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Graziottin A, Di Simone N, Guarano A. Postpartum care: Clinical considerations for improving genital and sexual health. Eur J Obstet Gynecol Reprod Biol 2024; 296:250-257. [PMID: 38484617 DOI: 10.1016/j.ejogrb.2024.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/15/2024] [Accepted: 02/20/2024] [Indexed: 04/19/2024]
Abstract
The postpartum period encompasses the biological and psychoaffective transition to motherhood. However, it remains a most neglected phase in a woman's life. Furthermore, the transition to parenthood is a critical and potentially disrupting factor in a couple's relationship, which can be complicated by undiagnosed biological and psychosexual difficulties. Lack of recognition of the many biological and medical factors that can affect women's health and sexuality in the postpartum period is a common and persistent clinical omission worldwide. Communication difficulties exist between healthcare professionals and women and there are wording biases in describing female genitalia. This can further contribute to the diagnostic lack of attention and timely diagnosis and treatment of even very bothersome symptoms. Early diagnosis and treatment of common postpartum conditions is vital and quality care for new mothers should include psychological and emotional support, lactation assistance, early diagnosis and treatment of genital and sexual pain symptoms, pelvic floor rehabilitation and sexual health guidance. The inclusion of correct genital hygiene practices is a critical element of postpartum gynaecological counselling and can help improve overall genital and sexual health. In this review, we summarise the variability in global professional guidelines for postpartum care, identify common health problems faced by postpartum women and discuss appropriate postpartum care. We pay specific attention to prominent biological or medical factors that can impact the emotional and psychosexual wellbeing of women and couples. The aetiology, diagnosis and treatment of sexual dysfunction, in particular sexual pain disorders, is therefore discussed with a pragmatic approach. Finally, the role of intimate hygiene care is discussed with special attention given to cleanser ingredients with solid scientific evidence to help clinicians adopt a more tailored approach with their clinical recommendations.
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Affiliation(s)
- Alessandra Graziottin
- Centre of Gynaecology and Medical Sexology, Department of Obstetrics and Gynaecology, San Raffaele Resnati Hospital, 20122 Milan, Italy; Department of Obstetrics and Gynaecology, University of Verona, 37129 Verona, Italy; Specialty School, Endocrinology and Metabolic Diseases Department, Federico II University, 80131 Naples, Italy; Alessandra Graziottin Foundation for the Cure and Care of Pain in Women, NPO, Italy
| | - Nicoletta Di Simone
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy; IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
| | - Alice Guarano
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy.
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Fernández-Fernández MJ, de Medina-Moragas AJ. Comparative study of postpartum sexual function: Second-degree tears versus episiotomy outcomes. Arch Gynecol Obstet 2024:10.1007/s00404-024-07494-2. [PMID: 38613578 DOI: 10.1007/s00404-024-07494-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/24/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE The effects of episiotomy and second-degree tears on postpartum sexual function are key areas of enquiry in women's health research. Episiotomy and second-degree tears are common procedures and injuries that occur during childbirth. Understanding their impact on post-childbirth sexuality is crucial to women's overall well-being. This study aimed to examine the relationship between episiotomy, second-degree tears, and post childbirth sexuality. METHODS A cross-sectional design was employed, including 83 women who gave birth to Cáceres in 2017. Participants were evaluated based on sociodemographic and sexual health factors. RESULTS No significant differences were found in dyspareunia or sexual function between women who underwent episiotomies and those with second-degree tears. However, women who underwent episiotomies waited longer before resuming sexual activity after childbirth. Factors such as age, number of previous births, employment status, educational level, and breastfeeding status affected the timing and frequency of postpartum sexual activity. CONCLUSION Dyspareunia negatively affects various aspects of sexual function. When comparing episiotomy and second-degree tears, their impacts on postpartum sexual function were similar. However, episiotomy delays the resumption of sexual activity. Sociodemographic factors significantly influence postpartum sexual health. These findings highlight the importance of individualised interventions and support for new mothers during the postpartum period to address potential sexual health concerns.
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Glavina WSN, Silva CM, Martins EL, Monteiro JCDS, Silva IW, Brito APA, Ferreira FM, Ruela LDO, Tomaz RGDO. Puerperal women's social interactions related to their sexual health after childbirth. Rev Esc Enferm USP 2024; 57:e20230056. [PMID: 38381890 PMCID: PMC10881122 DOI: 10.1590/1980-220x-reeusp-2023-0056en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 12/07/2023] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE To analyze puerperal women's experiences of sexual health after childbirth from the perspective of symbolic interactionism. METHOD Descriptive, qualitative study. Twenty semi-structured interviews were conducted by videoconference with women in the remote puerperium, captured by snowball technique and searched for "seeds" on Instagram®. Bardin's content analysis and Symbolic Interactionism were used as references. RESULTS The puerperal women signify sexual health from a perspective of comprehensive healthcare. However, due to the duality between "being a woman" and "being a mother", they recognize fear, bodily transformations and changes in focus from the love relationship to caring for the baby as factors that interfere with sexual health. And they choose to put themselves aside, prioritizing caring for others. They re-signify sexual health by recognizing the importance of taking care of themselves in biopsychosocial aspects and try to recover self-care for a healthy sexual experience. CONCLUSION Despite the meanings attributed, women's social interactions with the puerperium interfere negatively with sexual health. Professionals should be sensitized to the inclusion of actions that promote changes in the social action of these women towards self-care.
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Affiliation(s)
| | - Carla Marins Silva
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Psiquiátrica, São Paulo, SP, Brazil
| | - Elaine Lutz Martins
- Universidade do Estado do Rio de Janeiro, Faculdade de Enfermagem, Departamento de Enfermagem Materno-Infantil, Rio de Janeiro, RJ, Brazil
| | - Juliana Cristina dos Santos Monteiro
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto, SP, Brazil
| | | | | | - Fernanda Marçal Ferreira
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Psiquiátrica, São Paulo, SP, Brazil
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Ollivier R, Aston M, Price S, Sheppard-LeMoine D, Steenbeek A. 'Feeling Ready': A Feminist Poststructural Analysis of Postpartum Sexual Health. QUALITATIVE HEALTH RESEARCH 2024; 34:252-262. [PMID: 37967315 PMCID: PMC10768324 DOI: 10.1177/10497323231209842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
There exists a lack of literature surrounding how postpartum individuals define feeling 'ready' to resume sexual activities after childbirth. Many factors may influence feelings of desire or readiness for sexual activities, such as breastfeeding. Therefore, it is important to understand why and how postpartum individuals understand and make meaning of their experiences surrounding postpartum sexual activities, as well as how those experiences are influenced or negotiated through relations of power. This study was guided by feminist poststructuralism and discourse analysis. Eleven participants who were between 1 and 6 months postpartum and living in Nova Scotia, Canada, were interviewed using semi-structured interviews. Participants challenged certain discourses surrounding sexual activities postpartum, including the social discourse that positions sexual activities as a requirement within romantic relationships and the discourse that positions health care providers as the authority on postpartum sexual health. 'Feeling ready' centered on four main issues: (1) navigating physical recovery; (2) personal knowing and emotional readiness; (3) the 6-week check; and (4) redefining intimacy. This article describes one branch of the findings within the overall study. Choosing to resume sexual activities postpartum, or feeling ready to do so, is individual, fluid, and complex. This research has important implications for practice and policy, specifically as it pertains to postpartum care.
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Affiliation(s)
- Rachel Ollivier
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Megan Aston
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Sheri Price
- School of Nursing, Dalhousie University, Halifax, NS, Canada
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Meyling MMG, Frieling ME, Vervoort JPM, Feijen-de Jong EI, Jansen DEMC. Health problems experienced by women during the first year postpartum: A systematic review. Eur J Midwifery 2023; 7:42. [PMID: 38111746 PMCID: PMC10726257 DOI: 10.18332/ejm/173417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/05/2023] [Accepted: 11/15/2023] [Indexed: 12/20/2023] Open
Abstract
INTRODUCTION During pregnancy and childbirth, health issues can arise that can negatively influence women's postpartum health. Although it is imperative to identify these health problems in order to tailor care to women's needs, they often remain unrecognized. A comprehensive overview of postpartum health problems does not exist in the current literature. This systematic review aimed to explore the health problems experienced by women residing in high-income countries during the first year postpartum. METHODS Scientific databases were searched for articles on health problems experienced by women during the first year postpartum, published between January 2000 and 2 July 2021. Studies investigating the experiences of healthy women from the age of 18 years, residing in high-income countries, who gave birth to a healthy neonate, were included. Identified health issues were divided into five categories and presented in an overview. RESULTS A total of 25 articles were eligible for inclusion. In all, 83 health problems were identified and divided into five different categories (physical health problems, mental health problems, social health problems, problems related to feeding the infant, and other challenges). Common health issues postpartum were exhaustion, urinary incontinence, painful breasts, depressive symptoms, problems related to sexuality and sleep, lack of social support, and problems with breastfeeding. CONCLUSIONS This systematic review contributes to a wider understanding of postpartum health problems and can be used to adapt healthcare to women's needs. It distinguishes itself from previous studies by the wide variety of identified health problems and its specific focus on women's experiences in the postpartum period.
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Affiliation(s)
| | | | - Johanna P. M. Vervoort
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Esther I. Feijen-de Jong
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Midwifery Science, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Amsterdam, the Netherlands
- Midwifery Academy Amsterdam Groningen, Inholland, Groningen, the Netherlands
| | - Danielle E. M. C. Jansen
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Rahmani A, Fallahi A, Allahqoli L, Grylka-Baeschlin S, Alkatout I. How do new mothers describe their postpartum sexual quality of life? a qualitative study. BMC Womens Health 2023; 23:477. [PMID: 37689655 PMCID: PMC10492381 DOI: 10.1186/s12905-023-02619-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/24/2023] [Indexed: 09/11/2023] Open
Abstract
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.
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Affiliation(s)
- Azam Rahmani
- Nursing and Midwifery Care Research Centre, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezoo Fallahi
- Department of Public Health, Faculty of Health, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Leila Allahqoli
- Midwifery Department, Ministry of Health and Medical Education, Tehran, Iran
| | - Susanne Grylka-Baeschlin
- Research Institute of Midwifery and Reproductive Health, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Ibrahim Alkatout
- University Hospitals Schleswig-Holstein, Campus Kiel, School of Gynaecological Endoscopy, Arnold-Heller-Str. 3, Haus 24, 24105, Kiel, Germany
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Abrams M, Sheyn D, Kelley E, Hijaz A, Pope R. Correlates of health-seeking behavior for sexual dysfunction after childbirth: a cross-sectional study. Int Urogynecol J 2023; 34:1867-1876. [PMID: 36780020 DOI: 10.1007/s00192-023-05476-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 01/12/2023] [Indexed: 02/14/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Persistent sexual dysfunction (SD) after childbirth is common, but many patients do not receive adequate care, for unknown reasons. The aim of this study is to examine correlates for health care-seeking behavior for SD within 3 years after birth. METHODS Subjects filled out an electronic survey regarding sexual function, obstetric, relationship, and demographic characteristics. The Sexual Function Questionnaire's Medical Impact Scale) as well as a number of novel, targeted survey questions were used to measure the impact of childbirth on sexual function. Patients were stratified into those without SD, and those with SD, both seeking and not seeking care. These domains were then compared in a series of univariate, bivariate, and multivariate analyses. RESULTS Of 531 patients who completed the survey, 449 women (84.5%) reported some form of SD after birth. Only 16.0% of those with SD sought care for SD. Variables associated with care seeking include difficulty with perineal healing (adjusted odds ratio [aOR]=4.53, 95% confidence interval [CI]: 1.54-13.38), transfusion after birth (aOR=3.71, 95% CI: 1.44-9.56), current dyspareunia (aOR=3.41, 95% CI: 1.31-8.87). Factors associated with decreased probability of seeking care include children under 18 years in the home (aOR=0.61 per child, 95% CI: 0.43-0.88), number of cesarean births (aOR=0.46 per delivery, 95% CI: 0.29-0.74). CONCLUSIONS This study highlights that many more women suffer from SD after childbirth than seek care, and identified several important risk factors associated with decreased care seeking. Future work should focus on decreasing the difficulty of accessing care for SD after childbirth.
