Sex After Baby: Women’s Sexual Function in the Postpartum Period

Behavioral competition between infant care and sexual behavior in male but not female common marmosets

Sexual desire and parenthood sometimes compete in a sexually dimorphic manner, but the neural mechanism for this remains to be clarified. Here we show that, in the family-living primate common marmoset, fathers temporarily reduce infant care during the postpartum mating period leading to conception, whereas mothers do not. Functional suppression of the calcitonin receptor-expressing MPOA subregion (cMPOA) scalably disrupts infant care in both sexes and abolishes sexual behavior in males. The neuronal activation pattern induced by infant care is not identical to, but overlaps with that induced by male mating in the medial preoptic area (MPOA) of the forebrain. These data suggest that the commonality of the neural mechanism required for infant care and sexual behavior in the MPOA may lead to competition between these behaviors in fathers. Further studies are needed to identify the precise neuronal mechanism regulating this phenomenon in marmosets.

Emotional Disorders, Risk Factors, and Correlations of Post-Partum Depression and Post-Traumatic Stress Disorder with Sexual Function During Post-Partum Period

Background: This study aimed to investigate the presence of emotional disorders, the risk factors associated with these disorders, and the level of sexual function observed after childbirth. Additionally, the study aimed to explore how sexual function affects post-partum depression and Post-Traumatic Stress Disorder (PTSD), as well as how these emotional disorders, in turn, impact sexual function. Methodology: A total of 336 women participated in the study, who were asked to complete four questionnaires: a general women's personal information questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), the PTSD Scale (PCL-5), and the Female Sexual Functioning Index (FSFI). Results: The results showed that 33% of mothers scored on the EPDS above 14 points, which was considered a threshold value for the prognosis of post-partum depression. In addition, the women scored an average of 20.8 points on the FSFI, and thus, their level of sexual functioning was characterized as moderate. According to the total score of the PCL-5 scale, it was observed that 17.6% of the mothers show post-traumatic stress after childbirth and satisfy all four criteria of this scale. Lastly, multiple regression analysis showed that factors such as annual family income and negative body image had a significant contribution to the models. Conclusions: Finally, it was observed that reduced sexual functionality in women is linked to post-partum depression and post-traumatic stress after childbirth. In conclusion, our research emphasizes the need for further exploration of the psychological and emotional challenges women face during the puerperium, which can negatively affect sexual health.

Exploring Australian midwives' experiences providing sexual health information to women in the postnatal period

PROBLEM

Little is known about the influences on postnatal sexual health conversations from the midwife's perspective.

BACKGROUND

Women frequently experience sexual health challenges in the postnatal period. Women have stated that midwives do not enquire about postnatal sexual health challenges, and when concerns are raised, unhelpful advice is received. The lack of recognition from midwives leaves women feeling isolated, ashamed, and as though their experiences are abnormal.

QUESTION

What are Australian midwives' experiences providing sexual health information to women in the postnatal period?

METHODS

A qualitative descriptive study utilising purposive sampling and individualised semi-structured interviews to collect data from registered midwives (n=7) working across various contexts in Australia. Data was analysed using Braun and Clarke's method.

FINDINGS

Four major themes were identified from the data: 1) The medicalisation of birth, 2) Postnatal sexual health: It's complicated, 3) In our interest but whose responsibility? And 4) Enhancing the provision of postnatal sexual health information.

DISCUSSION

Although the midwife participants acknowledged the importance of discussing postnatal sexual health, the findings of this study highlight the various barriers Australian midwives face when providing sexual health information to postnatal women.

CONCLUSION

There are various influences on a midwife's ability to provide sexual health information to women in the postnatal period. The barriers of the medical system, inadequate training and professional development and an undefined role in sexual health create challenges for Australian midwives to effectively provide sexual health information.

Body Image and sex among postpartum women

Body image and sexuality both pertain to the body. Positive experiences in one domain are generally associated with positive experiences in the other. Yet, less is known about body image among postpartum women specifically. Women's bodies may change in socially undesirable ways after having a baby, which may relate to decreased comfort in partnered sexual activities. To that end, the current study aimed to examine links between body image and sexuality among postpartum women. Participants (N = 597) were women who had birthed a baby within the past year and lived in the United States. Most women resumed sex by 3 months after birth. Further, most women's first postpartum sexual experience was "not at all" to "somewhat" enjoyable, and nearly 2/3 of first postpartum sexual experiences were partner-initiated. Women who initiate partnered sexual activity, however, have less body image self-consciousness. Women who have higher body appreciation reported greater enjoyment of their first postpartum sexual experience; less body image self-consciousness was also related to earlier timing of first penetration. Findings suggest that women's body image is related to the timing of sexual activity after birth and how much women enjoy this activity.

Romantic Attachment and Sexual Satisfaction Trajectories Among Couples Transitioning to Parenthood

The transition to parenthood (TTP) is an exciting yet destabilizing time for couples. First-time parents may experience changes in their sexual satisfaction during the TTP, but little is known about the factors associated with these changes. Romantic attachment might help understand why some new parents experience a decrease in sexual satisfaction while others do not. This prospective and dyadic study aimed to examine new parents' sexual satisfaction trajectories through the moderator role of prenatal attachment anxiety and avoidance in these trajectories. A total of 221 primiparous Canadian couples completed four online questionnaires from the second trimester of pregnancy to 12 months postpartum. Dyadic latent growth curve analyses revealed that although pregnant people present lower prenatal sexual satisfaction than their partners, both parents show an increase in their sexual satisfaction from pregnancy to 12 months postpartum. For both parents, partners' attachment anxiety was related to one's own steeper increase in sexual satisfaction from pregnancy to 12 months postpartum. Finally, both parents' attachment avoidance was related to their own lower sexual satisfaction during pregnancy. These findings will help educate and support expectant parents about anticipated fluctuations in sexual satisfaction.

Attitudes toward mothers as sexual beings and the sexual functioning of parents

BACKGROUND

Research has shown that negative sexual attitudes are associated with lower levels of sexual functioning among men and women, however, little is known about how attitudes about mothers as sexual beings are associated with sexual functioning for parents.

AIM

The aim of the current study was to examine how attitudes toward mothers as sexual beings (ATMSB) were associated with sexual functioning for women and partners of women among parents with young children.

METHODS

Cross-sectional retrospective data were collected online via Qualtrics Panels from 475 women and men (partnered to women) who reported having their first child within the last 5 years.Outcomes: The Revised Female Sexual Function Index and revised Expanded Prostate Cancer Index Composite-Short Form were used to measure sexual function in women and men, respectively.

RESULTS

Results indicated that after controlling for age and relationship length, more positive ATMSB predicted higher levels of sexual functioning (and multiple domains of functioning) for men and women.Clinical Implications: These findings indicate that sexual functioning, especially in parents, is linked to the attitudes held toward seeing mothers as inherently sexual (or not).

STRENGTHS AND LIMITATIONS

This is the first study to examine how attitudes toward mothers as sexual beings can impact sexual functioning, though the cis heterosexual mostly white sample is a notable limitation.

