The effect of face-to-face or group education during pregnancy on sexual function of couples in Isfahan

The Effect of Sexuality Education During Pregnancy on Female Sexual Function: A Systematic Review and Meta-Analysis Study

Objective

This meta-analysis aimed to synthesize the effect of sexuality education during pregnancy on female sexual function. Although sexual dysfunction in pregnancy is a common problem, it is often overshadowed by other outcomes, such as pregnancy risks or birth complications. Therefore, understanding the impact of educational interventions on women's sexual health is crucial to improving their overall well-being during this period.

Method

Studies were searched on the electronic databases Google Scholar, Web of Science, Journal Park, the Cochrane Library, EBSCO Medline, Pubmed, and Scopus without imposing any restrictions on the publication year. This meta-analysis used the Preferred Reporting Items for Systematic Reviews and meta-analysis statement guidelines. Findings were analyzed using fixed- or random-effects models based on 95% confidence intervals, p values, and heterogeneity testing.

Results

This systematic review included 4 studies with 337 (training: 169 and control: 168) participants due to the limited number of studies on this topic. Interventions in the four studies using the Female Sexual Function Index showed that sexuality education provided to intervention groups had a statistically significant positive effect on the total female sexual function score compared to control groups (p < .001, range: 0.552-0.995).

Conclusion

This meta-analysis provides insights into the implementation of educational interventions considering their positive impact on female sexual function during pregnancy. Despite the limited number of studies (only 4 studies), the findings suggest that sex education leads to significant improvements in many aspects, such as sexual pleasure, vaginal lubrication, orgasm, sexual desire, and overall satisfaction. Furthermore, pregnancy provides an ideal opportunity to normalize and integrate this education into pregnancy care, as it is a time when women often attend antenatal checkups or childbirth classes.

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

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

Effect of sexual enrichment program on the sexual satisfaction of pregnant women in Iran: A randomized clinical trial

Background

To improve the sexual satisfaction of pregnant women, there needs to be a culturally appropriate sex education program. This study aimed at determining the effectiveness of a sexual enrichment program on the sexual satisfaction of pregnant women.

Methods

This single-blind randomized clinical trial was conducted on 61 pregnant women aged 18 to 35 years old with low-risk pregnancies and gestational ages of 14 to 32 weeks, who had referred to three healthcare centers in Mashhad. The participants were randomly assigned to two groups of control (n = 31) and intervention (n = 30) based on a table of blocks of four. The intervention group, in addition to receiving routine pregnancy training, participated in six one-hour sessions of a sexual enrichment program held on a weekly basis, while the control group received only the routine pregnancy healthcare. Larson's sexual satisfaction questionnaire was used to assess the sexual satisfaction of pregnant women prior to the study and two weeks after the intervention. Comparison of mean scores between and within the two groups was performed using SPSS software (version 21) using independent and paired t-tests.

Results

After the intervention, there was a significant difference between the mean sexual satisfaction scores of the two groups (p = 0.02). Comparison of the differences between the mean sexual satisfaction scores of the intervention group before and after the intervention indicated a significant change (p = 0.009), while in case of the control group this change was not significant (p = 0.46).

Conclusion

A sexual enrichment program can be effective in improving the sexual satisfaction of pregnant mothers.

Development of sexual health promotion package in pregnancy: The Delphi method

BACKGROUND

The World Health Organization recommendation requires the development and use of effective, brief, clear, and evidence-based education packages to improve health-care outcomes. No comprehensive sexual health improvement package exists for the pregnancy period in the Iranian health system. This study aimed to develop a package to promote sexual health in pregnancy.

MATERIALS AND METHODS

The present study is a qualitative study, which was conducted in 2019 in Tehran, Iran. Sexual health package during pregnancy was developed based on the National Institute for Health and Clinical Excellence (NICE) steps. The first step included reviewing of international guidelines, strategies, handbooks, education packages, and articles in this regard. The package was developed in the second step. In the third step, quality assessment was performed using expert opinion with the Appraisal of Guidelines for Research and Evaluation Instrument II (AGREE II) tool, and validation was performed using Delphi method.

RESULTS

Package content was designed in two sections: for midwives and health-care providers and for pregnant mothers in three sessions (in each trimester of pregnancy). The quality assessment using the AGREE II guidelines revealed excellent quality (>89%). The package was validated based on expert opinion (>95%).

CONCLUSION

The sexual health promotion package during pregnancy was designed with high quality and validity based on NICE steps. It is recommended, midwives be performed this designed and validated package in routine pregnancy care to promote the couple's sexual health.

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

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

Comparing the effect of face-to-face education and using educational films on couples' sexual dysfunction during pregnancy

BACKGROUND

Pregnancy is a special period in a woman's life during which physical, mental, social, and cultural changes would affect sexual desires during this period. The present study was conducted to compare the effect of face-to-face education and using educational films on the sexual dysfunction in couples.

