CONTRACEPTION AFTER CHILDBIRTH – THE IMMEDIATE PUERPERIUM (ABNORMAL BABY)
When the delivery is known to have been traumatic in physical terms, when the baby is not thriving or has died, or when an abnormal baby has been born, a particularly sensitive approach to discussion of contraception will be needed. The woman’s pain and distress or anger at what has happened may be hard for the family planning adviser to bear, and it may be tempting to avoid counselling such a woman with the excuse that she needs help in coping with her misfortune rather than consideration of her sexual activity in the future. And yet, these are often the women who need the most help, for to treat them differently may only increase their feelings of isolation and abnormality. They may have considerable anxieties about when to embark on a pregnancy again, and even at the height of their grief they may be looking forward in their mind. Time needs to be spent in allowing the woman to share her grief, while acknowledging with her that her need for comfort and closeness with her partner could lead to sexual activity. She may need encouragement to allow herself to consider sexual pleasure, especially where there are feelings of guilt or blame. Time spent exploring her anxieties at this stage may allow natural healing to begin to take place.
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