CONCLUSION

ATMSB may need to be examined and challenged in the context of treating sexual dysfunction during this transitional period for mothers and those partnered to mothers.

Exploring midwives' training needs and preferences for providing sexual health education for pregnant women: a mixed-methods study

Background Numerous studies highlight a common inadequacy among midwives in addressing sexuality and sexual health issues in pregnant women. These findings underscore the crucial need for sexual health education for midwives. Nevertheless, the specific training needs and preferences regarding sexual health education for pregnant women among midwives remain largely unexplored in existing literature. The aim of this study was to explore midwives' training needs and preferences for providing sexual health education for pregnant women. Methods The research employed a mixed-methods, institution-based cross-sectional study design conducted from July to August 2021. Convenience sampling was applied for quantitative research, while purposive sampling was utilised for the qualitative component. Midwives from 19 hospitals in Guangdong Province were invited to participate in a questionnaire survey addressing training needs and preferences for sexual health education for pregnant women among midwives. Qualitative data analysis was performed using thematic analysis. Results A total of 462 midwives participated in the quantitative study, while 12 skilled midwives were involved in the qualitative component. A significant majority (82.5%) of midwives expressed a strong desire to engage in sexual health education. Online education emerged as the preferred mode of training among participants. Key areas of interest included reproductive health, sexual psychology, sex sociology, and education methods, underscoring a consistent demand for comprehensive sexual health education within the midwifery community. Conclusions Our study emphasises the pressing need for enhanced sexual health education for midwives and explores their preferences for future training.

What to Expect When You're Expecting: Perinatal Sexual Education Is Linked with Couples' Sexual Well-Being in Pregnancy and the Postpartum

Up to 88% of expectant and new parents report problems with their sexual well-being, yet less than 30% of individuals receive information about potential sexual problems from health-care professionals. Lack of information may contribute to difficulty adjusting to sexual challenges, and in turn, to poorer sexual well-being. The current study examined the following: 1) the amount of perinatal sexual health information individuals receive/access; 2) gaps between desired and received information; 3) barriers to accessing information; and 4) links between the quantity of information received/accessed and sexual well-being outcomes in one sample of pregnant couples (N = 102) and another sample of couples in the postpartum (N = 102). Results revealed that most participants reported receiving/accessing little-to-no sexual health information, despite most participants wanting to receive a variety of information related to their perinatal sexuality. On average, expectant and new parents were indifferent regarding how easy/comfortable they felt discussing their sexuality with health-care professionals. Overall, when gestational parents received/accessed more pregnancy-related sexual health information and when either parent received/accessed more postpartum-related sexual health information, both members of the couples reported greater sexual well-being. Access to information might not only address couples' needs and concerns but may also bolster sexual well-being during a vulnerable period.

Let's Talk about Sleep Baby: Sexual Activity Postpartum and Its Links with Room Sharing, Parent Sleep, and Objectively Measured Infant Sleep and Parent Nighttime Crib Visits

The postpartum period may pose a considerable challenge for both parent sleep and sexual activity. This study assessed the links between partnered sexual frequency and satisfaction postpartum and parent sleep, infant sleep, parent nighttime caregiving, and parent-infant room sharing. Participants were 897 parents of infants aged 1-18-months (M = 8.8 ± 4.3, 49% girls). Parents completed an online survey about their sexual frequency and satisfaction, sleep, relationship satisfaction, depression, and demographic characteristics. Infant sleep and parent nighttime crib visits were measured objectively using auto-videosomnography during 2-weeks, with 8,460 nights assessed. Results indicated that the frequency of partnered sexual activity was 3.8 ± 4.2 times per month. Frequency of sexual activity increased with infant age, yet increases beyond the first 6 months postpartum were non-significant. Adjusted GEE modeling revealed that more parent nighttime crib visits were significantly associated with lower sexual frequency, regardless of infant age. Other parent and infant sleep-related factors were not significantly linked with sexual frequency in adjusted models. Moreover, sexual satisfaction was not associated with parent nighttime caregiving, parent or infant sleep, or parent-infant sleeping arrangements in adjusted models, suggesting that it may not be susceptible to the effects of disrupted sleep in the postpartum period. These findings suggest that it is not infant or parent sleep disruption per se, but rather parent nighttime engagement with the infant that is associated with parent sexual activity frequency. Longitudinal investigations are warranted to examine the directional pathways of these links.

Associations between New Mothers' Partner-Oriented Sexual Values and Sexual Distress in the Transition to Parenthood

Women commonly experience heightened sexual distress in pregnancy and postpartum, and there is limited knowledge of protective factors. Women report declines in the importance of sexuality during this time, suggesting that valuing sexuality could be a relevant individual difference factor. It may be particularly protective for women to feel successful in living in line with their sexual values. In a longitudinal study, we examined associations between the extent to which women valued their role as a sexual partner, and their success living in line with this partner-oriented sexual value, with their sexual distress. Women (N = 367) reported the importance of their role as a sexual partner, success living according to this value, and sexual distress during pregnancy (18-20 weeks) and at 3, 6, 12 and 24-months postpartum. More strongly valuing one's role as a sexual partner was associated with more sexual distress, both between-person (i.e., across women) and within-person (i.e., variation within women over time). Above and beyond these effects, greater success at living in line with one's partner-oriented sexual value was associated with less sexual distress. Finding ways to live in line with one's sexual values may protect against sexual distress for new mothers in the transition to parenthood.

How do new mothers describe their postpartum sexual quality of life? a qualitative study

BACKGROUND

Sexuality plays a critical role in a woman's postpartum quality of life and also has a strong impact on the quality of her relationship. Given the sparse body of published literature on the subject, we aimed to explore how new mothers explain their postpartum sexual quality of life.

METHOD

A qualitative study was carried out in Iran and Switzerland from December 2018 to March 2019. Focus groups and semi-structured in-depth interviews (IDIs) were conducted with mothers in the first four months after parturition. Mothers who were older than 18 years, were married or in a stable relationship, and experienced a low-risk vaginal birth or cesarean section participated in the study. We used Graneheim and Lundman's approach for analyzing the data. Multiple data collection methods, maximum variation sampling, and peer checks were applied to enhance the rigor of the data.

RESULTS

We achieved data saturation after two focus group discussions (FGDs), 15 IDIs in Iran, and 13 IDIs in Switzerland. We extracted three themes for postpartum sexual quality of life: (a) sexual worldview, (b) interpersonal relationship, and (c) postpartum sex storm. The participants described sexual worldview as "sexual beliefs", "sexual perceptions", and "sexual behaviors". The interpersonal relationship consists of "changes in postpartum interpersonal relationships" and "supportive role of the husbands/partners". The last one, postpartum sex storm, has three categories including "direct changes in sexual life", "indirect changes in sexual life", and "resumption of sexual intercourse". Differences between the two cultures were identified in some subcategories such as "sexual interests", "comparable to the first intercourse in life", "negative sexual behaviors of husbands/partners", "positive sexual behavior of mothers", "helping with child care and housework", and "emotional support".