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Affiliation(s)
- Megan Abrams
- Urology Institute, Case Western Reserve University Hospitals, 11100 Euclid Ave, Cleveland, OH, 44102, USA.
| | - David Sheyn
- Urology Institute, Case Western Reserve University Hospitals, 11100 Euclid Ave, Cleveland, OH, 44102, USA
| | - Erika Kelley
- Department of Reproductive Biology, Case Western Reserve University Hospitals, Cleveland, OH, USA
| | - Adonis Hijaz
- Urology Institute, Case Western Reserve University Hospitals, 11100 Euclid Ave, Cleveland, OH, 44102, USA
| | - Rachel Pope
- Urology Institute, Case Western Reserve University Hospitals, 11100 Euclid Ave, Cleveland, OH, 44102, USA
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Tarchi L, Merola GP, Selvi G, Caprara E, Pecoraro V, Cassioli E, Rossi E, Petraglia F, Ricca V, Castellini G. Pregorexia: a systematic review and meta-analysis on the constructs of body image dissatisfaction and eating disturbances by gestational age in the peripartum. Eat Weight Disord 2023; 28:64. [PMID: 37526698 PMCID: PMC10393903 DOI: 10.1007/s40519-023-01595-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/20/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE Pregorexia is a phenomenon posited to occur in the peripartum, characterized by an attempt to counter pregnancy's physiological changes in body shape through reduced calorie intake or increased physical activity. METHODS In this pre-registered systematic review and meta-analysis, body image dissatisfaction and eating psychopathology in the peripartum according to gestational age were formally assessed. PubMed was searched up to May 2023. Selection criteria were represented by studies on body image concerns or eating psychopathology in the peripartum (up to 1 year after delivery). The population needed to include women from the general population or among patients with a history of (or current) eating disorder. For the meta-analysis, 17 studies were included: 10 for body image dissatisfaction (2625 individuals overall), 7 for eating behaviors (2551 individuals overall). The interplay between body image and the following themes was examined in depth: the adoption of breastfeeding, peripartum depression, sociocultural influences on body image, sexual disturbances, experiencing or reporting an altered food intake. RESULTS Progressive dissatisfaction with body image during pregnancy by gestational age was observed, stably elevated for at least 12 months postpartum. Eating psychopathology was observed as elevated only at 12 months in the postpartum, but not during pregnancy. DISCUSSION The current work offers normative values of body image satisfaction and eating psychopathology in the peripartum by gestational age. The relevance of current results was discussed, in order to inform both current clinical practice and future public policies. LEVEL OF EVIDENCE Level I-Evidence obtained from: systematic reviews and meta-analyses.
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Affiliation(s)
- Livio Tarchi
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Giuseppe Pierpaolo Merola
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Giulia Selvi
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Eleonora Caprara
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Vincenzo Pecoraro
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Eleonora Rossi
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Felice Petraglia
- Obstetrics and Gynecology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy.
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Smetanina D, Awar SA, Khair H, Alkaabi M, Das KM, Ljubisavljevic M, Statsenko Y, Zaręba KT. Risk of sexual dysfunctions in breastfeeding females: protocol for a systematic review and meta-analysis. BMJ Open 2023; 13:e074630. [PMID: 37527888 PMCID: PMC10394553 DOI: 10.1136/bmjopen-2023-074630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/19/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Epidemiological studies do not provide accurate statistics on the percentage of breastfeeding women experiencing sexual dysfunctions and restraining from sexual activity. The data vary between 40% and 83% in the first group and 20-50% in the second one. Despite excessive studies on contributors to intimacy changes, breast feeding received little attention from researchers. The relationship between lactation and postpartum sexual dysfunctions remains unclear. This systematic review and meta-analysis will synthesise available data and establish the link between breast feeding and sexuality problems. METHODS AND ANALYSIS A comprehensive literature search will be performed in biomedical databases PubMed/Medline, Scopus, Web of Science, EMBASE and CINAHL. We will extract peer-reviewed original studies written in English, Arabic or Polish from 2000 to June 2023. We will also search for reports from international health organisations and local health authorities. The preliminary search was performed on 04 April 2023. The studies must provide data on dysfunction prevalence/incidence and the strength of the relationship between breast feeding and sexuality in generally healthy women. The Covidence software will be used to perform literature screening, data extraction and quality assessment of individual studies. We will use a random-effects model meta-analysis to calculate pooled weighted frequency measures and effect size. Between-study heterogeneity will be assessed with the I2 test. ETHICS AND DISSEMINATION This meta-analysis does not require ethical approval because it synthesises data from previously published original studies. The final work will be published in a peer-reviewed journal and presented at scientific conferences. PROSPERO REGISTRATION NUMBER CRD42023411053.
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Affiliation(s)
- Darya Smetanina
- Department of Radiology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, Abu Dhabi Emirate, UAE
- Medical Imaging Platform, ASPIRE Precision Medicine Research Institute Abu Dhabi, Al Ain, Abu Dhabi Emirate, UAE
| | - Shamsa Al Awar
- Department of Obstetrics & Gynecology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, UAE
| | - Howaida Khair
- Department of Obstetrics & Gynecology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, UAE
| | - Meera Alkaabi
- Department of Obstetrics & Gynecology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, UAE
| | - Karuna M Das
- Department of Radiology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, Abu Dhabi Emirate, UAE
| | - Milos Ljubisavljevic
- Department of Physiology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, Abu Dhabi Emirate, UAE
- Neuroscience Platform, ASPIRE Precision Medicine Institute in Abu Dhabi, Al Ain, Abu Dhabi Emirate, UAE
| | - Yauhen Statsenko
- Department of Radiology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, Abu Dhabi Emirate, UAE
- Medical Imaging Platform, ASPIRE Precision Medicine Research Institute Abu Dhabi, Al Ain, Abu Dhabi Emirate, UAE
| | - Kornelia Teresa Zaręba
- Department of Obstetrics & Gynecology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, UAE
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Daescu AMC, Navolan DB, Dehelean L, Frandes M, Gaitoane AI, Daescu A, Daniluc RI, Stoian D. The Paradox of Sexual Dysfunction Observed during Pregnancy. Healthcare (Basel) 2023; 11:1914. [PMID: 37444748 DOI: 10.3390/healthcare11131914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/24/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
The aim of this study is to analyze the evolution of sexual function throughout pregnancy and highlight the predicting factors of sexual dysfunction in pregnant women. Our study included 144 participants, aged 16 to 45. Patients were evaluated three times during pregnancy by filling out the Female Sexual Function Index (FSFI) and the Body Exposure in Sexual Activities Questionnaire (BESAQ). At the time of the last evaluation, we asked patients to also fill out Beck's Depression Inventory (BDI-II) and a questionnaire regarding their psychological status and relationship satisfaction. We observed that the FSFI lubrication, satisfaction, and pain domains and the FSFI total score significantly decreased from the 1st to the 3rd evaluation. We observed that an increase in BDI score and the presence of abortion in the patient's history increase the risk of developing female sexual dysfunction (FSD). Higher BMIs were found to be a protective factor against FSD, as was being unmarried. The relationship satisfaction score was found to be an independent predictor of FSD. These findings support previous studies that indicate that pregnancy and postpartum sexuality are multifaceted phenomena and that psycho-social factors have a greater impact on sexuality than biological factors.
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Affiliation(s)
- Ana-Maria Cristina Daescu
- Doctoral School Department, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Internal Medicine II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Neurosciences Department, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Dan-Bogdan Navolan
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Liana Dehelean
- Neurosciences Department, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Mirela Frandes
- Functional Sciences Department, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | | | - Andrei Daescu
- Department of Mathematics, Politehnica University of Timisoara, 300006 Timisoara, Romania
| | - Razvan-Ionut Daniluc
- Doctoral School Department, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Internal Medicine II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Dana Stoian
- Department of Internal Medicine II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Hababa H, Assarag B. Measurement of maternal morbidity during postpartum with the WHO-WOICE tools in Morocco. BMC Pregnancy Childbirth 2023; 23:310. [PMID: 37131181 PMCID: PMC10152575 DOI: 10.1186/s12884-023-05615-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/15/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Maternal morbidity refers to any health problems or complications experienced by a woman during pregnancy, childbirth, or the postpartum period. Many studies have documented the, mostly negative, effects of maternal ill-health on functioning. Although, measurement of maternel morbidity remains underdeveloped. We aimed to evaluate the prevalence of non-severe maternal morbidities (including overall health, domestic and sexual violence, functionality, and mental health) in women during postpartum care and further analyze factors associated with compromised mental functioning and clinical health by administration of the WHO's WOICE 2.0 instrument. METHODS A cross-sectional study was conducted at 10 Health centers in Marrakech, Morocco with WOICE questionnaire included three sections: the first with maternal and obstetric history, sociodemographic data, risk and environment factors, violence and sexual health; the second considers functionality and disability, general symptoms and mental health; and the third includes data on physical and laboratory tests. This paper presents descriptive data on the distribution of functioning status among postpartum women. RESULTS A total of 253 women averaging 30 years of age participated. For self-reported health status of women, more than 40% reported good health, and just 9.09% of women had a health condition reported by the attending physician. Among postpartum women with clinical diagnoses, 16.34% had direct (obstetric) conditions and 15.56% indirect (medical) problems. When screening for factors in the expanded morbidity definition, about 20.95% reported exposure to violence. Anxiety was identified in 29.24% of cases, and depression in 17.78%. Looking into gestational results, just 14.6% delivered by cesarean section and 15.02% had preterm birth. We found also that 97% reported "good baby health" in the postpartum evaluation, with 92% of exclusive breastfeeding. CONCLUSION Considering these results, improving the quality of care for women requires a multi-faceted approach, including increased research, better access to care, and improved education and resources for women and healthcare providers.
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Hannon S, Gartland D, Higgins A, Brown SJ, Carroll M, Begley C, Daly D. Physical health and comorbid anxiety and depression across the first year postpartum in Ireland (MAMMI study): A longitudinal population-based study. J Affect Disord 2023; 328:228-237. [PMID: 36801420 DOI: 10.1016/j.jad.2023.02.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/09/2023] [Accepted: 02/12/2023] [Indexed: 02/21/2023]
Abstract
INTRODUCTION Little is known of the associations between physical health issues and mental health issues such as anxiety, depression and comorbid anxiety and depression (CAD) occurring in the perinatal period. METHODS A longitudinal cohort study with 3009 first-time mothers giving birth in Ireland collected physical and mental health data in pregnancy and at 3, 6, 9 and 12 months postpartum. Mental health was measured using the depression and anxiety subscales of the Depression, Anxiety and Stress Scale. Experience of eight common physical health issues (e.g. severe headaches/migraines, back pain) were assessed in pregnancy, with an additional six assessed at each postpartum data collection point. RESULTS 2.4 % of women reported depression alone in pregnancy and 4 % reported depression across the first postpartum year. Anxiety alone was reported by 3.0 % of women in pregnancy, and 2 % in the first year postpartum. Prevalence of comorbid anxiety/depression (CAD) was 1.5 % in pregnancy and almost 2 % postpartum. A higher proportion of women reporting, compared to women not reporting, postpartum CAD were younger, not partnered, not in paid employment in pregnancy, have fewer years of education, and had a caesarean birth. Extreme tiredness/exhaustion and back pain were the most common physical health issues in pregnancy and postpartum. Constipation, haemorrhoids, bowel issues, breast issues, infection and pain in the perineum or caesarean wound, pelvic pain and urinary tract infections were highest at three months postpartum and gradually decreased thereafter. Women reporting depression alone or anxiety alone were equivalent in terms of physical health issues. However, women without mental health symptoms reported significantly fewer physical health issues than women reporting depressive or anxiety symptoms alone or CAD at every time point. Women with CAD reported a significantly higher number of health issues than women reporting depression alone or anxiety alone at 9 and 12 months postpartum. CONCLUSION Reports of mental health symptoms are associated with higher physical health burden demonstrating a need for integrated approaches in mental and physical health care pathways in perinatal services.
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Affiliation(s)
- Susan Hannon
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
| | - Deirdre Gartland
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Vic, Australia.
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
| | - Stephanie J Brown
- Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic, Australia; Department of General Practice, University of Melbourne, Melbourne, Vic, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Vic, Australia.
| | - Margaret Carroll
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
| | - Déirdre Daly
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin DO2 T283, Ireland; Trinity Centre for Maternity Care Research (TCMCR), School of Nursing and Midwifery, Trinity College Dublin, No. 2 Clare Street, Dublin 2, Ireland.
