite being a key component to be addressed during postnatal period, sexuality has long been a subject of secrecy and taboo in Africa. Resumption of sexual intercourse after giving birth has been shown to reduce extramarital affairs and consequently reduce risk of sexually transmitted infections like HIV/AIDS. Consequences of early resumption of sexual intercourse include unwanted pregnancy, genital trauma and puerperal infection.

Breastfeeding play a crucial role in child nutrition and development status. Studies have shown that infant weight and height gains during early postnatal life are influenced by infant feeding practices (Picciano et al., 2001).

The World Health Organization (WHO) and United Nations International Children’s Emergency Fund (UNICEF) recommended that after delivery, optimal early breastfeeding practices should be encouraged. These optimal practices include initiating breastfeeding within 30 minutes to an hour of birth, giving colostrum. The international Baby Friendly Hospital Initiative (BFHI), which was launched in 1991 by UNICEF and WHO promotes and protects maternal and child health. This is achieved by ensuring that mothers are supported and helped with breastfeeding in maternity care facilities. Breastfeeding practices are determined by various factors including cultural norms, beliefs, mother’s knowledge and previous experience (Amal et al., 2007; Nkala & Msuya, 2011). These factors operate differently across communities and therefore, do affect child health to varying degrees.

According to Remy and White (1987), traditional obstetric text prohibited sexual intercourse from 6 weeks before to 6 weeks after delivery. It is essential with adequate nutrition for the infant to ensure good health, growth and development. Breast milk contains all the nutrients that an infant needs; fat, carbohydrates, protein, vitamins, minerals, water and factors that protects the infant against infection.

Elliston (2005) Explained post-partum taboos of having sexual intercourse while the woman is breastfeeding as the semen will contaminate the breast milk this can cause the infant to fall sick.

Fathalla (2003) declared that, traditional postpartum abstinence was as observed in many Africa communities in order to avoid the contamination of the breast milk Mothers are expected to abstain from sex until the baby has been weaned (Achana, 2010).

Childbirth is a unique but challenging experience. For the mother it exerts profound physical, mental and emotional strain, which could influence health and the time to resumption of sexual activities. Yet the postnatal period extending up to six weeks

(42days) after birth receives less attention from health care providers than pregnancy and childbirth. Postpartum sexual changes may not be easy to discuss, for both patient and provider. Yet sexual concerns are common, and the majority of patients welcome help from their primary care provider.

Previously, women were culturally obliged to stay away from their husbands to breastfeed for as long as 2-3 years5.Recent reports indicate that duration of postpartum abstinence is becoming considerably shortened to an average of six to eight weeks. Most women resumed intercourse in the early postnatal period while a small proportion delayed till up to six months. Many gynecologists now recommend waiting for 4 to 6 weeks after delivery to allow cessation of lochial loss and healing of episiotomies, tears or other birth-related perineal injuries. Although the delivery-coitus resumption interval has been reported from different countries, such as, we are not aware of any such study from Cameroon.

 

1.2 STATEMENT OF PROBLEM

Sexual functioning is now recognized as a multidimensional phenomenon, influence by many biophysical factors.

According to Alder and Bancroft (1988), sexual functioning decline during pregnancy, and remains low during postpartum period for many women and often takes a year before sexual interests and activities to regain back due to traditional beliefs and cultural norms of the couples.

During postpartum, maternal sexuality may be affected by a number of variables including hormonal changes, breast feeding, body image, well-being, sexual attitudes and adjustment to changes to social roles, relationship qualities that may be experience by either new mothers or her sexual partner (De-Judicibus and McCabe, 2002).

Amanda et al., (2003) mentioned that, sexual difficulties experienced during postpartum by new mother’s and her partner can cause much distress, due in part of the influence of sexual functioning in quality of life, physical, mental well-being and relationship functioning.

As breast milk is considered to be an ideal food for newborns, women are encouraged to breastfed their newborns for a considerable number of time. However, many women believed that sexual activities during postpartum can affect their quality of breast milk secretion, thus affecting the growth development of their babies.

Very limited literature exists on the early breastfeeding knowledge, practices, and attitudes of mothers with regards to their sexual practices. Thus this study seeks to establish the knowledge, attitudes, and practices on early breast feeding among nursing mothers living in the Tiko Water Tank community.

 

1.3 GENERAL OBJECTIVE

The main objective of this study will be to evaluate nursing mother’s knowledge on the practice of sexual intercourse during lactation in the Tiko Water Tank community.

 

1.4 SPECIFIC OBJECTIVES

1. To identify the knowledge of the women on what happens when having sexual intercourse during breast feeding period in the Tiko Water Tank community.
2. To identify the attitude women exhibit with sexual intercourse during breast feeding in the Tiko Water Tank Community.

• To determine some of the challenges faced by breast feeding mothers on the practice of sexual intercourse in the Tiko Water Tank community.

 

1.5 RESEARCH QUESTIONS

1. What knowledge do breast feeding mothers have with respect to sexual intercourse during breast feeding in the Tiko Water Tank community?
2. What factors are associated with nursing mother’s sexual intercourse during breast feeding in the Tiko Water Tank community?
3. What are some of the challenges faced by breastfeeding mothers on the practice of sexual intercourse in Tiko Water tank?

 

1.6 HYPOTHESIS

H0: There is no significant association between nursing mother’s perception of breast feeding towards the practice of sexual intercourse

H1: There is a significant association between nursing mother’s perception of breast feeding towards the practice of sexual intercourse.