CONCLUSION

New mothers explained postpartum sexual quality of life as a three-theme phenomenon. Although most results were similar in both cultures, there were some differences. Our study's results suggest that sexual quality of life is a topic that encompasses international as well as cultural aspects.

Biopsychosocial Predictors of Couples' Trajectories of Sexual Function and Sexual Distress Across the Transition to Parenthood

The prevailing narrative about sexual declines during the transition to parenthood is largely based on studies assessing the average couple, but there is increasing evidence of variability in the sexual well-being of new parents. We sought to establish distinct subgroups of couples based on sexual function and sexual distress trajectories and examine biopsychosocial risk and protective factors of these trajectories. A prospective cohort of 257 first-time parent couples reported on sexual function and sexual distress from 20-week pregnancy (baseline) to 6 months postpartum across four time-points. Biopsychosocial factors were assessed at baseline and 3 months postpartum. Dyadic latent class growth analysis identified two distinct sexual function classes (high, 85%; discrepant, 15%) and three sexual distress classes (low, 77%; moderate, 12%; discrepant, 11%). We identified biomedical (vaginal delivery, perineal tear, breastfeeding) and psychosocial (fatigue, stress, anxiety, depression, attitudes toward sex during pregnancy, relationship quality, perceived partner support) factors that can be assessed at critical time-points (i.e., 20-week pregnancy and 3 months postpartum) to identify high-risk couples. Current results indicate that the course of change in sexual well-being for new parents is heterogeneous, with most new parents retaining high function and low distress and only a minority showing trajectories in which mothers, but not fathers, experience clinically significant and persistent levels of low sexual function and high sexual distress. These results may facilitate more nuanced approaches to the assessment and intervention of new parents' sexual well-being.

A Systematic Review of the Correlation Between Marital Relationship and Breastfeeding Self-Efficacy, and Duration of Breastfeeding

Background: Breastfeeding as an important key to sustainable development strategies is the best nutrition for ensuring healthy growth and development in the first 1,000 days of life. Objective: The current systematic review and meta-analysis were conducted to evaluate the correlation between marital relationship satisfaction and breastfeeding self-efficacy and duration of breastfeeding. Method: A systematical search was carried out in main electronic databases (PubMed, Scopus, Embase, ProQuest, and Web of Science) and gray literature until June 2022. The study's risk of bias was assessed using the Newcastle-Ottawa risk-of-bias tool. Publication bias was evaluated using a funnel plot, and Begg's and Egger's tests. The degree of heterogeneity was assessed using the I² test. To estimate common effect size r coefficient (r) and confidence intervals (95% CIs), random-effect models were fitted, and the results were presented using forest plots. Results: In total, 13 studies with 5,843 subjects were included in the meta-analysis. Overall, the pool estimates show a positive correlation between marital relationship satisfaction, and breastfeeding self-efficacy (r = 0.27, 95% CI (0.09-0.50), p = 0.024), but this relationship was not found in the term of breastfeeding duration (r = 0.11, 95% CI [-0.01 to 0.23], p = 0.079). The heterogeneity of studies was high (I² = 95.2%) Conclusion: Our finding confirms a positive and moderate level of correlation between marital relationship satisfaction and breastfeeding self-efficacy. It is suggested to conduct more studies to reach appropriate conclusions regarding marital relationship satisfaction and breastfeeding duration.

Sexual dysfunction in the third trimester of pregnancy and postpartum period: a prospective longitudinal study

The purpose of this prospective longitudinal study was to determine the prevalence of sexual dysfunction (SD) in women in the third trimester of pregnancy and at 8 week and 6 months in the postpartum period, as well as to identify the factors affecting sexual function in the postpartum period. 110 pregnant women were included in the study. The results showed significant differences in the scores between pregnancy and 6 months after delivery and between 8 weeks and 6 months after delivery. The scores in desire, sexual arousal, lubrication, orgasm, and satisfaction subdimensions were significantly higher and the score in pain subdimension was significantly lower at 6 months than during pregnancy and at eight weeks after delivery. Sexual dysfunction is a common problem in women in the last trimester of pregnancy and at eight weeks after delivery. However, this problem substantially resolves at postpartum 6 months.IMPACT STATEMENTWhat is already known on this subject? Physiological, psychological, and hormonal changes, especially during pregnancy and postpartum period, have a considerable impact on sexual function. Therefore, identifying various aspects of sexual problems during pregnancy and postpartum period and improving the body of knowledge about sexual function would contribute to the health of women and couples.What the results of this study add? Sexual dysfunction is a common problem in women in the last trimester of pregnancy and at 8 weeks after delivery. However, this problem substantially resolves at postpartum 6 months.What the implications are of these findings for clinical practice and/or further research? A striking finding in the study is the increase of SD risk in the sixth month of postpartum with women's starting to work. This problem, which has been addressed sparsely in the current literature, can be considered a condition requiring an in-depth research.

Estimating the prevalence of dyspareunia according to mode of delivery: a systematic review and meta-analysis

The present study aimed to examine the prevalence of dyspareunia in the post-partum period in relation to the mode of delivery. In this systematic review and meta-analysis, published articles until February 2020 were searched through the related key term based on mesh term in national and international databases. In the initial search, 1391 articles were found that after removing duplicate, unrelated or non-English and non-Persian articles, finally 20 studies with a sample size of 11354 of women who had given birth were introduced in this study. The prevalence of dyspareunia following vaginal delivery, C-section, and instrumental delivery with 95%CI was 42%(31-56%), 26%(19-34%), and 37%(28-46%) respectively. In addition, the prevalence of dyspareunia in primiparous was higher than multiparous (34%vs.24%), in breastfeeding women was higher than non-breastfeeding women (48%vs.33%), in women who non-used hormonal contraceptive methods were higher than who used hormonal contraceptive methods (43%vs.35%) and its prevalence was similar in women with and without episiotomy. The results indicated that vaginal delivery, breastfeeding, used hormonal contraceptive and primiparity have an impact on dyspareunia. Thus, considering the high prevalence of dyspareunia, and its impact on the quality of life of couples in the postpartum period, attention to, planning, and designing effective interventions in this regard are essential.IMPACT STATEMENTWhat is already known on this subject? Dyspareunia is one of the common experiences of women in the post-partum period. One of the most important factors affecting dyspareunia in the post-partum period is the mode of delivery.What do the results of this study add? The present study adds to examine the prevalence of dyspareunia in the postpartum period in terms of the mode of delivery. So far, no study has been found which comprehensively and systematically estimating the prevalence of dyspareunia in relation to the type of delivery mode in women who have given birth recently. In addition to the type of delivery the prevalence of dyspareunia was estimated based on parity, breastfeeding, episiotomy and consumption of hormonal contraceptive status.What are the implications of these findings for clinical practice and/or further research? This finding will be a small step to familiarise physicians and midwives as well as people with the relationship between delivery mode and dyspareunia. In addition, in the absence of medical indications and the possibility of choosing the mode of delivery selectively, help them decide and choose the appropriate method of termination of labour and ultimately improve the mental and physical health of the birthing person, family and community.