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Ozcan S. Does the postpartum body image of primiparous women giving vaginal delivery affect their sexual functions and depression and fatigue levels? Health Care Women Int 2023; 45:495-511. [PMID: 36943288 DOI: 10.1080/07399332.2023.2190980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 03/10/2023] [Indexed: 03/23/2023]
Abstract
The body image-related problems can negatively affect women's lives in many ways. The study was aimed at investigating the effects of postpartum body image on sexual functions, and fatigue and depression levels of primiparous women who gave birth vaginally. This cross-sectional study was conducted with 133 women who presented to the obstetrics and gynecology clinics of a state hospital in Turkey between June 2021 and December 2021. At the end of the study, a moderate relationship was determined between the women's body image and their depression (r = 0.500; p < 0.001) and fatigue (r = 0.666; p < 0.001) levels, and a weak relationship between their body image and sexual functions (r = -0.372; p < 0.001). According to the backward regression model used in the study, the women's fatigue and education levels accounted for their body image by 45.7%.
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Affiliation(s)
- Sadiye Ozcan
- Faculty of Health Sciences, Department of Obstetrics & Gynecological Nursing, Yalova University, Yalova, Turkey
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Ram-Weiner M, Hayman-Mendelson A, Allouche-Kam H, Lev-Sagie A. Postpartum dyspareunia: clinical evaluation, causes, and treatment outcomes. J Sex Med 2023; 20:324-331. [PMID: 36763952 DOI: 10.1093/jsxmed/qdac040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/17/2022] [Accepted: 11/21/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Dyspareunia affects approximately half of postpartum women and is attributed to multiple factors. Despite its high prevalence and resultant negative effects, data are lacking regarding the causes and different pain components, the usefulness of recommended treatments, and the prognosis. AIM To evaluate causes of postpartum dyspareunia, targeted treatment modalities, and their effectiveness. METHODS A retrospective observational study was conducted of women diagnosed with postpartum dyspareunia between September 2008 and January 2017 at a single designated vulvovaginal disorder clinic. The inclusion criterion was complaint of painful intercourse commencing postdelivery. The cohort was divided into 4 groups based on the causes of dyspareunia: muscle hypertonicity, scar tenderness, vestibular tenderness, and atrophy. OUTCOMES The following were assessed for each group: patient background demographics, clinical and obstetric data, physical findings, recommended therapy, adherence to the suggested treatment, level of improvement at follow-up visits, and length of time until maximal improvement. RESULTS A hundred women met the inclusion criterion; the majority (n = 60) presented with >1 causative factor. The most common finding was vestibular tenderness (n = 78, 78%), which was significantly associated with atrophy (adjusted odds ratio [aOR], 15.08; 95% CI, 2.45-93.35), contraceptive usage (aOR, 4.76; 95% CI, 1.07-21.39), and primiparity (aOR, 4.89; 95% CI, 1.01-23.88). Episiotomy was the only risk factor for scar tenderness (aOR, 5.43; 95% CI, 1.20-24.53), while the existence of a spontaneous perineal tear was not. No specific correlation was found with pelvic floor muscle hypertonicity. Targeted treatment resulted in significant improvement in most patients. CLINICAL IMPLICATIONS A targeted diagnostic and treatment approach for postpartum dyspareunia is effective and can be beneficial for caregivers treating postpartum women. STRENGTHS AND LIMITATIONS A uniform and consistent protocol for patient selection and management is a major strength, which magnifies the clinical implication of our findings. The retrospective nature of the study is the primary limitation. CONCLUSION Postpartum dyspareunia is a common problem; however, many women refrain from discussing it with their providers. Therefore, it is important to assess this condition with all women during the postpartum visit as targeted diagnosis and treatment can significantly improve outcomes.
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Affiliation(s)
| | | | - Hadas Allouche-Kam
- Department of Obstetrics and Gynecology, Hadassah University Medical Center-Mt Scopus, Jerusalem 9190501, Israel
| | - Ahinoam Lev-Sagie
- Clalit Health Organization, Jerusalem 9780214, Israel.,Faculty of Medicine, Hebrew University of Jerusalem, 9190401, Israel
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Kul Uçtu A, Karakoç H. Breastfeeding Sexual Lives of First-Time Mothers: A Qualitative Explorative Study. Breastfeed Med 2022; 17:1025-1033. [PMID: 36475936 DOI: 10.1089/bfm.2022.0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Problems with sexuality are experienced in the first 6 months at the most, and often in the first 12 months after birth. Although there are studies reporting negative effects of breastfeeding on sexuality, the evidence is limited. Objective: This study was conducted with the aim of exploring the breastfeeding sexual lives of first-time mothers. Materials and Methods: The research was carried out in Turkey between October 2020 and December 2021. The study was conducted with 41 women who met the inclusion criteria. Participants were selected by the "snowball" sampling procedure among nonprobability sampling methods. A qualitative approach was used to gather data through semistructured interviews. Content analysis was used for data analysis as described by Graneheim and Lundman. Data analysis was performed using NVivo software (Version 11). Results: According to the results of the content analysis, three themes were created: factors affecting sexuality in the breastfeeding process, sexual interaction with the spouse during the breastfeeding process, and understood expectations. The theme, titled factors affecting sexuality in the breastfeeding process, consists of five categories: physical, psychological, sociocultural, infant-related, and health professionals-related factors. The theme of "understood expectations" consists of desires for improving sexual satisfaction and satisfaction during lactation, and sexual communication categories. The contact of sexual interaction with spouse during breastfeeding consists of positive interaction and negative interaction categories. Conclusions: It has been concluded that the sexual intercourse of women is adversely affected during the breastfeeding period and that women have expectations to increase their sexual satisfaction. Sexual problems during the breastfeeding process cause problems in the spousal relationship.
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Affiliation(s)
- Arzu Kul Uçtu
- Department of Midwifery, Faculty of Gulhane Health Sciences, Health Sciences University, Ankara, Turkey
| | - Hediye Karakoç
- Department of Midwifery, College of Health Science, KTO Karatay University, Konya, Turkey
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Ghasemi V, Beheshti Nasab M, Saei Ghare Naz M, Shahsavari S, Banaei M. Estimating the prevalence of dyspareunia according to mode of delivery: a systematic review and meta-analysis. J OBSTET GYNAECOL 2022; 42:2867-2878. [PMID: 35980976 DOI: 10.1080/01443615.2022.2110461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
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.
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Affiliation(s)
- Vida Ghasemi
- Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Maryam Beheshti Nasab
- Department of Midwifery, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marzieh Saei Ghare Naz
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeideh Shahsavari
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mojdeh Banaei
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Harrison LN, Neiterman E, MacEachen E, Gibson MF. Navigating return to sex: A qualitative Reddit analysis of parents' perceptions about the timing of resuming sex after a birth. SEXUAL & REPRODUCTIVE HEALTHCARE 2022; 34:100782. [PMID: 36179395 DOI: 10.1016/j.srhc.2022.100782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/22/2022] [Accepted: 09/09/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Given the many transitions that occur in the postpartum period as men and women navigate the return to sex after a birth, this study aimed to explore parents' experiences of resuming sexual activity. METHODS This was a qualitative study that used posts from both men and women from the online public forum Reddit. Data were analysed using constructivist grounded theory. RESULTS This study found that the discourse surrounding sexual activity in the postpartum period was dominated by an understanding that medical guidelines prohibited sex prior to six weeks after giving birth. Although some parents disagreed, many Reddit users perceived a high degree of risk in resuming sex prior to six weeks and medical expertise was highly valued as parents negotiated the return to sex. While Reddit users were largely in agreement that penetrative vaginal sex prior to six weeks was a risky activity, there was less consensus as to the risk involved in other sexual activities. CONCLUSION This study recommends that medical practitioners initiate conversations with men and women about returning to sexual activity after a birth, and that these conversations should consider parents' emotional well-being as they resume sex. Further research is needed to establish evidence-based and comprehensive guidelines to facilitate these conversations.
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Affiliation(s)
- Lauren Nicole Harrison
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada.
| | - Elena Neiterman
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada
| | - Ellen MacEachen
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada
| | - Margaret F Gibson
- Social Development Studies, Renison University College, 240 Westmount Rd N, Waterloo, ON N2L 3G4, Canada
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Trajectories of Postpartum Recovery: What is Known and Not Known. Clin Obstet Gynecol 2022; 65:594-610. [PMID: 35797600 DOI: 10.1097/grf.0000000000000726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Women's postpartum health is a public health issue that has lifelong consequences. Timely recognition and treatment of physical and mental health issues can have positive health consequences while lack of access to effective treatments or health care services can lead to long-term health problems. To advance knowledge of priority health symptoms and trajectories of postpartum recovery from women's health perspectives, we share findings from the Maternal health And Maternal Morbidity in Ireland (MAMMI) study. Data from 3047 first-time mothers recruited to a longitudinal maternal health study in Ireland from 2012 to 2017 reveal the trajectories of maternal health and health problems experienced up to 12 months postpartum. Morbidities explored include urinary incontinence, pelvic girdle pain, and sexual and mental health issues. Viewed together, and over time, the scale and persistent nature of many physical and mental health problems become apparent, yet considerable proportions of women were not asked directly about health problems by health care professionals. When women do not know what is and is not normal postpartum, they may suffer in silence and the consequence is that health problems/issues that are preventable, and treatable, are likely to become chronic. To make positive contributions to women's health, maternity care systems must be truly woman-centered and structured in ways that place emphasis on women's own health needs. In systems where women's voices and concerns are acknowledged and central, women are likely to thrive and flourish in motherhood.
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Kelley EL, Sheyn D, Hijaz A, Kingsberg SA, Pope RJ. Sexual Function and Help-Seeking Behaviors following Childbirth: A Cross-Sectional Study. JOURNAL OF SEX & MARITAL THERAPY 2022; 49:331-341. [PMID: 36039380 DOI: 10.1080/0092623x.2022.2117747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
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.
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Affiliation(s)
- E L Kelley
- Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center; Cleveland, Ohio, USA
- Urology Insttitue, University Hospitals System, Cleveland, Ohio, USA
- Department of Reproductive Biology, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Urology, Case Western Reserve University, Cleveland, Ohio, USA
| | - D Sheyn
- Urology Insttitue, University Hospitals System, Cleveland, Ohio, USA
- Department of Urology, Case Western Reserve University, Cleveland, Ohio, USA
| | - A Hijaz
- Urology Insttitue, University Hospitals System, Cleveland, Ohio, USA
- Department of Urology, Case Western Reserve University, Cleveland, Ohio, USA
| | - S A Kingsberg
- Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center; Cleveland, Ohio, USA
- Urology Insttitue, University Hospitals System, Cleveland, Ohio, USA
- Department of Reproductive Biology, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Urology, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio, USA
| | - R J Pope
- Urology Insttitue, University Hospitals System, Cleveland, Ohio, USA
- Department of Urology, Case Western Reserve University, Cleveland, Ohio, USA
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Rashidi Ahmad Abadi M, Valiani M, Kabir K, Khalajinia Z, Yazdkhasti M. The Effectiveness of Auriculotherapy on Women's Sexual Function: A Randomized Controlled Trial. IRANIAN JOURNAL OF PSYCHIATRY 2022; 17:265-275. [PMID: 36474700 PMCID: PMC9699811 DOI: 10.18502/ijps.v17i3.9726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 11/10/2021] [Accepted: 04/03/2022] [Indexed: 06/17/2023]
Abstract
Objective: Majority of breastfeeding women experience changes in sexual function. The present study was designed to assess effectiveness of auriculotherapy on improving sexual function in breastfeeding women. Method : In this randomized sham controlled trial, accomplished from January 2018 to May 2019 in a referral sexual health clinic in city of Qom, Iran, 60 eligible participants were assigned to either intervention and control groups via block randomization. In the intervention group, electrical stimulation was applied for 15 seconds on Shen Men, Zero, Thalamic, Master Cerebral, Libido, Relax, Excitement, Ovary, and Uterus points in 10 auriculotherapy sessions. Then, Vaccaria seeds were stuck on these points. The control group received the same procedure with the device off as a sham method. Data were gathered using the Female Sexual Function Index (FSFI) at three different time points. Results: At baseline, mean scores of sexual function dimensions were not significantly different between the intervention and control groups except for orgasm. Post-intervention, the results showed significant differences in sexual desire (P = 0.002), sexual arousal (P = 0.008), lubrication (P = 0.001), sexual satisfaction (P = 0.001), and orgasm (P = 0.009). One month after the intervention, the results showed significant differences in sexual desire, sexual arousal, lubrication, sexual satisfaction (P = 0.001), orgasm (P = 0.006), and dyspareunia (P = 0.015). Differences in mean score of sexual function in post-intervention and one-month follow-up were only significant in the intervention group (P = 0.001). Conclusion: Based on evidence from this study, auriculotherapy is an effective technique for improving sexual function in breastfeeding women.