MATERIALS AND METHODS

The present study was a semi-experimental research. Study population contained pregnant women and their husbands. Samples were selected randomly. Data were gathered using demographic characteristic questionnaire and sexual dysfunction in men and women questionnaire. Sample size was 96 couples (32 couples in the face-to-face group, 32 in the educational films group, and 32 in the control group). Data were analyzed using SPSS20 software.

RESULTS

The mean total score of preintervention sexual function in face-to-face education group was 46.72 ± 9.79, in educational film group 47.82 ± 13.07, and in control group 43.84 ± 12.76. In the case of postintervention, it was, respectively, 60.62 ± 9.72, 57.37 ± 14.74, and 43.61 ± 14.21. Face-to-face education led to the treatment of sexual dysfunction during pregnancy (P < 0.001). In the educational film group (P = 0.40), sexual dysfunction during pregnancy was not treated, but there was an improvement in sexual function (P = 0.001). In the control group, there was a significant difference regarding the decrease in the score of sexual function and untreated sexual dysfunction during pregnancy (P = 0.001). Furthermore, no improvement was observed in the sexual dysfunction during pregnancy (P = 0.90).

CONCLUSIONS

According to the results, face-to-face and film education are effective in sexual function during pregnancy, but face-to-face education in pregnancy is more effective in the treatment of sexual dysfunction, and so this causes promoting sexual health during this period.

The effect of sexual health education on sexual activity, sexual quality of life, and sexual violence in pregnancy: a prospective randomized controlled trial

Background

Some women avoid sexual intercourse during pregnancy due to the physiological changes they undergo during this period as well as their fear of causing harm to the fetus and to themselves, which can lead to problems in sexual health. The aim of the present study was to investigate the effects of a sexual health education package on the dimensions of sexual health in pregnant women.

Methods

This randomized, longitudinal, clinical trial was carried out in 2018–2019 on 154 pregnant women in early to late pregnancy who presented to comprehensive health centers in Rasht, Iran, and were divided into three groups: Group A or the training group (50 participants), Group B or the self-training group (53 participants), and Group C or the control group (51 participants). The study tools included the Pregnancy Sexual Response Inventory (PSRI), the Sexual Quality of Life-Female (SQOL-F) and the Sexual Violence Questionnaire. The dimensions of sexual health were examined before beginning each intervention in each trimester of pregnancy and then at the end of pregnancy using these questionnaires. The collected data were analyzed using statistical tests, namely the Chi-square test, one-way ANOVA, Cochrane’s test, and the repeated measures ANOVA at a significance level of P < 0.05.

Results

There was no statistically significant difference in the mean total scores of SQOL-F and PSRI in the three groups at baseline. As for the intergroup results, there was a statistically significant difference in the mean score of SQOL-F and PSRI at the end of pregnancy. The mean scores of PSRI and SQOL-F in the training group (Group A) increased from the beginning to the end of pregnancy compared to the control and self-training groups. As for the intergroup comparisons, there was no statistically significant difference in the mean total scores of sexual violence among the pregnant women in the different groups in the third trimester of pregnancy and at the end of the third trimester. Although sexual violence was not statistically significant, the number of sexually-violated women in the training group decreased during the training period compared to the self-training and control groups.

Conclusion

The results obtained in the intervention group compared to the control group revealed the effectiveness of the sexual health education package in terms of improvement in the dimensions of sexual health. According to the results, in order to maintain and promote the sexual health of pregnant women, health care providers are recommended to offer sexual health training during pregnancy along with other health care services.

Trial registration

IRCT20190427043398N1; the trial was registered on June 2, 2019. (retrospective registration).

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

INTRODUCTION

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

METHODS

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

RESULTS

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

DISCUSSION

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

The effect of educational classes during pregnancy on the level of sexual satisfaction after delivery in nulliparous women

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.

Effect of a structured educational package on women's sexual function during pregnancy

OBJECTIVE

To explore the effect of a structured educational package based on ADDIE (analysis, design, development, implementation, evaluation) to reduce sexual dysfunction during pregnancy.

METHODS

A randomized controlled trial study among pregnant women attending prenatal clinics in Tehran, Iran, from October 2017 to September 2018. The implementation group received the structured educational package; the control group received training on breastfeeding and normal delivery. The outcome measure was changes in total and domain scores of the Female Sexual Function Index (FSFI) questionnaire before and after the intervention; the groups were compared by repeated-measures analysis of variance (ANOVA).

RESULTS

Overall, 70 women completed the study: 36 in the intervention group and 34 in the control group. Sexual desire (P=0.019), arousal (P=0.001), lubrication (P=0.001), orgasm (P=0.001), satisfaction (P=0.007), and total FSFI score (P<0.001) improved significantly in the intervention group as compared with the control group. However, there was no difference in sexual pain after the intervention (P=0.78).

CONCLUSION

The structured educational package was found to reduce sexual dysfunction by improving knowledge of and attitudes toward the physical and psychologic changes that occur during pregnancy among Iranian women attending routine prenatal care visits as part of a healthcare center's program. Iranian Registry of Clinical Trials: IRCT20140907019077N14.