Predictors of early resumption of post-partum sexual intercourse among post-partum period women in Ethiopia: A multilevel analysis based on Ethiopian demographic and health survey 2016

Background

Early resumption of post-partum sexual intercourse has an adverse outcome on the health of women and indirectly unintended pregnancy might happen and affects both the health of women and the delivered baby. There is limited evidence that shows predictors at the individual and community level from the Ethiopian demographic and health survey. Therefore, the aim of this study was to assess predictors of early resumption of post-partum sexual intercourse among post-partum period women in Ethiopia: a multilevel analysis based on Ethiopian demographic and health survey 2016.

Methods

This study used an in-depth secondary data analysis of the survey using the 2016 main EDHS. A total weighted sample of 6447 post-partum women who have children aged 0 to 36 months (about 3 years) was included for the analysis. Multilevel binary logistic regression analysis was conducted considering the hierarchical nature of the EDHS data. Intra-class Correlation Coefficient (ICC), and deviance [-2 Log-Likelihood Ratio (LRR)] were used for model comparison and for assessing model fitness. In a multivariable analysis adjusted OR with a 95% CI (Confidence Interval) was reported with a p-value <0.05 was used to declare a significant association between the explanatory and the outcome variables.

Results

The proportion of early resumption of post-partum sexual intercourse was found to be 60.41% [95% CI 59.19–61.63]. Women with age group of 25–28 (AOR = 0.8; 95% CI 0.67–0.96), 29–32 (AOR = 0.79; 95% CI 0.63–0.98), and 33–49 (AOR = 0.67; 95% CI 0.53–0.85), women with sex of child female (AOR = 0.82; 95% CI 0.73–0.92), women whose child is alive (AOR = 0.52; 95% CI 0.38–0.69), women who delivered by cesarean section(AOR = 0.34; 95% CI 0.23–0.49), women with primary educational level (AOR = 1.27; 95% CI 1.09–1.48), women with secondary educational level (AOR = 1.61; 95% CI 1.19–2.17) and women with higher educational level (AOR = 1.6; 95% CI 1.05–2.45), Para 3–4 women (AOR = 1.45; 95% CI 1.21–1.73) and women with grand multi parity (AOR = 1.61; 95% CI 1.29–2), women with fertility desire wanted latter (AOR = 0.81; 95% CI 0.69–0.94), women with fertility desire wanted no more (AOR = 0.81; 95% CI 0.66–1.01), women who are on family planning use (AOR = 1.2; 95% CI 1.05–1.38) and participant with currently on working (AOR = 0.79; 95% CI 0.69–0.91) were significantly associated with early resumption of post-partum sexual intercourse.

Conclusions

The magnitude of early resumption of post-partum sexual intercourse was found to be high. Giving emphasis to the age groups of 25–28, 29–32, and 33–49 women, women with the sex of child female, women who delivered by cesarean section, currently working, the child is live, fertility desire wanted later and no more were suggested to reduce early resumption of post-partum sexual intercourse. On the other hand, improved educational attainments of women, women with parity 3–4, and >5, and family planning use were variables to increase early resumption of post-partum sexual intercourse. Therefore, the health care providers and program managers should act on early resumption of post-partum sexual intercourse through health education and promotion considering the significant factors.

Sexual Function and Help-Seeking Behaviors following Childbirth: A Cross-Sectional Study

This study examined 573 postpartum women's perceptions of changes in their sexual function and their help-seeking behaviors. Women residing in Ohio, Michigan, or Pennsylvania, USA, completed an online survey. Most women reported decreased postpartum sexual desire and/or arousal. Among women reporting decreased sexual function, most did not seek help from informal sources of support or health care professions (HCPs). Of those who did seek help from an HCP, in each domain of sexual function, only around half received helpful treatment. Women who did not seek help for their decreased sexual desire or arousal reported greater negative perceived impact of pregnancy/childbirth on their sexual function than women who did seek help.

The effectiveness of "Women's Postpartum Sexual Health Program (WPSHP)" on Iranian women's postpartum sexual health: A randomized clinical trial

In this study, we examined the effectiveness of Women's Postpartum Sexual Health Program (WPSHP) on Iranian women's sexual health in the postpartum period. A single-blinded randomized clinical trial was conducted in 2016 on 80 postnatal women in Iran. We used the Female Sexual Function Index, Sexual Quality of Life - Female questionnaire and Female Sexual Distress Scale. The intervention group received counseling based on WPSHP. After 28 weeks, the mean score of the Female Sexual Function Index and Female Sexual Quality of Life significantly increased in the WPSH group (p < 0.001, p < 0.001), while the mean score of the Female Sexual Distress significantly decreased in the WPSH group (p < 0.001). We concluded that Women's Postpartum Sexual Health Program could promote postnatal women's sexual function and female sexual quality of life and reduces female sexual distress in women suffering from sexual problems in the postpartum period.

A Longitudinal Investigation of Couples' Sexual Growth and Destiny Beliefs in the Transition to Parenthood

Beliefs about sexuality tend to become more salient during sexual challenges and are associated with how individuals respond to these difficulties and, in turn, their sexual well-being. The transition to parenthood is marked by significant changes to couples' sexuality. As such, this period of vulnerability may be an important context in which these beliefs impact how couples manage sexual stressors and may have implications for their sexual well-being. In a longitudinal dyadic study, we examined whether couples' sexual growth beliefs (e.g., beliefs that sexual problems can be resolved through effort) and sexual destiny beliefs (e.g., beliefs that sexual problems reflect incompatibility with their partner) correspond with changes to various facets of couples' sexual well-being over time. First-time parent couples (N = 203) completed online surveys assessing these beliefs in pregnancy (32 weeks) and measures of sexual well-being (satisfaction, desire, and distress) in pregnancy (20 and 32 weeks) and across the postpartum period (3, 6, 9, 12 months). Dyadic latent growth curve models showed that expectant mothers who reported stronger sexual destiny beliefs in pregnancy reported higher sexual distress and lower sexual satisfaction at 3 months postpartum. When partners reported stronger sexual destiny beliefs in pregnancy, both they and new mothers reported greater sexual desire at 3 months postpartum. Unexpectedly, partners' higher sexual growth beliefs in pregnancy predicted mothers' lower sexual desire at 3 months postpartum. Sexual growth and destiny beliefs were not associated with change in couples' sexual well-being beyond 3 months postpartum. Findings shed light on the potential benefits and costs of sexual growth and destiny beliefs for couples' sexual well-being early in the postpartum period, but not over time.