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Affiliation(s)
| | - Mahboubeh Valiani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Iran
| | - Kourosh Kabir
- Department of Community Medicine, School of Medicine, Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Zohre Khalajinia
- Department of Midwifery, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran
| | - Mansoureh Yazdkhasti
- Department of Midwifery, School of Medicine, Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Hidalgo-Lopezosa P, Pérez-Marín S, Jiménez-Ruz A, López-Carrasco JDLC, Cubero-Luna AM, García-Fernández R, Rodríguez-Borrego MA, Liébana-Presa C, López-Soto PJ. Factors Associated with Postpartum Sexual Dysfunction in Spanish Women: A Cross-Sectional Study. J Pers Med 2022; 12:jpm12060926. [PMID: 35743712 PMCID: PMC9225642 DOI: 10.3390/jpm12060926] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/28/2022] [Accepted: 05/29/2022] [Indexed: 12/01/2022] Open
Abstract
(1) Background: Female sexual dysfunction (FSD) has a high prevalence globally, and perinatal factors favor FSD, especially in the postpartum period. The aim was to determine the prevalence and factors influencing FSD in the postpartum period; (2) Methods: An observational study carried out in three primary care centers in southern Spain, with women in the postpartum period who had a single low-risk birth. One hundred and seventeen women answered the Female Sexual Function questionnaire during the 4th month postpartum, between January 2020 and December 2021. Sociodemographic, obstetric, neonatal variables and level of self-esteem were analyzed. A multiple logistic regression model was carried out; (3) Results: 78.4% had high level of self-esteem. FSD prevalence was 89.7%. Factors related to FSD were having an instrumental vaginal delivery, women with university studies, and prenatal preparation. Maternal age ≥ 35, multiparity, pathological processes in the child, a medium–low level of self-esteem and newborn weight were associated with disorders in some of domains of sexual function; (4) Conclusions: FSD is highly prevalent in the postpartum period and is associated with preventable factors. A preventive approach by health professionals to these factors is essential. Health services should implement postpartum follow-up programs, which may coincide in time and place with newborn follow-up programs.
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Affiliation(s)
- Pedro Hidalgo-Lopezosa
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (S.P.-M.); (A.J.-R.); (J.d.l.C.L.-C.); (A.M.C.-L.); (M.A.R.-B.); (P.J.L.-S.)
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
- Correspondence: ; Tel.: +34-957-218-107
| | - Sandra Pérez-Marín
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (S.P.-M.); (A.J.-R.); (J.d.l.C.L.-C.); (A.M.C.-L.); (M.A.R.-B.); (P.J.L.-S.)
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
| | - Andrea Jiménez-Ruz
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (S.P.-M.); (A.J.-R.); (J.d.l.C.L.-C.); (A.M.C.-L.); (M.A.R.-B.); (P.J.L.-S.)
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
| | - Juan de la Cruz López-Carrasco
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (S.P.-M.); (A.J.-R.); (J.d.l.C.L.-C.); (A.M.C.-L.); (M.A.R.-B.); (P.J.L.-S.)
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
| | - Ana María Cubero-Luna
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (S.P.-M.); (A.J.-R.); (J.d.l.C.L.-C.); (A.M.C.-L.); (M.A.R.-B.); (P.J.L.-S.)
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
| | - Rubén García-Fernández
- SALBIS Research Group, Departamento de Enfermería y Fisioterapia, Universidad de León, Campus de Ponferrada s/n, 24400 Ponferrada, Spain; (R.G.-F.); (C.L.-P.)
| | - María Aurora Rodríguez-Borrego
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (S.P.-M.); (A.J.-R.); (J.d.l.C.L.-C.); (A.M.C.-L.); (M.A.R.-B.); (P.J.L.-S.)
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
| | - Cristina Liébana-Presa
- SALBIS Research Group, Departamento de Enfermería y Fisioterapia, Universidad de León, Campus de Ponferrada s/n, 24400 Ponferrada, Spain; (R.G.-F.); (C.L.-P.)
| | - Pablo Jesús López-Soto
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; (S.P.-M.); (A.J.-R.); (J.d.l.C.L.-C.); (A.M.C.-L.); (M.A.R.-B.); (P.J.L.-S.)
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
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Baratieri T, Natal S. Implementation of postpartum care for women in primary care in the South of Brazil. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2022. [DOI: 10.1590/1806-93042022000100004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to determine the implementation level and analyze favorable and unfavorable aspects of operationalization women’s care in postpartum period in primary care. Methods: evaluation study of the normative type, performed through a multiple case study in three cities in the South States in Brazil, with a collection of primary and secondary data. The implementation level (classification: satisfactory, partial, incipient, and critical) was determined by the Matriz de Análise e Julgamento (Analysis and Judgment Matrix), consisted of the dimensions of management and execution, and the respective sub-dimensions. Thematic and imbricated analysis of the cases were performed. Results: postpartum care was incipient in the management dimension for all the cases, with a higher implementation level for the “care coordination and intersectorality mechanisms” (partial) sub-dimension. In the execution dimension in case 3 was partially implemented, and the others were incipient. The breastfeeding sub-dimension had a higher implementation level for all the cases, and the longitudinality, mental health and reproductive planning sub-dimensions had a lower implementation level. Care in relation to domestic violence and mental health occurred unsystematically, and reproductive planning focused on hormonal contraceptive methods. Conclusion: management does not provide ideal conditions for healthcare professionals’ performance; and, in the execution dimension are not incorporated as the main necessity in the health care practice in women’s health.
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Affiliation(s)
| | - Sonia Natal
- Universidade Federal de Santa Catarina, Brazil
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Walker LO, Murry N. Maternal Stressors and Coping Strategies During the Extended Postpartum Period: A Retrospective Analysis with Contemporary Implications. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:104-114. [PMID: 35136882 PMCID: PMC8812510 DOI: 10.1089/whr.2021.0134] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 01/03/2022] [Indexed: 12/18/2022]
Abstract
Background: Despite recent emphasis on the "fourth trimester" and beyond, most knowledge of stressors affecting women is focused on the first 6 postpartum weeks. Our aim was to identify postpartum-specific stressors and coping over the extended postpartum period. Methods: We analyzed data from two surveys for a combined sample of 346 postpartum women. Principal components analysis of survey items on sources of stress was used to identify categories of postpartum-specific stressors. Content analysis was used to categorize text data on coping strategies. Results: Seven stressors were identified: Overload, Working mother concerns, Isolated motherhood, Limited supportive resources, Exhaustion, Parenting demands, and Changes in body and sexuality. Overload was the most frequent stressor (F = 49.32, p < 0.001) and was significantly higher at 9-12 months than at 5-8 months or at 13 months or more (F = 6.42, p = 0.002). Fulltime employment and having more than one child were associated with elevated scores on several stressors. Content analysis yielded seven coping strategies, such as Take time alone or with others, Manage emotions and thoughts, and Maintain a manageable workload. Five of the seven stressors were associated with at least one of the top five coping strategies; none was associated with Overload or Limited supportive resources. Conclusions: Women's predominant source of stress was from overload and was highest at 9 to 12 months postpartum. Community resources and public health policy and programming are needed to prepare and support women during the challenging first postpartum year.
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Affiliation(s)
- Lorraine O Walker
- The University of Texas at Austin, School of Nursing, Austin, Texas, USA
| | - Nicole Murry
- The University of Texas at Austin, School of Nursing, Austin, Texas, USA
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Delgado-Pérez E, Rodríguez-Costa I, Vergara-Pérez F, Blanco-Morales M, Torres-Lacomba M. Recovering Sexuality after Childbirth. What Strategies Do Women Adopt? A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020950. [PMID: 35055771 PMCID: PMC8775547 DOI: 10.3390/ijerph19020950] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 01/15/2023]
Abstract
This study aimed to determine the strategies used by women to adapt to the changes that affect the first sexual relations after childbirth. A qualitative study with a phenomenological approach used three data collection techniques (in-depth interviews, discussion groups, and online forums). Thirty-six women in the first six months postpartum participated in the study, from physiotherapy centers with maternal child specialties in several locations in Spain. Women with different types of delivery, presence or absence of perineal trauma during delivery, previous deliveries, and different types of breastfeeding were included. Among the strategies, closeness support and understanding were the ones that women used to adjust to the new situation, in order to improve the couple's relationship, intimacy, and cope with the significant changes that appear in the first six months postpartum. Changes and adaptations in sexual practices become a tool for coping with a new sexuality, especially if it is affected by the presence of pain or discomfort associated with physical changes. Personal time facilitates emotional management and improvement of emotional changes related to the demands of motherhood. Accepting the changes that motherhood brings is critical to dealing with the new situation. Strategies used by postpartum women focus on acceptance, self-care, partner, couple time, personal time, and adapting encounters. The findings of this study are of interest to health professionals as they provide insight into how women cope with the changes that appear in the first six months postpartum. In this way, the findings will be able to transmit to couples the alternatives they can adopt before the resumption of sexual relations to improve satisfaction both as a couple and in terms of sexuality after childbirth.
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Affiliation(s)
- Esther Delgado-Pérez
- Physiotherapy Department, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (E.D.-P.); (M.B.-M.)
| | - Isabel Rodríguez-Costa
- Humanization in the Intervention of Physiotherapy for the Integral Attention to the People (HIPATIA) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28801 Madrid, Spain
- Correspondence:
| | - Fernando Vergara-Pérez
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28801 Madrid, Spain; (F.V.-P.); (M.T.-L.)
| | - María Blanco-Morales
- Physiotherapy Department, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (E.D.-P.); (M.B.-M.)
| | - María Torres-Lacomba
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28801 Madrid, Spain; (F.V.-P.); (M.T.-L.)
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Maternal mental health in the first year postpartum in a large Irish population cohort: the MAMMI study. Arch Womens Ment Health 2022; 25:641-653. [PMID: 35488067 PMCID: PMC9072451 DOI: 10.1007/s00737-022-01231-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 02/06/2023]
Abstract
PURPOSE The international perinatal literature focuses on depression in the postpartum period. Prevalence and pathways of depression, anxiety and stress from pregnancy through the first postpartum year are seldom investigated. METHODS MAMMI is a prospective cohort study of 3009 first-time mothers recruited in pregnancy. Depressive, anxiety and stress symptoms measured using the Depression, Anxiety and Stress Scale (DASS 21) in pregnancy and at 3-, 6-, 9- and/or 12-months postpartum. RESULTS Prevalence of depressive and stress symptoms was lowest in pregnancy, increasing to 12-months postpartum. Anxiety symptoms remained relatively stable over time. In the first year after having their first baby, one in ten women reported moderate/severe anxiety symptoms (9.5%), 14.2% reported depression symptoms, and one in five stress symptoms (19.2%). Sociodemographic factors associated with increased odds of postpartum depression, anxiety and stress symptoms were younger age and being born in a non-EU country; socioeconomic factors were not living with a partner, not having postgraduate education and being unemployed during pregnancy. Retrospective reporting of poor mental health in the year prior to pregnancy and symptoms during pregnancy were strongly associated with poor postpartum mental health. CONCLUSIONS The current findings suggest that the current model of 6-week postpartum care in Ireland is insufficient to detect and provide adequate support for women's mental health needs, with long-term implications for women and children.
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Delgado-Pérez E, Yuste-Sánchez MJ, Pérez-Martín Y, Abuín-Porras V, Rodríguez-Costa I. New Motherhood Concepts, Implications for Healthcare. A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413118. [PMID: 34948727 PMCID: PMC8701737 DOI: 10.3390/ijerph182413118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 12/14/2022]
Abstract
The aim of this study was to explore the experience of women who take care of their children in postpartum and who desire to be understood by society, with no judgements. For this purpose, a qualitative methodology was followed. In-depth interviews, discussion groups, and an online forum were used for data collection. The participants were Spanish women that had given birth in the past 6 months, and their partners. Healthcare specialists with experience in the topic were also included. Results showed three main categories: lack of priority, self-demand, and self-esteem changes. As a conclusion, the concept of motherhood needs to be redefined, as women feel that they are living under the pressure of being a “perfect mother”. It is important that mothers allow themselves to fail in reaching the imposed requirements. Simple acceptance of motherhood boundaries could help in this transition.
