Intentions and Actual Practices of Antenatal and Postpartum Sexual Abstinence in Delhi, India: An Opportunity to Promote Safe Sex Practices

Anurag Mishra, Population Council
Leila Varkey, Population Council
Anjana Das, Population Council
Emma Ottolenghi, Population Council
Shahina Begum, Population Council

Marital abstinence from sexual intercourse during pregnancy and for some time after delivery is traditionally practiced in most societies. The recently conducted National Family Health Survey in India shows the median duration of postpartum abstinence as 3.3 months. This extended period of abstinence may increase the likelihood of men engaging in extra-marital sex, which in turn increases chances of STIs and HIV/AIDS infection in the absence of use of condoms as a means of protection as evidenced by recently conducted studies in west Africa (Ali M, Cleland J, 2001; Lawoyin TO, 2002). An operations research study with pregnant women and their husbands, which included this issue, was conducted in Delhi. It added family planning discussions and demonstrating correct condom use and other safe sex practices into counselling sessions for men as a component of care when they accompany their wives to clinics for prenatal and postnatal visits. Data gathered from 488 women and their husbands in the baseline survey shows that in the prenatal period, 80 percent of men and 89 percent of women did not know about STI symptoms and only 38 percent of men report having ever used condoms. The median intended prenatal duration of abstinence for men and women is 5 months and 4 months, and by the seventh month of pregnancy almost everyone intends to abstain. Eighty-nine percent of men and women said they would abstain in the postpartum period. Men intended about 3 months and women intended about 2 months of postpartum sexual abstinence. We will present data that explores differences between men and women’s intentions and actual reported abstinence based on the prenatal and six months postpartum interviews with the same cohort of married couples. We will also discuss implications for initiation of postpartum contraception and STI protective behaviours during and after pregnancy once men and women are knowledgeable of their importance.