Relationship Between the Genital Self-Image and the Sexual Quality of Life of Primiparous Women in the Postpartum Period in Heterosexual Couples

Objectives: This study was planned to investigate the relationship between the genital self-image of primiparae and their sexual quality of life in the postpartum period in heterosexual couples. Method: In this cross-sectional and correlational study, the data were collected through face-to-face interviews in the eastern part of Turkey. Results: The results demonstrated that the relationship between the genital self-image and sexual quality of life of the participants who were sexually active after birth was moderate (r = 0.52, p <.001). Both the genital self-image and sexual quality of life of the participating women were affected by the romantic relationship between them and their partners after birth (p <.01). Conclusions: Healthcare professionals should encourage and support couples to look over their relationship and problems they experience in their romantic relationship after birth.

Longitudinal Associations between Depressive Symptoms and Postpartum Sexual Concerns Among First-time Parent Couples

Most first-time parents experience novel concerns about their sexuality such as worries about the effects of labor and delivery on their sex lives. The link between postpartum depressive symptoms and problems with sexual function is bidirectional; however, associations with postpartum sexual concerns (i.e., worries about one's sexuality that are not necessarily related to sexual function) have not been examined. First-time parent couples (N = 99) completed measures assessing their postpartum sexual concerns and depressive symptoms at 3, 6, and 12 months postpartum. Dyadic latent growth curve modeling revealed that mothers' and partners' initial frequencies of postpartum sexual concerns were positively associated, with significant declines in the frequency of these concerns over time for both partners. Mothers' and partners' initial depressive symptoms were also positively associated; however, mothers' depressive symptoms did not change over time whereas partner's depressive symptoms worsened. Mothers' and partners' higher initial depressive symptoms were associated with partners' higher frequency of postpartum sexual concerns. Mothers' depressive symptoms at 3 months postpartum and the degree to which these symptoms changed over time were associated with a steeper decline in partners' postpartum sexual concerns over time. Results provide preliminary support for depressive symptoms as a risk factor for partners' postpartum sexual concerns.

The effect of intra-vaginal oxytocin on sexual function in breastfeeding mothers: a randomized triple-blind placebo-controlled trial

BACKGROUND

Considering the importance of sexual function, high prevalence of sexual dysfunction (especially dyspareunia caused by atrophic vaginitis) in breastfeeding women, and lack of effective interventions, the present research aimed to determine the effect of oxytocin (OXT) vaginal gel on sexual function (primary outcome), sexual satisfaction, and depression (secondary outcomes) in the breastfeeding women.

METHODS

This randomized triple-blind controlled trial was conducted on 64 breastfeeding women who referred to health centers in the city of Tabriz, Iran, in 2020-21. Participants were equally assigned to intervention/control groups using block randomization. 200 IU of OXT vaginal gel was given to the participants in the intervention group daily for eight week and the same protocol was carried out for the control group with placebo. Standard questionnaires of Female Sexual Function Index (FSFI), Edinburgh Postpartum Depression Scale (EPDS) and Sexual satisfaction scale for women (SSSW) were completed at baseline and 8 weeks after intervention. ANCOVA test was used to compare post-intervention mean score of the groups, adjusted for the baseline values.

RESULTS

After intervention, there was no statistically significant difference between groups in terms of mean total score of FSFI (Adjusted Mean Difference (AMD): 1.14; 95% Confidence Interval (95% CI): -1.28 to 9.16; P= 0.349) and sexual satisfaction (AMD: 5.01; 95% CI: -0.53 to 10.56; P= 0.075). However, there was statistically significant difference between the groups in terms of mean scores of sexual contentment (AMD: 1.56; 95% CI: 0.29 to 2.83; P = 0.017) and depression (AMD: -1.90; 95% CI: -1.27 to -2.54; P < 0.001). One participant in the OXT group and one participant in the placebo group reported mild uterine contraction and one person in the placebo group reported vaginal burning sensations.

CONCLUSIONS

No evidence was found for the effects of OXT gel in the improvement of FSFI, even though, OXT significantly improved sexual satisfaction in the domain of contentment, and improved the symptoms of depression in comparison to the placebo group. However, a definite conclusion requires more research in this regard.

TRIAL REGISTRATION

the Iranian Registry of Clinical Trials (IRCT), code: IRCT20120718010324N55 , Date of registration: 27/05/2020, URL: https://en.irct.ir/user/trial/44986/view .

How to Deal With Sexual Changes During and After Pregnancy: Results of a Brief Psycho-Educational Workshop With Future and New Parenting Couples

After documenting parenting couples' needs regarding perinatal sexuality, this study developed and evaluated a brief psycho-educational workshop on perinatal sexuality. Participants (16 future and 17 new parents) completed five steps: (1) online questionnaire (T1) assessing needs toward the workshop and sexoperinatal knowledge, attitudes, and perceptions; (2) 2-hour online workshop on perinatal sexuality; (3) post-workshop satisfaction questionnaire; (4) 1-month (T2) and (5) 2-month (T3) post-workshop questionnaires with the same measures as in T1. One month after the workshop, knowledge, attitudes, and perceptions toward perinatal sexuality increased significantly. Sexoperinatal interventions from health-care workers are still uncommon, although there is a need for information and support. This brief online workshop is promising for better education and empowerment of parenting couples regarding perinatal sexuality.

Putative Mental, Physical, and Social Mechanisms of Hormonal Influences on Postpartum Sexuality

Purpose of Review

Much research has documented changes in postpartum sexuality, including changes in sexual functioning and satisfaction for both the birthing parent and their partner(s). These changes are often linked to postpartum changes in hormonal and immune responses, which can have both direct and indirect effects on sexuality.

Recent Findings

Here, we review how postpartum sexuality may be changed via mental, physical, and social/relationship effects of a variety of hormones, including estrogens, progestogens, androgens, cortisol, and oxytocin. We also review the ways in which inflammation may act alongside hormones to influence postpartum sexuality.

Summary

We argue that, as each of these factors strongly influence the action of others, the next phase of research in postpartum sexuality must examine the bidirectional interactions of hormones and their effects on behavior, cognition, and social relationships.

Associations Between Postpartum Depressive Symptoms and Couples' Sexual Function and Sexual Distress Trajectories Across the Transition to Parenthood

BACKGROUND

The transition to parenthood is associated with changes to new parents' mood and sexual health. Sexual dysfunction-problems with sexual function accompanied by sexual distress (i.e., worries and concerns about one's sex life)-is linked to poorer overall health, yet few studies have examined how sexual dysfunction unfolds for couples during this transition. Postpartum depression is a risk factor for sexual dysfunction; however, the association between depressive symptoms and how postpartum sexual dysfunction evolves has not been examined.

PURPOSE

To establish trajectories of sexual function and sexual distress for mothers and partners and to examine if postpartum depressive symptoms were associated with these trajectories.

METHODS

Data were collected from 203 first-time parent couples from midpregnancy until 12-months postpartum. Sexual function and sexual distress were assessed at six time points (two prenatal) and depressive symptoms were assessed at 3-months postpartum.

