The postpartum period is a 6-12-week period that starts with the delivery of the placenta
and continues with the disappearance of the physiologic and anatomic changes that
occurred during pregnancy . Spousal and family support is very important for a healthy
and harmonious passage of this period. With the realization of delivery, the mode of
delivery, body image changes, hormonal changes, lactation and breast problems, fatigue,
vaginal bleeding, problems related to the baby, sexual reluctance and the relationship
between spouses affect the sexual life of women. Although the time to start postpartum
sexual intercourse varies from person to person and culture to culture, this period is
traditionally 6 weeks. As a result of the studies, it is reported that the time to start
postpartum sexual intercourse is between 5-8 weeks. Couples are concerned about starting
sexual intercourse when there is bleeding, laceration or episiotomy in the woman in the
postpartum period. Physiologic changes that occur during pregnancy and delivery affect
sexual intercourse in the postpartum period, and perineal pain and dyspareunia due to
episiotomy and laceration are observed in women. However, according to studies, sexual
function problems encountered by women in this period include dyspareunia, pelvic floor
dysfunction, vaginal dryness, sexual desire / intercourse. satisfaction as a decrease in
sexual satisfaction. In a study conducted by Lagaert et al. with 109 women in the
postpartum period; women who had spontaneous vaginal delivery and women who had
interventional delivery were compared and women who had interventional delivery stated
that they experienced more painful sexual intercourse . In the postpartum period, reasons
such as episiotomy, perineal pain, vaginal bleeding and discharge, fatigue, pelvic floor
dysfunction, feeling less attractive due to physical changes lead to a decrease in sexual
desire and consequently to withdrawal from sexuality.
During the first year after birth, new parents face many personal and interpersonal
changes, including changes in their sexual relationships. In particular, it has been
found that most new parents experience sexual concerns specific to the postpartum period,
wondering when to restart sexual intercourse after birth, pain during sexual intercourse,
and the impact of body image concerns on sexual activity. Lorenz et al. found that
couples generally experienced a decrease in the frequency of sexual activity in the
postpartum phase . In a study conducted with 1507 women in the postpartum period, 89% of
women were reported to have sexual health problems. In the postpartum 3rd month, the most
common complaints were loss of sexual desire, pain during sexual intercourse, and vaginal
dryness. Although traditional and complementary treatment practices are utilized in the
treatment of sexual dysfunctions, the effectiveness of very few of them has been shown in
studies with high level of evidence. Traditional and Complementary Medicine practices
used in sexual dysfunctions include natural products (plants, vitamins, minerals and
probiotics etc.), mind and body practices such as yoga, mindfulness-based intervention,
acupuncture and other methods. The use of mindfulness-based therapies has recently become
widespread in the treatment methods of women diagnosed with sexual dysfunction. With
these therapies, it has been observed that there is a significant improvement in general
sexual function level, arousal and sexual problems. Through mindfulness practices, it has
been observed that women perceive stimuli better and are able to recognize clues that
they did not notice before. Compassionate mindfulness program is one of these practices.
CFT (Compassion Focused Therapy) is known to integrate well with existing approaches to
psychosexual therapy and offers some useful ways to reduce sexual problems to provide a
coherent rationale for treatment strategies .Self-compassion proceeds in parallel with
the individual's self-knowledge, acceptance, positive perspective towards life, social
activities, consciousness, character structure open to development and subjectivity.
There is an inverse relationship with anxiety disorder, mental depression and the
negativities provided by negative situations.
In order to develop compassionate involvement in therapy, the therapist's non-judgmental,
warm and encouraging stance when talking about sexual intercourse, as well as detailed
information about sexual difficulties, can be a starting point for the client to cope
with the difficulties they experience. The therapist can then use a normalizing and
non-shaming CFT (Compassion Focused Therapy) formulation to help the client turn towards
the difficulties they are experiencing and look at them with understanding. In this
sense, the place of midwives who are in constant one-to-one communication with women in
the protection and development of sexual health is very important. Determining the sexual
needs of women in any period of women's life, eliminating sexual problems, explaining
behaviors and attitudes related to sexual life, providing education and guidance are
among the roles of midwifery. Midwives have the responsibilities of taking anamnesis,
identifying sexual problems and providing education and counseling for these problems in
order to maintain and increase the sexual health of pregnant women during pregnancy. It
is important for midwives to communicate as a very good listener, to take into account
the concerns of the woman, to ask effective questions, to speak by reassuring and stating
that privacy will be ensured, to identify the sexual problems of the woman and to provide
effective counseling.