Effect of pregnancy on sexual function of couples

OBJECTIVE

Sexual function is an important part of each human being's personality and in the general couple relationship, with an obvious impact on quality of life and safe sexual performance during pregnancy is important for couples. The objective of this study was to assess effects of pregnancy on sexual function of couples.

MATERIALS

In a prospective cohort study 123 couples were enrolled in the study when women were first diagnosed to be pregnant. During their pre-natal visits, Sexual function of couples was evaluated using the Iranian Version Index of Erectile Function (IIEF) in men and Female Sexual Function Index (FSFI) in women in three trimesters. Statistical analysis was performed.

RESULTS

Indices of sexual function showed significant regressions over time during pregnancy. The greatness of the problem was highest during the third trimester. Female sexual arousal and sexual satisfaction domain scores had the major correlation to IIEF total score. On the other hand, male intercourse satisfaction domain score had the maximum correlation to FSFI total score. A strong correlation between male and female sexual function was observed.

CONCLUSION

Sexual function is a widespread problem during pregnancy among Iranian couples. Therefore, pregnant women and their husbands need counseling about healthy sexual function in pregnancy.

The effect of educational package on sexual function in cold temperament women of reproductive age

INTRODUCTION

Sexual health is one of the key factors to sustain marital life and having a good sexual function. On the other hand, temperament affects sexual function. Training is also one of the basic foundations for promoting sexual health. Therefore, the researcher has designed and implemented a study (2017) aimed "determining the study of educational package on sexual function in cold temperament women of reproductive age."

METHODS

This randomized clinical trial study was performed on 80 women in two groups (40 in each group). This study was done, in available method, on no pregnant women aged 20-40 years old that referred to health centers in Mashhad. DASS 21 sexual function and determining temperament questionnaires were completed in two groups before intervention. At first, the sexual function training package was held by the researcher at 6 sessions (twice a week for 3 weeks) that was based on nutrition, sport, and lifestyle axes. The control group also received routine care. A week after intervention finished, all the units completed a sexual function questionnaire. The results were analyzed by these techniques as SPSS software (version 16) and statistical tests such as Independent t-test, T-pair, Mann-Whitney, Chi-square, and Fisher's exact test.

RESULTS

At the beginning of the study, there was no statistically significant difference between the personal characteristics and the mean score of sexual function and all its dimensions in the two groups. The mean sexual performance score and all its dimensions after intervention were significantly different in intervention and control groups P < 0.001. Sexual function and all its dimensions were improved after intervention in the intervention group.

CONCLUSION

Giving sexual function package has improved the sexual function of cold temperament women. So, for routine caring of cold temperament women, it is better that health center employees consider this training package as an effective, easy, available, nonpharmacological, and economic intervention.

Effect of Sexual Education on Sexual Function of Iranian Couples During Pregnancy: A Quasi Experimental Study

BACKGROUND

The aim of this study was to evaluate the impact of husbands' participation in sexual education on sexual function during pregnancy.

METHODS

This quasi experimental study was conducted on 123 couples who were divided in two intervention (A: couples, B: pregnant women) and one control (C) groups. Group A couples received sex education, Group B women received sex education without their spouses, and Group C women received routine prenatal care without sex education. Sexual functions of couples were assessed by Female Sexual Function Index (FSFI) and International Index Erectile Function (IIEF) questionnaires, before sex education, four weeks after the intervention, at the end of the second trimester and at the end of the third trimester.

RESULTS

Mean total scores of FSFI and IIEF were not different at baseline in three groups. Repeated measure analysis showed significant differences between groups (A and B with C) in the mean total scores of FSFI and IIEF during the third trimester. The mean total scores of the two intervention groups of A and B were not significant.

CONCLUSION

According to the results of the present study, promoting the sexual function of pregnant women needs to include the sex education on prenatal care. Whereas spouses' participation was suggested to have a great role in the effectiveness and strengthening of the education in various studies, this study showed that the lack of spouses' participation for whatever reasons may lead to the same results of previous studies which emphasized the necessity of spouses' participation.

Health information needs of pregnant women: information sources, motives and barriers

BACKGROUND

Pregnant women should be provided with relevant and useful information to manage this specific period of their lives. Assessing information needs of this group is a prerequisite for providing this information.

OBJECTIVE

The aim of this study was to assess the information needs of pregnant women during their pregnancy and childbirth.

METHODS

This descriptive study was conducted on the pregnant women who attended antenatal clinics and obstetricians/gynaecologists' offices in Kerman, Iran, in 2015. Data were collected using a self-administered, valid and reliable questionnaire. A total of 400 women participated in the study.

FINDINGS

Most pregnant women needed information about care of the foetus (n = 344, 86%), physical and psychological complications after delivery (n = 333, 83%), development and growth of the foetus (n = 330, 82.5%), pregnancy nutrition (n = 327, 82%) and special tests during pregnancy (n = 326, 81.5%). They mostly (n = 195, 49%) looked for information when they were suffering from a disease or pregnancy complications.

CONCLUSIONS

As pregnant women need extensive information to be able to take care of themselves and their babies, their information needs should be identified and taken into consideration when planning educational programmes for this group of women.