RESULTS

Dyadic latent piece-wise growth curve models revealed significant declines in mothers' and partners' sexual function between pregnancy and 3-months postpartum and significant improvements from 3- to 12-months postpartum. Mothers' sexual distress increased between pregnancy and 3-months postpartum and decreased thereafter, whereas partner's sexual distress remained stable. Depressive symptoms were associated with poorer sexual function and higher sexual distress at 3-months postpartum for both partners but did not predict change over time.

CONCLUSIONS

Mothers and their partners experience changes to their sexual function during the transition to parenthood; however, mothers are at greater risk of sexual dysfunction. Depressive symptoms are a risk factor for poorer sexual health at 3-months postpartum for both parents.

Testing an Online Training Session on Couples' Perinatal Sexual Changes Among Health Care Professionals and Paraprofessionals

INTRODUCTION

During and after pregnancy, couples have to adapt to sexual changes. Although many couples have questions and preoccupations regarding those changes, they are rarely addressed by professionals and paraprofessionals in perinatal health care, mainly because of lack of knowledge and training. An online training session that addressed couples' perinatal sexual changes tailored for health care perinatal professionals (nurses and midwives) and paraprofessionals (doulas) was developed, implemented, and evaluated.

METHODS

Participants completed 4 steps: (1) a baseline online questionnaire assessing training needs and measures on knowledge, attitudes, and perceived counseling skills regarding couples' perinatal sexual changes; (2) a 2-hour online training session on the topic with theoretical and practical content; (3) an online post-training satisfaction questionnaire; and (4) a one-month follow-up assessment using the same measures as at baseline.

RESULTS

Of the 74 participants (20 nurses, 20 midwives, 34 doulas) who completed the study, 37.8% had previous training in sexuality and 18.9% in perinatal sexuality. Results showed pre- to post-training significant increases in knowledge and attitudes toward couples' perinatal sexual changes, characterized by more positivity, flexibility, openness, and sense of competence regarding the topic. There were also significant pre- to post-training increases in perceived utility, comfort, intention, and sense of self-efficacy related to counseling skills regarding couples' perinatal sexual changes. After training, more participants discussed couples' sexual changes with couples during and after pregnancy. After training, significantly fewer participants reported lack of knowledge, lack of training, and lack of discomfort as barriers to discussions on couples' perinatal sexual changes, whereas more reported lack of time as a barrier. Global satisfaction with the training was high.

DISCUSSION

This training can help foster more discussions on the topic from perinatal professionals and paraprofessionals to better meet couples' needs for information and support.

#postbabyhankypanky: An Empirically Based Knowledge Sharing Initiative About Sex and the Transition to Parenthood

Despite the many sexual concerns experienced by new parents, and their reported desire for more information on this topic, both parents and healthcare providers remain reticent to broach the subject. The goal of this project was to disseminate evidence-based knowledge from our prior research in a way that was accessible, engaging, and would spark further interest and communication for both new parents and healthcare providers. We convened a multidisciplinary advisory group that also involved community parents who provided feedback at all phases of this project. We developed five brief YouTube videos, each featuring a core research finding. Following an empirically supported strategic knowledge translation plan, we disseminated the videos to our target audiences (i.e., expectant and new parents, healthcare providers, educators, and other stakeholders) using social media from February 2018 to November 2019. Data were collected using YouTube analytics and an online survey (convenience sample: N = 225 parents; N = 161 healthcare providers). From the date of the launch, the videos had a reach of 91,766 views from 14 countries, with viewers watching an average of 90% of a video. Overall, quantitative and qualitative survey results suggested that the videos were acceptable and appropriate, and respondents were more confident and comfortable discussing sexual issues (with their partner/with their patients) and would like more information about postpartum sexuality after watching the videos. YouTube videos are an acceptable and effective way to disseminate evidence aimed at raising awareness of factors affecting sexuality in the transition to parenthood.

#postbabyhankypanky: An Empirically Based Knowledge Sharing Initiative About Sex and the Transition to Parenthood

Despite the many sexual concerns experienced by new parents, and their reported desire for more information on this topic, both parents and healthcare providers remain reticent to broach the subject. The goal of this project was to disseminate evidence-based knowledge from our prior research in a way that was accessible, engaging, and would spark further interest and communication for both new parents and healthcare providers. We convened a multidisciplinary advisory group that also involved community parents who provided feedback at all phases of this project. We developed five brief YouTube videos, each featuring a core research finding. Following an empirically supported strategic knowledge translation plan, we disseminated the videos to our target audiences (i.e., expectant and new parents, healthcare providers, educators, and other stakeholders) using social media from February 2018 to November 2019. Data were collected using YouTube analytics and an online survey (convenience sample: N = 225 parents; N = 161 healthcare providers). From the date of the launch, the videos had a reach of 91,766 views from 14 countries, with viewers watching an average of 90% of a video. Overall, quantitative and qualitative survey results suggested that the videos were acceptable and appropriate, and respondents were more confident and comfortable discussing sexual issues (with their partner/with their patients) and would like more information about postpartum sexuality after watching the videos. YouTube videos are an acceptable and effective way to disseminate evidence aimed at raising awareness of factors affecting sexuality in the transition to parenthood.

Factors Affecting Women's Adjustment to Postpartum Changes: A Narrative Review

Background

Postpartum period is associated with stress and pressure, and the woman must adjust herself to these changes. This study aimed to review the factors affecting women's adjustment to postpartum changes in conducted studies.

Materials and Methods

This review was conducted by searching databases such as ISI Web of Science, Science Direct, Scopus, Cochrane, PubMed and Scientific Information Database (SID), Iranian Medical Articles Database (IranMedex), Iranian Research Institute for Information Science and Technology (IranDoc), and the Iranian Magazine Database (MagIran), as well as searching through Google Scholar (as a Web search engine) in December 2019. Publications from July 2004 to October 2019 were reviewed and limited to Persian and English. The keywords used included "Postpartum", "Women's needs", "Adjustment" and "Coping". After reviewing the articles, out of 60 original articles, 17 articles were selected for final evaluation.

Results

Factors affecting adjustment to postpartum changes were divided into personal and social factors. Personal factors included previous experiences, coping styles and strategies, personality traits, self-efficacy and awareness, and social factors included family and relatives, healthcare providers, cultural context, and laws and regulations.

Conclusions

Adjustment to postpartum changes depends on the personal and social factors that can interact with each other. Women's awareness enables them to use positive coping strategies in this critical situation. Educating women's spouse and family members can contribute to increase the women's social support. Additionally, the law support guarantees the implementation of many interventions in promoting the mother's health.

A Comparison of the Sexual Well-Being of New Parents With Community Couples

BACKGROUND

Changes in sexual well-being are common for new mothers and their partners after the birth of a baby. However, most research has sampled mothers not couples, assessed only one aspect of sexual well-being, and has not included a control sample of couples.

AIM

This study aimed to compare the sexual well-being (ie, sexual frequency, sexual satisfaction, sexual desire, sexual distress) of first-time mothers and their partners in the transition to parenthood (first 12-month postpartum) to community couples who are not actively in this transition. We also compared the sexual well-being within couples (eg, mothers to their partners).