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Affiliation(s)
- Esther Delgado-Pérez
- Physiotherapy Department, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (E.D.-P.); (V.A.-P.)
| | - Maria José Yuste-Sánchez
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28805 Madrid, Spain;
| | - Yolanda Pérez-Martín
- Humanization in the Intervention of Physiotherapy for the Integral Attention to the People (HIPATIA) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28805 Madrid, Spain;
| | - Vanesa Abuín-Porras
- Physiotherapy Department, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (E.D.-P.); (V.A.-P.)
| | - Isabel Rodríguez-Costa
- Humanization in the Intervention of Physiotherapy for the Integral Attention to the People (HIPATIA) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28805 Madrid, Spain;
- Correspondence:
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Fan X, Zhou F, Li Y, Xia W, Che Y. Factors associated with postpartum resumption of sexual intercourse among women in China: A retrospective multicenter study. J Obstet Gynaecol Res 2021; 48:230-238. [PMID: 34788897 DOI: 10.1111/jog.15088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 09/16/2021] [Accepted: 10/22/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To examine the prevalence and factors associated with early resumption of sexual intercourse among postnatal women in China. METHOD We conducted a retrospective multicenter study of 15 834 postpartum women from 60 hospitals in 15 different locations across China. Data were obtained from questionnaires administered to the participants. All dates were analyzed using a one-way ANOVA and two-level Cox multiple linear regression models. RESULTS More than half of the participating women (55.9%) resumed sexual intercourse by 3 months postpartum. The independent variables associated with the postpartum resumption of sexual intercourse included sociodemographic characteristics (age, geographic location, educational attainment) and medical histories, including the previous abortion (incorporate with spontaneous and voluntary abortion) frequency, menstrual recovery, exclusive breastfeeding, and number of living children (p < 0.05). CONCLUSION More than half of the women in this study resumed sexual intercourse within 3 months postpartum. Women with a lower educational attainment and from the western regions of China were more likely to resume sexual intercourse earlier. Increasing age, delayed recovery of menses, and exclusive breastfeeding were associated with a delayed resumption of sexual intercourse. Women who had greater experience with abortion or the number of living children resumed sexual intercourse earlier than their counterparts.
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Affiliation(s)
- Xiaorong Fan
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Zhou
- Reproductive Medicine Department, Hubei Maternal and Child Health Hospital, Wuhan, China
| | - Yuyan Li
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - Wei Xia
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Che
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China.,NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
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O'Malley D, Smith V, Higgins A. Sexual health issues postpartum-A mixed methods study of women's help-seeking behavior after the birth of their first baby. Midwifery 2021; 104:103196. [PMID: 34767981 DOI: 10.1016/j.midw.2021.103196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/05/2021] [Accepted: 10/25/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To identify women's help-seeking behavior in relation to sexual health issues after the birth of their first baby. DESIGN A mixed methods sequential explanatory study design was utilized. Phase one of the study consisted of a prospective cohort study to identify the help-seeking behavior of women experiencing sexual health issues at 3, 6, and 12 months postpartum. Phase two consisted of a qualitative descriptive design to explore women's help-seeking behavior for sexual health issues postpartum. SETTING & PARTICIPANTS The setting was a large urban tertiary referral maternity unit (greater than 8000 births per year) in the Republic of Ireland. Nulliparous women aged 18 years and over were invited to participate in phase one. Phase two consisted of a subsample of women who consented to being contacted for further research on admission to the study. FINDINGS Few women consulted a clinician for postpartum sexual health issues at each of the study's three, six and twelve month time-points. For example, only 2.9% (n=18) of women experiencing dyspareunia, and 3.6% (n=16) of those experiencing a lack of vaginal lubrication spoke to their General Practitioner (GP) about these issues at three months postpartum. The qualitative data supported the quantitative findings and suggested that even when women proactively sought help from healthcare professionals they were met with unhelpful responses. In the absence of support from practitioners, women became active agents and sought information from other women or the internet. In an effort to improve practice women recommended a greater focus on their physical and emotional recovery from birth. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Very few women consulted with a clinician about their experience of sexual health issues after birth. Findings will contribute to and assist policy makers in planning future postnatal services for women to include extending the final postnatal assessment beyond six weeks after birth.
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Affiliation(s)
- Deirdre O'Malley
- School of Nursing and Midwifery, University of Dublin Trinity College, 24 D'Olier Street, Dublin, Ireland..
| | - Valerie Smith
- School of Nursing and Midwifery, University of Dublin Trinity College, 24 D'Olier Street, Dublin, Ireland
| | - Agnes Higgins
- School of Nursing and Midwifery, University of Dublin Trinity College, 24 D'Olier Street, Dublin, Ireland
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O’Malley D, Higgins A, Smith V. Exploring the Complexities of Postpartum Sexual Health. CURRENT SEXUAL HEALTH REPORTS 2021. [DOI: 10.1007/s11930-021-00315-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
Purpose of Review
This paper explores the complexities of postpartum sexual health. It answers the question on what should be considered normal sexual health after birth and what should be considered abnormal.
Recent Findings
Many women experience physical sexual health issues in the months after birth, such as dyspareunia, lack of vaginal lubrication and a loss of sexual desire. For some women, these issues can persist 12 and 18 months after birth. Mode of birth is not associated with long-term dyspareunia 6 and 12 months after birth. There is conflict seen in the literature with regard to the association between perineal trauma and short-and long-term sexual health. Breastfeeding and the existence of pre-existing sexual health issues are strongly predictive of sexual health issues at 6 and 12 months after birth. Women have described a discordance in their sexual desire to that of their partner, for some this caused distress but for couples who communicated their feelings of sexual desire, concern over baby’s well-being and adapting to parenthood distress was not experienced. Resuming sexual intercourse after birth was not spontaneous, women considered their mode of birth, the presence of perineal trauma and their physical and emotional recovery from birth. One fifth of women had not resumed sexual intercourse 12 weeks after birth.
Summary
A discussion is presented on the challenges associated with viewing postpartum sexual health from a physical perspective only, and why prevalence studies alone do not capture the nuances of postpartum sexual health. Future research needs to take account of the psychosocial and relational dimensions of postpartum sexual health as well as physical dimensions.
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Doke PP, Vaidya VM, Narula APS, Patil AV, Panchanadikar TM, Wagh GN. Risk of non-resumption of vaginal sex and dyspareunia among cesarean-delivered women. J Family Med Prim Care 2021; 10:2600-2607. [PMID: 34568142 PMCID: PMC8415658 DOI: 10.4103/jfmpc.jfmpc_2482_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/21/2021] [Accepted: 03/12/2021] [Indexed: 12/15/2022] Open
Abstract
Context: Many women have postpartum sexual dysfunction. The mode of delivery is an important determinant. Aims: To calculate the risk ratio of non-resumption of vaginal sex and dyspareunia during the postpartum period among cesarean-delivered women. Settings and Design: This large multisite study was conducted in 13 selected hospitals in Pune District during 2017–19. Methods and Material: A total of 3,112 women (half cesarean delivered and half vaginally) were interviewed by trained health workers using a structured questionnaire. Women were interviewed at 4 weeks, 6 weeks, and 6 months. Statistical analysis used: Chi-square test was applied. A risk ratio with a 95% confidence interval was calculated. Results: At 6 weeks, the risk ratio of non-resumption of vaginal sex was significantly high among cesarean-delivered participants (1.14). Cesarean-delivered women had a lesser risk ratio of dyspareunia at both follow-ups (0.59, 0.49). Even at 6 months, about one-third vaginally delivered women had dyspareunia. The proportion of women non-resuming vaginal sex gradually decreased from 6 weeks to 6 months. The proportion of women having dyspareunia also decreased from 6 weeks to 6 months following childbirth. Residence in the rural area and cesarean delivery were the significant determinants of an early resumption of vaginal sex. Dyspareunia was significantly high among vaginal delivered than cesarean. About 25% of women continued to have dyspareunia up to 6 months. Conclusions: A large number of women suffer from dyspareunia; hence antenatal and postnatal care should include some counseling and management about the resumption of sex and dyspareunia.
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Affiliation(s)
- Prakash Prabhakarrao Doke
- Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune, Maharashtra, India
| | - Varsha Mahesh Vaidya
- Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune, Maharashtra, India
| | - Arvinder Pal Singh Narula
- Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune, Maharashtra, India
| | | | | | - Girija Narendra Wagh
- Department of Obstetrics and Gynecology, Bharati Vidyapeeth Deemed University Medical College, Pune, Maharashtra, India
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Cattani L, De Maeyer L, Verbakel JY, Bosteels J, Deprest J. Predictors for sexual dysfunction in the first year postpartum: a systematic review and meta-analysis. BJOG 2021; 129:1017-1028. [PMID: 34536325 DOI: 10.1111/1471-0528.16934] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 08/27/2021] [Accepted: 09/08/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pregnancy and childbirth increase the risk for pelvic floor dysfunction, including sexual dysfunction. So far, the mechanisms and the extent to which certain risk factors play a role remain unclear. OBJECTIVES In this systematic review of the literature we aimed to determine risk factors for sexual dysfunction in the first year after childbirth. SEARCH STRATEGY We searched MEDLINE, Embase and CENTRAL using the search strategy: sexual dysfunction AND obstetric events. SELECTION CRITERIA We included original, comparative studies, reported in English, that used validated questionnaires and the ICS/IUGA terminology for sexual dysfunction, dyspareunia and vaginal dryness. DATA COLLECTION AND ANALYSIS We assessed the quality and the risk of bias of the included studies with the Newcastle-Ottawa scale. We extracted the reported data and we performed random-effects meta-analysis to obtain the summary odds ratios (ORs) with 95% confidence intervals (95% CIs). Heterogeneity across studies was assessed using the I2 statistic. MAIN RESULTS Anal sphincter injury was associated with increased odds for both sexual dysfunction (OR 3.00, 95%CI 1.28-7.03) and dyspareunia (OR 1.92, 95% CI 1.47-2.52). Episiotomy was associated with dyspareunia (OR 1.64, 95% CI 1.25-2.14), but not with sexual dysfunction (OR 1.90, 95% CI 0.94-3.84). Compared with spontaneous birth, caesarean section reduced the odds for dyspareunia (OR 0.68, 95% CI 0.54-0.86) but not for sexual dysfunction (OR 1.14, 95% CI 0.89-1.46). Instrumental vaginal birth increased the odds for sexual dysfunction (OR 1.70, 95% CI 1.05-2.76), yet no difference was found for dyspareunia (OR 1.82, 95% CI 0.88-3.75). One study of low quality reported on vaginal dryness and found no association with obstetric events. CONCLUSIONS Perineal trauma, rather than mode of birth, increases the odds for sexual dysfunction in the first year after childbirth. TWEETABLE ABSTRACT Perineal trauma, rather than mode of birth, correlates with sexual dysfunction and dyspareunia postpartum. #dyspareunia #OASI #episiotomy.
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Affiliation(s)
- L Cattani
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - L De Maeyer
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - J Y Verbakel
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - J Bosteels
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, Imelda Hospital, Bonheiden, Belgium
| | - J Deprest
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Research Department of Maternal Fetal Medicine, Institute for Women's Health, University College London, London, UK
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Secondary Dyspareunia After Childbirth: A Pilot Study for Comparison Between Group of Women With Episiotomy and Women Without Perineal Trauma. INTERNATIONAL JOURNAL OF CHILDBIRTH 2021. [DOI: 10.1891/ijcbirth-d-20-00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PROBLEMDyspareunia research following childbirth usually includes women who received an episiotomy during childbirth. Few studies have examined dyspareunia after childbirth in women who had no episiotomy or perineal trauma.PURPOSEThe purpose of this study was to compare the incidence of dyspareunia in women with perineal trauma related to childbirth to women without perineal trauma related to childbirth. The second aim was to assess risk factors for dyspareunia after childbirth.METHODSA quantitative cross-sectional study was designed and data were collected from a questionnaire that were sent via the internet (online). The study was performed in Slovenia. The study design included purposive and snowball sampling. Participants were assured anonymity.Analysis of data was conducted using SPSS 20.0. Factor analysis determined the validity and Cronbach's coefficient alpha determined the reliability of the questionnaire. The adequacy of a correlation matrix for factorization was assessed with the Kaiser–Meyer–Olkin (KMO) test and the Bartlett's test. To determine statistically significant differences, the chi-square (χ2) test was used. Kullback–Leibler divergence was used to measure how one probability distribution was different from the other probability distribution when the χ2 test was not satisfactory.FINDINGSThere were 387 respondents to the online questionnaire and 22% of the women who received an episiotomy prior to childbirth reported dyspareunia after childbirth; 13.69% reporteddyspareunia when they had no perineal trauma associated with childbirth. Dyspareunia persisted up to 18 months in 11% of participants who had an episiotomy and in 8% of women who experienced no perineal trauma.DISCUSSIONAfter an atraumatic childbirth, women can also experience dyspareunia. Pregnant women may benefit when their provider knows the risk factors for dyspareunia and limits episiotomy to those situations when there is a clear indication. Additional research may elucidate risk factors for dyspareunia following an atraumatic delivery.
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Effect of Epidural Analgesia on Pelvic Floor Dysfunction at 6 Months Postpartum in Primiparous Women: A Prospective Cohort Study. Sex Med 2021; 9:100417. [PMID: 34419692 PMCID: PMC8498962 DOI: 10.1016/j.esxm.2021.100417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/02/2021] [Accepted: 07/07/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Epidural analgesia has become a universal intervention for relieving labor pain, and its effect on the pelvic floor is controversial. AIM To investigate the effect of epidural analgesia on pelvic floor dysfunction (PFD) in primiparous women at 6 months postpartum. METHODS We performed a prospective cohort study involving 150 primiparous women in preparation for vaginal delivery, with 74 (49.3%) receiving epidural analgesia. Baseline demographic and intrapartum data were collected. At 6 months postpartum, PFD symptoms, including stress urinary incontinence, overactive bladder, defecation disorder, pelvic organ prolapse, and 4 kinds of sexual dysfunction (arousal disorder, low sexual desire, dyspareunia, and orgasm disorder), were evaluated. Pelvic floor muscle (PFM) function and postpartum depression were also assessed. Multivariate logistic regression was applied to identify factors associated with the PFD symptoms affected by epidural analgesia. MAIN OUTCOME MEASURE PFD symptoms and sexual dysfunction were evaluated through Pelvic Floor Distress Inventory-20 (PFDI-20) and Female Sexual Function Index (FSFI-12). PFM function was examined with palpation and surface electromyography (sEMG). Postpartum depression was assessed using Self-Rating Depression Scale (SDS). RESULTS At 6 months postpartum, women who delivered with epidural analgesia had a higher incidence of dyspareunia (43.2% vs 26.3%, P <0.05) and longer first, second, and total stage of labor durations (P <0.01) than those who without. No significant difference in other PFD symptoms or PFM function was found between the 2 groups (P >0.05). Multivariate logistic regression revealed that epidural analgesia (OR = 3.056, 95% CI = 1.217-7.671) and SDS scores (OR = 1.066, 95% CI = 1.009-1.127) were independent risk factors for dyspareunia. CONCLUSION At 6 months postpartum in primiparous women, epidural analgesia was associated with an increased risk of postpartum dyspareunia and longer labor durations, which deserves attention for rehabilitation after delivery. Future studies with a larger sample size are needed to evaluate the impact of epidural analgesia on other PFD symptoms. Du J, Ye J, Fei H, et al. Effect of Epidural Analgesia on Pelvic Floor Dysfunction at 6 Months Postpartum in Primiparous Women: A Prospective Cohort Study. Sex Med 2021;9:100417.
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Szöllősi K, Komka K, Szabó L. Risk factors for sexual dysfunction during the first year postpartum: A prospective study. Int J Gynaecol Obstet 2021; 157:303-312. [PMID: 34418077 DOI: 10.1002/ijgo.13892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/01/2021] [Accepted: 08/20/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the connection of postpartum sexual dysfunction with mode of delivery, amenorrhea, depressive symptoms, and relationship satisfaction. METHODS For a prospective longitudinal study, we invited 729 Hungarian obstetrics patients to complete questionnaires at 3 months (T1), 6 months (T2), and 12 months (T3) postpartum. We sent them the Female Sexual Function Index (FSFI), the Edinburgh Postnatal Depression Scale (EDPS), the Relationship Assessment Scale (RAS), and a self-constructed questionnaire for body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) and other data. Of the 389 who responded at T1, we selected 293 who met our criteria for age, obstetrical history, relationship history, completeness of response, and sexual activity. At T2 and T3, we selected 214 and 95. We analyzed their data by multivariate logit regression. RESULTS The rates of sexual dysfunction were 44.70% (T1), 40.18% (T2), and 23.15% (T3). Mode of delivery was not a risk factor. Amenorrhea was a risk factor at T1 (P = 0.012) and T2 (P = 0.001). Obesity was a protective factor at T1 (P = 0.021). The higher the EPDS score (T1: P < 0.001; T2: P = 0.035; T3: P = 0.043), and the lower the RAS score (T1: P = 0.016; T2: P = 0.010; T3: P = 0.032), the greater was the risk of dysfunction. CONCLUSION Level of relationship satisfaction, severity of depressive symptoms, amenorrhea, and BMI are connected with sexual dysfunction within a year postpartum.
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Affiliation(s)
- Katalin Szöllősi
- School of PhD Studies, Semmelweis University, Budapest, Hungary.,Department of Family Care Methodology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Kinga Komka
- Department of Chemical and Environmental Process Engineering, Faculty of Chemical Technology and Biotechnology, Budapest University of Technology and Economics, Budapest, Hungary
| | - László Szabó
- Department of Family Care Methodology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary.,Heim Pál Children's Hospital, Budapest, Hungary
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Holanda JBDL, Richter S, Campos RB, Trindade RFCD, Monteiro JCDS, Gomes-Sponholz FA. Relationship of the type of breastfeeding in the sexual function of women. Rev Lat Am Enfermagem 2021; 29:e3438. [PMID: 34287538 PMCID: PMC8294779 DOI: 10.1590/1518.8345.3160.3438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 09/19/2020] [Indexed: 11/22/2022] Open
Abstract
Objective: to relate the type of breastfeeding in the women’s sexual function. Method: a cross-sectional study conducted with 150 women in the postpartum period
registered in the Family Health Strategy of a large Brazilian municipality.
Two instruments were used: one for characterizing sociodemographic,
obstetric and breastfeeding variables, and the Female Sexual Function Index
for the sexual function. Descriptive data analysis was performed, comparing
the variables of interest using the Analysis of Variance, Brown-Forsythe and
Tukey tests. Results: there was statistical significance between the groups that practiced
different types of breastfeeding in the vaginal lubrication domain (p =
0.015), with the mothers in mixed or partial breastfeeding presenting a
higher score for this domain (3.8). Conclusion: there is a difference in the female sexual function between different types
of breastfeeding. Women who presented better vaginal lubrication belonged to
the mixed breastfeeding group.
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Affiliation(s)
- Juliana Bento de Lima Holanda
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Solina Richter
- Faculty of Nursing, Univerasity of Alberta, Edmonton, Alberta, Canada.,Professor and Academic Director, Global Nursing Office
| | - Regiane Bezerra Campos
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Universidade do Oeste do Paraná, Centro de Educação Letras e Saúde, Foz do Iguaçu, PR, Brazil.,Scholarship holder at the Fundação Araucária, Brazil
| | | | - Juliana Cristina Dos Santos Monteiro
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Flávia Azevedo Gomes-Sponholz
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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de Sousa NQ, Borges AC, Sarabando R, Bivar L, Viana J, Cerqueira M, Miranda A, Reis I, Nogueira-Silva C. The Role of Operative Vaginal Delivery in Postpartum Sexual Dysfunction: MOODS - A Prospective Study. J Sex Med 2021; 18:1075-1082. [PMID: 37057472 DOI: 10.1016/j.jsxm.2021.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 03/22/2021] [Accepted: 04/02/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Childbirth brings many changes to women's life and sexual health. The influence of operative vaginal delivery on sexual function has produced inconsistent results. AIM To evaluate the effects of mode of vaginal delivery (spontaneous or operative) in postpartum sexual function. METHODS Descriptive prospective study (MOODS- Maternal-neonatal Outcomes in Operative Vaginal Delivery) including 304 women who had a singleton term vaginal delivery (operative or spontaneous in a relation 2:1). Women were invited to answer a questionnaire at 3, 6 months and 1 year postpartum. OUTCOMES MEASUREMENT A validated questionnaire was applied, the Female Sexual Function Index (FSFI) Score, to evaluate effects of operative delivery on sexual health. Sexual dysfunction was defined by FSFI score <26.55. RESULTS 211 women answered at least one questionnaire. Overall rate of sexual dysfunction was 62%, 43% and 48% at 3, 6 and 12 months respectively. At 3 months, total FSFI score was significantly lower in operative vaginal delivery group (mean±SD, 21.3±8.6 vs 24.9±7.9, P = 0.015). Arousal (P = 0.028), orgasm (P = 0.029), satisfaction (P = 0.015) and pain (P = 0.007) FSFI domains were also significantly inferior. At this time, 44% women in spontaneous delivery group and 70% in operative delivery group had sexual dysfunction (P = 0.0002). At 6 months, there were no differences in FSFI scores according the type of delivery. At 12 months, total FSFI score was similar in both groups, but pain domain was significantly lower in operative delivery (P = 0.004). Considering type of instrument (Thierry's Spatulas or Kiwi Vacuum), no differences were found regarding episiotomy, perineal trauma, obstetric anal sphincter injury or postpartum complications. FSFI scores did not differ between the two instruments at any time point. A logistic regression showed that, when controlled for perineal trauma, mode of delivery was independently associated with sexual dysfunction at 3 months (P = 0.02). CLINICAL IMPLICATIONS Clinicians should assess women's sexual health during pregnancy and postpartum period in order to enhance their wellbeing. STRENGTHS/LIMITATIONS Strengths include its prospective design, standardized questionnaire and the new perspectives about a different obstetrical instrument (Thierry's spatulas). Limitations include the absence of pre-pregnancy sexual function data and considerable drop-out rate. CONCLUSION Sexual dysfunction affects a great proportion of newly mothers and in postpartum period mode of delivery and perineal trauma seem to play an important role. Although there was a progressive reduction over time, prevalence of sexual dysfunction at 6 months and 1 year postpartum was still considerable. The type of obstetrical instrument does not seem to influence short or long-term sexual function. de Sousa NQ, Borges AC, Sarabando R, et al. The Role of Operative Vaginal Delivery in Postpartum Sexual Dysfunction: MOODS - A Prospective Study. J Sex Med 2021;18:1075-1082.
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Affiliation(s)
| | | | - Rita Sarabando
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
| | - Leonor Bivar
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
| | - Johanna Viana
- School of Medicine, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Margarida Cerqueira
- School of Medicine, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Alexandra Miranda
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal; School of Medicine, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Isabel Reis
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
| | - Cristina Nogueira-Silva
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal; School of Medicine, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
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Alnuaimi K, Almalik M. Sexual educational needs of Jordanian women after giving birth. Birth 2021; 48:52-60. [PMID: 33215767 DOI: 10.1111/birt.12509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pregnancy and birth entail many bodily changes, including changes in sexual activity. The postpartum period is a time of considerable recovery and adaptation for women, yet women do not always receive adequate information, especially in countries where such topics may be considered taboo. The purpose of this project was to explore the sexual educational needs of Jordanian women after giving birth. METHODS A qualitative, phenomenological approach was used. A purposive sample of 25 women were recruited from two health care centers. Semi-structured, in-depth interviews were conducted in person in Arabic between August and November 2015. Transcripts were independently analyzed and coded by each researcher. RESULTS Two major themes with six subthemes emerged. Theme 1, sexual education, included discussions about the women's needs for scientific information and the husband's involvement, and their psychological needs. Theme 2, professional approaches, involved discussions about the most appropriate person to deliver education, preferred place and time for education, and effective educational approaches to be used. DISCUSSION Congruent with previous studies, findings indicated that issues related to sexuality are often ignored in this population. CONCLUSIONS Jordanian women have many unmet educational needs with respect to sexuality after giving birth. More efforts are needed from health care professionals and other stakeholders to help improve Jordanian women's sexual health education after giving birth. These should include greater access to classes, websites with scientific information, and informational handouts that target husbands, and postpartum women themselves.