METHODS

Couples in the transition to parenthood (n = 99) completed measures of sexual satisfaction, sexual desire, sexual distress, and sexual frequency at 3, 6, and 12 months postpartum, and community couples (n = 104) completed the measures at a single time point.

OUTCOMES

Measures included the following: (i) Global Measure of Sexual Satisfaction Scale; (ii) Female Sexual Function Index and International Index of Erectile Function sexual desire subscale; (iii) Female Sexual Distress Scale-Revised; and (iv) checklist of sexual behaviors.

RESULTS

Compared with community controls, new parents reported lower sexual satisfaction, lower sexual desire, and higher sexual distress at all time-points; however, these group differences became less pronounced by 12 months postpartum. By 6 months postpartum, there was no difference in sexual frequency between postpartum couples and the control group. Mothers experienced persistently lower sexual desire relative to their partners throughout the 12 months postpartum. Between 39% and 59% of mothers reported clinically low sexual desire, and 47-57% reported significant sexual distress at all time points. There were no significant differences reported in sexual satisfaction, sexual desire, or sexual distress between women and their partners in the community sample.

CLINICAL IMPLICATIONS

Clinicians should be aware that sexual well-being may be compromised in new parents, and some of these challenges are still present for new parents at 12 months postpartum. Findings can be used to educate new parents regarding their expectations about postpartum sexual well-being.

STRENGTHS & LIMITATIONS

The strengths of the present study are the dyadic approach, assessing multiple aspects of sexual well-being in new parents over time, and the comparison with a community sample. An important limitation is that the control sample was not followed up over time.

CONCLUSION

Education regarding postpartum sexual well-being should be incorporated in routine perinatal and postnatal healthcare practices to support new parents in developing realistic expectations about changes during the transition to parenthood, potentially preventing undue distress. Schwenck GC, Dawson SJ, Muise A, et al. A Comparison of the Sexual Well-Being of New Parents With Community Couples. J Sex Med 2020;17:2156-2167.

Are Couples More Satisfied When They Match in Sexual Desire? New Insights From Response Surface Analyses

While sexual frequency and satisfaction are strong contributors to the quality and longevity of romantic relationships and overall well-being, mismatches in sexual desire between partners are common and have been linked with poorer satisfaction. Previous findings linking mismatches in desire with poorer relationship and sexual outcomes have typically been derived using difference scores, an approach that does not account for partners’ overall levels of desire. In a sample of 366 couples, we investigated whether partners who match in desire are more satisfied than desire-discrepant couples. Results of dyadic response surface analyses provided no support for a unique matching effect. Higher desire rather than matching in desire between partners predicted relationship and sexual satisfaction. These findings shed new light on whether the correspondence between partners’ levels of sexual desire is associated with satisfaction and suggest the need to focus on sustaining desire and successfully navigating differences rather than promoting matching in desire.

A Close and Supportive Interparental Bond During Pregnancy Predicts Greater Decline in Sexual Activity From Pregnancy to Postpartum: Applying an Evolutionary Perspective

A common topic for advice given to parents after childbirth – both from relationship experts and popular media – is how to “bounce back” to one’s pre-pregnancy sexuality, with warnings that postpartum declines in sexual frequency will take a serious toll on one’s relationship. However, these admonishments may not accurately reflect the ways in which the unique reproductive context of pregnancy and the postpartum transition alter associations between sexual frequency and relationship quality. Evolutionary perspectives on reproductive strategies would suggest that in the postpartum context, decreased sexual activity would help target parental investment in the current offspring (rather than creating new offspring); however, if the parental relationship is lacking in intimacy and support, continued sexual activity may help seal the cracks in the bond. We tested this theory in a longitudinal dyadic study of changes in relationship quality and sexual frequency from pregnancy to 6 months postpartum among 159 heterosexual couples. We found that across three different measures of relationship quality taken from interviews and behavioral observation of couple interactions, higher relationship quality (i.e., greater support, intimacy, and responsiveness) predicted greater decline in sexual frequency whereas sexual frequency remained relatively stable in lower quality relationships. These findings suggest that, during the postpartum transition, decreased sexual frequency may not be a reliable signal of poor relationship quality.

Is Mode of Delivery Associated With Sexual Response? A Pilot Study of Genital and Subjective Sexual Arousal in Primiparous Women With Vaginal or Cesarean Section Births

INTRODUCTION

Although postpartum sexual concerns are common, limited data exist on postpartum sexual response. Furthermore, the physiological process of vaginal birth may negatively impact genital response compared with unlabored cesarean section (C-section), but this hypothesis has yet to be tested.

AIM

To (i) compare genital and subjective sexual response and sexual concordance by mode of delivery with inclusion of a control group, (ii) compare groups on self-reported sexual function over the past month, (iii) examine the relationship between laboratory measurement of sexual response and self-reported sexual function, and (iv) investigate association between obstetrical factors and breastfeeding and between sexual response and self-reported sexual function.

METHODS

3 groups of cisgender women were recruited from the community: primiparous women who delivered via vaginal birth within the past 2 years (VB group; n = 16), primiparous women who delivered via unlabored C-section within the past 2 years (CS group, n = 15), and age-matched nulliparous women (NP group, n = 18). Laser Doppler imaging was used to assess genital response while participants watched a neutral and erotic film.

MAIN OUTCOME MEASURES

The main outcome measures were change in flux units from neural to erotic video as a measure of genital response, subjective sexual arousal rated continuously throughout films, perceived genital response rated after films, and Female Sexual Function Index (FSFI).

RESULTS

Women in the VB group had significantly lower change in flux units than women in the CS (P = .005, d = 1.39) and NP (P < .001, d = 1.80) groups. Groups did not differ on their subjective indices of sexual response or in sexual concordance. Women in both postpartum groups reported lower FSFI scores than women in the NP group. No relationship was determined between FSFI scores and sexual response in the laboratory. Results suggested that genital trauma and breastfeeding may negatively impact FSFI scores, but they were not related to genital response or subjective sexual arousal as measured in the laboratory.

CLINICAL IMPLICATIONS

Results underscore the importance of balancing objective and subjective indices of sexual response and function, especially considering the biopsychosocial nature of postpartum sexuality.

STRENGTHS & LIMITATIONS

The present study is the first to apply modern sexual psychophysiological methodology to the study of postpartum sexuality. Cross-sectional methodology limits the ability to make causal inferences, and the strict inclusion criteria limits generalizability.

CONCLUSION

Physiological changes as a result of labor and delivery may have a detrimental impact on genital response; however, these physiological differences may not impact women's subjective experience of postpartum sexuality. Cappell J, Bouchard KN, Chamberlain SM, et al. Is Mode of Delivery Associated With Sexual Response? A Pilot Study of Genital and Subjective Sexual Arousal in Primiparous Women With Vaginal or Cesarean Section Births. J Sex Med 2020; 17:257-272.