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Affiliation(s)
- Karimeh Alnuaimi
- Maternal and Child Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Mona Almalik
- Maternal and Child Health Nursing Department, Faculty of Nursing, University of Mutah, Mutah, Jordan.,Department of Health Sciences, Higher colleges of Technology, SJW, UAE
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Pardell-Dominguez L, Palmieri PA, Dominguez-Cancino KA, Camacho-Rodriguez DE, Edwards JE, Watson J, Leyva-Moral JM. The meaning of postpartum sexual health for women living in Spain: a phenomenological inquiry. BMC Pregnancy Childbirth 2021; 21:92. [PMID: 33509133 PMCID: PMC7844957 DOI: 10.1186/s12884-021-03578-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 01/20/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Sexual health is a multidimensional phenomenon constructed by personal, social, and cultural factors but continues to be studied with a biomedical approach. During the postpartum period, a woman transitions to mother, as well as partner-to-parent and couple-to-family. There are new realities in life in the postpartum period, including household changes and new responsibilities that can impact the quality of sexual health. This phenomenon is understudied especially in the context of Spain. The purpose of this study was to describe the lived experience of postpartum sexual health among primiparous women giving birth in Catalonia (Spain). METHODS This was a phenomenological study with a purposive sample of primiparous women. Data was collected through semi-structured interviews until saturation. Analysis followed Colaizzi's seven-step process with an eighth translation step added to limit cross-cultural threats to validity. Also, the four dimensions of trustworthiness were established through strategies and techniques during data collection and analysis. RESULTS Ten women were interviewed from which five themes emerged, including: Not feeling ready, inhibiting factors, new reality at home, socio-cultural factors, and the clinician within the health system. Returning to sexual health led women to engage in experiential learning through trial and error. Most participants reported reduced libido, experienced altered body image, and recounted resumption of sexual activity before feeling ready. A common finding was fatigue and feeling overloaded by the demands of the newborn. Partner support was described as essential to returning to a meaningful relationship. Discussions about postpartum sexual health with clinicians were described as taboo, and largely absent from the care model. CONCLUSION Evidence-based practices should incorporate the best evidence from research, consider the postpartum sexual health experiences and preferences of the woman, and use clinician expertise in discussions that include the topic of postpartum sexual health to make decisions. As such, human caring practices should be incorporated into clinical guidelines to recognize the preferences of women. Clinicians need to be authentically present, engage in active communication, and individualize their care. More qualitative studies are needed to understand postpartum sexual health in different contexts, cultures, and countries and to identify similarities and differences through meta-synthesis.
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Affiliation(s)
- Lidia Pardell-Dominguez
- Department d'Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213. Campus de la UAB, 08193, Bellaterra, (Cerdanyola del Vallès), Barcelona, Spain
| | - Patrick A Palmieri
- Vicerrectorado de Investigación, Universidad Norbert Wiener, Av. Arequipa 444, 15046, Lima, Peru. .,College of Graduate Health Studies, A. T. Still University, 800 West Jefferson Street, Kirksville, MO, 63501, USA. .,Center for Global Nursing, Texas Woman's University, 6700 Fannin Street, Houston, TX, 77030, USA. .,Center for Qualitative Research, EBHC South America: A Joanna Briggs Institute Affiliated Group, Calle Cartavio 402, 15023, Lima, Peru.
| | - Karen A Dominguez-Cancino
- Center for Qualitative Research, EBHC South America: A Joanna Briggs Institute Affiliated Group, Calle Cartavio 402, 15023, Lima, Peru.,Universidad Científica del Sur, Carr. Panamericana Sur 19, Villa EL Salvador, 15067, Lima, Peru.,Escuela de Salud Pública, Universidad de Chile, Independencia 939, Independencia, 8380453, Santiago de Chile, Chile
| | - Doriam E Camacho-Rodriguez
- Center for Qualitative Research, EBHC South America: A Joanna Briggs Institute Affiliated Group, Calle Cartavio 402, 15023, Lima, Peru.,School of Nursing, Universidad Cooperativa de Colombia, Calle 30, Santa Marta, Magdalena, Colombia
| | - Joan E Edwards
- Center for Global Nursing, Texas Woman's University, 6700 Fannin Street, Houston, TX, 77030, USA.,Nelda C. Stark College of Nursing, Texas Woman's University, 6700 Fannin St, Houston, TX, 77030, USA
| | - Jean Watson
- Watson Caring Science Institute, 4450 Arapahoe Avenue, Suite 100, Boulder, CO, 80304, USA.,College of Nursing, Anschutz Medical Campus University of Colorado, 13120 East 19th Avenue, Aurora, CO, 80045, USA
| | - Juan M Leyva-Moral
- Department d'Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213. Campus de la UAB, 08193, Bellaterra, (Cerdanyola del Vallès), Barcelona, Spain.,Center for Global Nursing, Texas Woman's University, 6700 Fannin Street, Houston, TX, 77030, USA.,Center for Qualitative Research, EBHC South America: A Joanna Briggs Institute Affiliated Group, Calle Cartavio 402, 15023, Lima, Peru
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What happens to female sexual function during pregnancy? Eur J Obstet Gynecol Reprod Biol 2021; 258:265-268. [PMID: 33485263 DOI: 10.1016/j.ejogrb.2021.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/28/2020] [Accepted: 01/02/2021] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Female sexual function remains an under-investigated and neglected topic in medical research. Studies have found a strong association between female sexual dysfunction (FSD) and decreased physical, emotional and overall life satisfaction [1]. Although FSD and the impact it has on quality of life is becoming increasingly recognised, the effect of pregnancy on FSD is relatively under-researched. METHODS Based on a significance level of 5% and a study power of 80 % a power calculation was performed using an assumed 20 % loss to follow up rate. 85 primiparous women with singleton pregnancies were recruited at their dating scan and asked to complete the Female Sexual Function Index (FSFI) questionnaire in each trimester. The total score and the six domains (pain, satisfaction, orgasm, desire, lubrication and desire) were compared with Friedman's ANOVA. The validated cut-off score of 26.55 was used to diagnose FSD. RESULTS There was an overall decrease in total FSFI scores across the three trimesters, from a median full-scale score of 27.5 in the first trimester, to 24.7 in the second and 21.4 in the third trimester. There was a very significant decrease in all scores (the full scale score and the six domains- desire, lubrication, arousal, orgasm, satisfaction and pain), from the first trimester to the third trimester with each outcome (p < 0.0001). There were 30 women with FDS in the first trimester, 50 in the second and 68 in the third (p < 0.05). CONCLUSIONS For primiparous women pregnancy appears to have a negative impact on sexual function with 86.1 % of women being classified as suffering from FSD in the third trimester. The importance of sexual function in overall quality life is well known and so it is important that the changes experienced by women and their partners are discussed by doctors with their patients.
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Abstract
Background: Although postpartum sexual problems are common, the impact of the infant feeding method on sexual life is still unclear. The aim of this study was to investigate the effects of different infant feeding methods and other influencing factors on female sexual life 3 months postpartum. Materials and Methods: Three hundred women from three obstetrical institutes were enrolled in this cross-sectional study. An online questionnaire was administered 3 months postpartum. Women were categorized into three groups: exclusive breastfeeding (n = 180), mixed feeding (n = 75), and formula-feeding (n = 45) groups. The infant feeding method was assessed by self-constructed questions. Sexual dysfunctions were evaluated by the Hungarian version of the Female Sexual Function Index (FSFI). Results: Of the women, 50.55% reported sexual dysfunction in the exclusive breastfeeding group, 42.66% in the mixed feeding group, and 31.11% in the formula-feeding group. Lack of sexual desire was the most prevalent dysfunction regardless of the infant feeding method. Significantly lower median scores were found in the exclusive breastfeeding group compared with the formula-feeding group for the total FSFI score (p = 0.002), arousal (p = 0.034), lubrication (p = 0.020), orgasm (p = 0.015), and pain (p = 0.021) subgroups. Breastfeeding (p = 0.032) and the quality of prepregnancy sexual life (p < 0.001) were significant factors, whereas prepregnancy dyspareunia, parity, age, income, and educational level did not predict women's postpartum sexual function. Conclusions: Our findings indicate that exclusive breastfeeding women have an increased likelihood of sexual problems 3 months postpartum. Extensive and professional counseling is needed for couples about postpartum sexuality and influencing factors such as breastfeeding to maintain sexual health and promote long-term breastfeeding.
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Affiliation(s)
- Katalin Szöllősi
- Department of Family Care Methodology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary.,School of PhD Studies, Semmelweis University, Budapest, Hungary
| | - László Szabó
- Department of Family Care Methodology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary.,School of PhD Studies, Semmelweis University, Budapest, Hungary.,Heim Pál Children's Hospital, Department of Pediatrics, Budapest, Hungary
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Zgliczynska M, Zasztowt-Sternicka M, Kosinska-Kaczynska K, Szymusik I, Pazdzior D, Durmaj A, Szlachta M, Bartnik P, Wielgos M. Impact of childbirth on women's sexuality in the first year after the delivery. J Obstet Gynaecol Res 2020; 47:882-892. [PMID: 33372310 DOI: 10.1111/jog.14583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/16/2020] [Accepted: 11/15/2020] [Indexed: 12/14/2022]
Abstract
AIM The aim was to compare the quality of sexual life before pregnancy and after delivery and to find out whether and how selected factors affect women's sexuality during this period. METHODS The study group consisted of 433 women who completed the survey containing basic demographic questions and two Female Sexual Function Index (FSFI) questionnaires: a retrospective one, regarding time before pregnancy and the current period. The inclusion criteria: time between 10 weeks and 1 year after delivery, vaginal intercourses before pregnancy and the resumption of vaginal intercourses after delivery. RESULTS We observed the negative impact of labor on the total FSFI score, regardless of the time that had passed since birth and the delivery mode. The decrease by at least 10% of the initial FSFI score was noticed in 44.3% of the participants. FSD (Female Sexual Dysfunction) occurred statistically more commonly after delivery than before pregnancy (45.3% vs 17.1%; P < 0.001). The following factors had an impact on the risk of post-partum FSD: pre-pregnancy FSD (adjusted odds ratio [aOR] = 4.17 [95% confidence interval [CI] 2.38-7.31]) and nulliparity (aOR = 1.67 [95% CI 1.09-2.53]). CONCLUSION Childbirth has an undeniable impact on women's sexuality. The prevention and treatment of sexual dysfunctions is very important, especially in this crucial period of life.
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Affiliation(s)
- Magdalena Zgliczynska
- Second Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Warsaw, Poland
| | - Monika Zasztowt-Sternicka
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | | | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Dominika Pazdzior
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Aneta Durmaj
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Szlachta
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Bartnik
- Second Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
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Banaei M, Kariman N, Ozgoli G, Nasiri M, Ghasemi V, Khiabani A, Dashti S, Mohamadkhani Shahri L. Prevalence of postpartum dyspareunia: A systematic review and meta‐analysis. Int J Gynaecol Obstet 2020; 153:14-24. [DOI: 10.1002/ijgo.13523] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/06/2020] [Accepted: 12/08/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Mojdeh Banaei
- Student Research Committee School of Nursing and Midwifery Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Nourossadat Kariman
- Midwifery and Reproductive Health Research Center School of Nursing and Midwifery Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Giti Ozgoli
- Midwifery and Reproductive Health Research Center School of Nursing and Midwifery Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Maliheh Nasiri
- Department of Biostatistics School of Nursing and Midwifery Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Vida Ghasemi
- Asadabad Faculty of Medical Sciences Asadabad Iran
| | - Azam Khiabani
- Mother and Child Welfare Research Center Hormozgan University of Medical Sciences Bandar Abbas Iran
| | - Sareh Dashti
- Department of Community Health Faculty of Medicine and Health Sciences University Putra Malaysia Serdang Selangor Malaysia
- Department of Midwifery Mashhad Branch Islamic Azad University Mashhad Iran
| | - Leila Mohamadkhani Shahri
- Student Research Committee School of Nursing and Midwifery Shahid Beheshti University of Medical Sciences Tehran Iran
- Department of Midwifery College of Nursing & Midwifery Karaj Branch Islamic Azad University Karaj Iran
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Rahimi F, Goli S, Eslami F. The effect of educational classes during pregnancy on the level of sexual satisfaction after delivery in nulliparous women. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:253. [PMID: 33224997 PMCID: PMC7657405 DOI: 10.4103/jehp.jehp_54_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/12/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND In the postpartum period, changes in sexual desire and marital satisfaction can be seen. Learning and giving enough information on changes in pregnancy and postpartum can help to increase marital satisfaction. The purpose of this study was to determine the effect of prenatal training on the level of postpartum marital satisfaction in nulliparous women. METHODS This study is a semi-experimental two-group study in which 150 nulliparous women were divided into two groups: control and intervention groups. The samples into intervention group received routine prenatal care and eight sessions of prenatal education with a training package (educational pamphlet on sexual health and sexual issues and an educational CD on pregnancy and pelvic exercises), and the control group received only routine prenatal care along with a pregnancy education pamphlet. Marital satisfaction was measured before intervention during pregnancy and 3 months after delivery (after intervention) using the ENRICH Marital Satisfaction Scale. Data were analyzed using t-test, paired t-test, Mann-Whitney, and Chi-square test. RESULTS There was no significant difference in demographic and obstetric variables and pregnancy status between the two intervention and control groups (P > 0.05). There was no significant difference in marital satisfaction during pregnancy between the two groups (before intervention) (P > 0.05). However, there was a significant difference in the level of postpartum marital satisfaction in the intervention group (P < 0/05). So that, the average marital satisfaction is increased from 52.2 to 64.6. CONCLUSION The results of this study show that eight sessions of prenatal education class with a training package (educational pamphlet on sexual health and sexuality and training CD of prenatal and pelvic floor exercise) can improve postpartum marital satisfaction in women.
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Affiliation(s)
- Farzaneh Rahimi
- Nursing and Midwifery Sciences Development Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Shadi Goli
- Nursing and Midwifery Sciences Development Research Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Fariba Eslami
- Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Darmody E, Bradshaw C, Atkinson S. Women's experience of obstetric anal sphincter injury following childbirth: An integrated review. Midwifery 2020; 91:102820. [PMID: 32861872 DOI: 10.1016/j.midw.2020.102820] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/24/2020] [Accepted: 08/16/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Perineal injury during childbirth is a very common event which affect women during childbirth. Significant morbidities are associated with third-and-fourth degree perineal tears in particular, also referred to as obstetric anal sphincter injuries (OASIS). With an increasing global birth rate and rising interventions in birth, the incidence of perineal trauma following vaginal birth is increasing on an international scale, impacted also by more accurate classification and definitions of OASIS and increased pre-existing co morbidities amongst affected women. The consequences of OASIS can be physically and psychologically distressing for affected women and have significant impact on quality of life. METHODOLOGY The aim of this integrative review was to examine women's experience of OASIS following childbirth using a systematic approach. This is presented in a five-stage process that includes problem identification, literature search, data extraction and evaluation, data analysis and presentation of results. A number of academic electronic databases were systematically searched and results are presented and analysed. Results of the complete search are presented in PRISMA format. Eight papers, which were assessed for quality using an appropriate appraisal tool, are included in the review and thematic analysis used to identify themes. FINDINGS The themes identified were; psychological consequences, the role of the health care professionals and implications for future pregnancies. Psychological consequences included anxiety, loneliness, isolation, shame, fear, many of which were associated with physical ramifications of OASIS and how these feelings affect activities of daily living. The importance of access to and support from health care professionals was highlighted. The impact the experience of OASIS had on women's decisions about future pregnancies was also evident. CONCLUSION The association between OASIS and maternal quality of life following childbirth can be substantial as evidenced by this literature review. The review identifies the need for improvement in the care and management of these women to alleviate the physical and psychological consequences of OASIS, including decisions in relation to future pregnancies and childbirth. Health care professionals caring for women in pregnancy and childbirth need to be educated and informed on the sequelae of OASIS, to ensure appropriate information and support is provided to these women and their families. Such knowledge may enable health care professionals to alleviate symptoms associated with OASIS and help women make sense and cope with their experiences.
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Affiliation(s)
- Ella Darmody
- University Maternity Hospital Limerick, Ennis Road, Limerick
| | - Carmel Bradshaw
- Dept. of Nursing and Midwifery, University of Limerick, Limerick, Ireland.
| | - Sandra Atkinson
- Dept. of Nursing and Midwifery, University of Limerick, Limerick, Ireland
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Postpartum perineal pain and dyspareunia related to each superficial perineal muscle injury: a cohort study. Int Urogynecol J 2020; 31:2367-2375. [DOI: 10.1007/s00192-020-04317-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/13/2020] [Indexed: 12/14/2022]
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Sheikhi ZP, Navidian A, Rigi M. Effect of sexual health education on sexual function and resumption of sexual intercourse after childbirth in primiparous women. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:87. [PMID: 32509895 PMCID: PMC7271915 DOI: 10.4103/jehp.jehp_591_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 12/13/2019] [Indexed: 05/17/2023]
Abstract
INTRODUCTION A large number of women experience sexual health problems during the postpartum period. This study aimed to evaluate the effect of sexual health education on sexual function and time of sexual intercourse resumption after childbirth in primiparous women in Southeast Iran. MATERIALS AND METHODS This randomized clinical trial was conducted on 94 primiparous women randomly divided into two groups of intervention and control. The intervention group was subjected to three training sessions 3-5, 10-14, and 30-45 days after childbirth (first session lasting 20 min and other sessions 60 min). On the other hand, the participants in the control group only received the routine postpartum training. The Female Sexual Function Index (FSFI) was completed by all participants before and 8 weeks after the intervention. Data were analyzed in SPSS software (version 22) using descriptive and inferential statistics, such as Chi-square test, independent t-test, and paired sample t-test. P < 0.05 was considered statistically significant. RESULTS The mean score of FSFI in the intervention group was increased from 12.70 ± 6.166 before the onset of the intervention to 17.36 ± 5.407 after 8 weeks (P = 0.01). In the control group, the mean score of FSFI was decreased from 13.09 ± 4.306 to 12.29 ± 3.511 on the 8th week postpartum (P = 0.06). The mean times of sexual intercourse resumption in the intervention and control groups were 5.82 ± 0.17 and 5.81 ± 0.22 weeks, respectively, which were not significantly different between the two groups (P = 0.879). CONCLUSION Sexual health education for women in the postpartum period could improve their sexual function after childbirth. However, it is recommended to use sexual health education programs in women during the postpartum period to promote female sexual function.
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Affiliation(s)
- Zahra Pahlavani Sheikhi
- Pregnancy Health Research Center, Zahedan University of Medical Science, Department of Counseling Midwifery, Nursing and Midwifery School, Zahedan University of Medical Science, Zahedan, Iran
| | - Ali Navidian
- Pregnancy Health Research Center, Zahedan University of Medical Science, Department of Counseling Midwifery, Nursing and Midwifery School, Zahedan University of Medical Science, Zahedan, Iran
| | - Mahnaz Rigi
- Student of Midwifery Counseling, School of Nursing and Midwifery Zahedan University of Medical Science, Zahedan, Iran
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Moran PS, Wuytack F, Turner M, Normand C, Brown S, Begley C, Daly D. Economic burden of maternal morbidity - A systematic review of cost-of-illness studies. PLoS One 2020; 15:e0227377. [PMID: 31945775 PMCID: PMC6964978 DOI: 10.1371/journal.pone.0227377] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/17/2019] [Indexed: 02/07/2023] Open
Abstract
Aim To estimate the economic burden of common health problems associated with pregnancy and childbirth, such as incontinence, mental health problems, or gestational diabetes, excluding acute complications of labour or birth, or severe acute adverse maternal outcomes. Methods Searches for relevant studies were carried out to November 2019 in Medline, Embase, CINAHL, PsycINFO and EconLit databases. After initial screening, all results were reviewed for inclusion by two authors. An adapted version of a previously developed checklist for cost-of-illness studies was used for quality appraisal. All costs were converted to 2018 Euro using national consumer price indices and purchasing power parity conversion factors. Results Thirty-eight relevant studies were identified, some of which reported incremental costs for more than one health problem (16 gestational diabetes, 13 overweight/obesity, 8 mental health, 4 hypertensive disorders, 2 nausea and vomiting, 2 epilepsy, 1 intimate partner violence). A high level of heterogeneity was observed in both the methods used, and the incremental cost estimates obtained for each morbidity. Average incremental costs tended to be higher in studies that modelled a hypothetical cohort of women using data from a range of sources (compared to analyses of primary data), and in studies set in the United States. No studies that examined the economic burden of some common pregnancy-related morbidities, such as incontinence, pelvic girdle pain, or sexual health problems, were identified. Conclusion Our findings indicate that maternal morbidity is associated with significant costs to health systems and society, but large gaps remain in the evidence base for the economic burden of some common health problems associated with pregnancy and childbirth. More research is needed to examine the economic burden of a range of common maternal health problems, and future research should adopt consistent methodological approaches to ensure comparability of results.
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Affiliation(s)
- Patrick S. Moran
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
- * E-mail:
| | | | | | - Charles Normand
- Centre for Health Policy and Management, Trinity College, Dublin, Ireland
- Cicely Saunders Institute, King’s College, London, United Kingdom
| | - Stephanie Brown
- General Practice and Primary Health Care Academic Centre, University of Melbourne, Melbourne, Australia
- Murdoch Children’s Research Institute, Melbourne, Australia
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
| | - Deirdre Daly
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
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Gommesen D, Nøhr E, Qvist N, Rasch V. Obstetric perineal tears, sexual function and dyspareunia among primiparous women 12 months postpartum: a prospective cohort study. BMJ Open 2019; 9:e032368. [PMID: 31848167 PMCID: PMC6937116 DOI: 10.1136/bmjopen-2019-032368] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Sexuality is an important aspect of human identity and contributes significantly to the quality of life in women as well as in men. Impairment in sexual health after vaginal delivery is a major concern for many women. We aimed to examine the association between degree of perineal tear and sexual function 12 months postpartum. DESIGN A prospective cohort study SETTING: Four Danish hospitals between July 2015 and January 2019 PARTICIPANTS: A total of 554 primiparous women: 191 with no/labia/first-degree tears, 189 with second-degree tears and 174 with third-degree/fourth-degree tears. Baseline data were obtained 2 weeks postpartum by a questionnaire and a clinical examination. Sexual function was evaluated 12 months postpartum by an electronic questionnaire (Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12)) and a clinical examination. PRIMARY OUTCOME MEASURES Total PISQ-12 score and dyspareunia RESULTS: Episiotomy was performed in 54 cases and 95 women had an operative vaginal delivery. The proportion of women with dyspareunia was 25%, 38% and 53% of women with no/labia/first-degree, second-degree or third-degree/fourth-degree tears, respectively.Compared with women with no/labia/first-degree tears, women with second-degree or third-degree/fourth-degree tears had a higher risk of dyspareunia (adjusted relative risk (aRR) 2.05; 95% CI 1.51 to 2.78 and aRR 2.09; 95% CI 1.55 to 2.81, respectively). Women with third-degree/fourth-degree tears had a higher mean PISQ-12 score (12.2) than women with no/labia/first-degree tears (10.4). CONCLUSIONS Impairment of sexual health is common among primiparous women after vaginal delivery. At 12 months postpartum, more than half of the women with a third-degree/fourth-degree tear experienced dyspareunia. Women delivering with no/labia/first-degree tears reported the best outcomes overall. Thus, it is important to minimise the extent of perineal trauma and to counsel about sexuality during and after pregnancy.
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Affiliation(s)
- Ditte Gommesen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Ellen Nøhr
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Niels Qvist
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Gastroenterological Surgery, Odense University Hospital, Odense, Denmark
| | - Vibeke Rasch
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
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Alp Yılmaz F, Şener Taplak A, Polat S. Breastfeeding and Sexual Activity and Sexual Quality in Postpartum Women. Breastfeed Med 2019; 14:587-591. [PMID: 31298557 DOI: 10.1089/bfm.2018.0249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
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.
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Affiliation(s)
- Figen Alp Yılmaz
- Department of Nursing, Faculty of Health Sciences, Bozok University, Yozgat, Turkey
| | - Ayşe Şener Taplak
- Department of Nursing, Faculty of Health Sciences, Bozok University, Yozgat, Turkey
| | - Sevinç Polat
- Department of Nursing, Faculty of Health Sciences, Bozok University, Yozgat, Turkey
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