Understanding women's postpartum sexual experiences

This study aimed to understand women's sexual health experiences, specifically knowledge, attitudes and norms related to sexual behaviour resumption during the postpartum period. Semi-structured, reproductive health-focused interviews (N = 70) were conducted among women aged 18 years or older (range: 19-78) residing in South Carolina. Findings demonstrated that women identified clinicians as most influential concerning when they should and could resume sexual activity. Some women noted returning to sex earlier than anticipated due to personal and partner desire and indicated achieving considerable sexual satisfaction during the postpartum period. However, other participants noted difficulties resuming sexual activity, including pain and exhaustion from caring for a new baby. Findings provide practical recommendations for health professionals to further develop tailored, timely health messaging related to safe and healthy postpartum sexual behaviours. We discuss recommendations for health professionals to bring further awareness to varied postpartum sexual experiences.

Breastfeeding and Sexual Activity and Sexual Quality in Postpartum Women

Background: Breastfeeding is the ideal source of nutrition for infants. Breastfeeding can affect sexual activity and sexual quality of women in the postpartum period. Objective: The present study was carried out to determine the effect of breastfeeding on sexual activity and sexual quality in postpartum women. Materials and Methods: The sample of the study consisted of 161 breastfeeding and 176 nonbreastfeeding women who were cared for in the Family Health Centers utilizing the Descriptive Information Form and Sexual Quality of Life-Female (SQOL-F) questionnaire. Results: Half of the breastfeeding and nonbreastfeeding women included in the study had cesarean delivery and the women in both groups reported changes in their sexual life (having less sexual intercourse, and suffering from dyspareunia) during the postpartum period. In the present study, 68.3% of the breastfeeding women and 47.7% of the nonbreastfeeding women experienced dyspareunia, and the difference between them was statistically significant (p < 0.05). There was also a statistical difference between the breastfeeding women and nonbreastfeeding women in terms of the types of changes experienced in sexual life (p < 0.05). The rate of the women who enjoyed sexual satisfaction more was higher in the nonbreastfeeding women (15.9%) than in the breastfeeding women (1.2%). The SQOL-F scale total mean score was 60.07 ± 9.88 in the breastfeeding women and 62.81 ± 9.66 in the nonbreastfeeding women, but the difference between the groups was not statistically significant (p > 0.05). Conclusions: In the present study, the sexual life quality mean scores between the breastfeeding and nonbreastfeeding women were moderate and similar to each other. The fact was that the reported sexual life quality was similar in the breastfeeding and nonbreastfeeding women despite the association of a lower sexual desire and frequency of intercourse in the breastfeeding group, suggesting that breastfeeding may serve as a sexual alternative for nursing mothers.

Sexual well-being and perceived stress in couples transitioning to parenthood: A dyadic analysis

Background/Objective

The transition to parenthood encompasses several psychological and relational changes that might contribute to couples’ high levels of stress postpartum. Although common across the postpartum, couples’ sexual changes are frequently overlooked.

Method

We surveyed 255 mixed-sex new parent couples to examine the associations between sexual well-being—sexual satisfaction, desire, and postpartum sexual concerns—and perceived stress postpartum. Couples completed self-report questionnaires assessing perceived stress and sexual well-being.

Results

For both mothers and fathers, greater sexual satisfaction was associated with their partners’ lower perceived stress and, for fathers, this was also associated with their own lower perceived stress. For mothers, greater partner-focused sexual desire was associated with their own lower perceived stress whereas, for fathers, greater partner-focused sexual desire was associated with their partners’ higher perceived stress. In addition, greater solitary sexual desire and postpartum sexual concerns were associated with both parents’ own higher perceived stress.

Conclusions

This study highlights the association between sexual well-being and couples’ postpartum stress, suggesting that more positive sexual experiences are linked to lower perceptions of stress across this vulnerable period. Couples’ sexual well-being may be an important target for interventions aimed at helping postpartum couples cope with stress.

Depression across pregnancy and the postpartum, antidepressant use and the association with female sexual function

BACKGROUND

There is an established relationship between depression and sexual functioning in women. However, there is limited research examining the relationship between perinatal depression and sexual functioning.

METHODS

This study draws on the Mercy Pregnancy and Emotional Wellbeing Study and reports on 211 women recruited in early pregnancy and followed to 12 months postpartum. Women were assessed for depression using the Structured Clinical Interview for the DSM-IV, repeated measurement of depressive symptoms using the Edinburgh Postnatal Depression Scale and sexual functioning using the Female Sexual Functioning Inventory. Data were also collected on antidepressant use, mode of delivery, history of childhood trauma, breastfeeding and partner support.

RESULTS

Women showed a decline in sexual functioning over pregnancy and the first 6 months postpartum, which recovered by 12 months. For women with depression, sexual functioning was lower throughout pregnancy and continued to be lower at 6 months postpartum than those without depression. Ongoing depressive symptoms at 12 months were also associated with lower sexual functioning. Sexual functioning was not predicted by mode of delivery, antidepressant use or childhood trauma. Breastfeeding predicted lower sexual functioning only at 6 months. Higher partner support predicted higher female sexual functioning.

CONCLUSIONS

Pregnancy and the postpartum are a time of reduced sexual functioning for women; however, women with depression are more likely to have lower levels of sexual functioning and this was not predicted by antidepressant use. In women with perinatal depression, consideration of the impact on sexual functioning should be an integral part of care.

Determinants of Female Sexual Function in Breastfeeding Women

Knowledge about the determinants of female sexual function in breastfeeding women is limited. A total of 355 breastfeeding women completed the Female Sexual Function Index (FSFI) and the Qol-8 quality of life questionnaire. FSFI scores decreased in the first six months of breast feeding. There was a positive relationship between FSFI scores and the importance of sex, level of communication, income, quality of life, and receiving brief sexual counseling.

Perceptions of the effects of childbirth on sexuality among nulliparous individuals

BACKGROUND

Media representations of sexuality after childbirth depict vaginal birth as harmful and cesarean delivery as protective, although research does not support these depictions. The objective of the current study was to investigate perceptions of the effects of mode of delivery on sexuality.

METHODS

Nulliparous participants who were able to and interested in giving birth (N = 1428) completed an online survey about their preferences for mode of delivery and their perceptions of childbirth as they specifically relate to sexuality. Participants provided demographic information, rated how influential different sources of information about childbirth were, and completed the Attitudes Toward Women's Genitals Scale.

RESULTS

Up to half (16-48%), the participants agreed with different statements about vaginal birth as harmful to, and cesarean delivery as protective of, future sexuality. Participant characteristics that were independently predictive of endorsing these beliefs were: self-identifying as heterosexual, holding negative attitudes toward women's genitals, and reporting that reality media, nonreality media, and online media sources are influential sources of childbirth information. Participants who rated health care professionals as an influential source of information were less likely to endorse these beliefs.

CONCLUSION

Given that there is no clear evidence in the empirical literature to support the claim that vaginal births are harmful and cesarean delivery is protective to one's future sexual life, it is important to dispel the existing misconceptions. Various media sources likely play a role in the perpetuation of this misinformation.