Factors Influencing Couples' Sexuality in the Puerperium: A Systematic Review

The Effect of Sexual Counseling Based on PLISSIT and EX-PLISSIT Models on Sexual Function, Satisfaction, and Quality of Life: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis study aimed to investigate the effect of sexual counseling based on PLISSIT (Permission, Limited Information, Specific Suggestions, and Intensive Therapy) and EX-PLISSIT models on sexual function, satisfaction, and quality of sexual life. We searched seven electronic databases (MEDLINE, CINAHL, Web of Science, Cochrane Library, ProQuest, Scopus, and PubMed). Studies published between January 1, 2010, and August 16, 2022, were included in the search. Eighteen articles were eligible for inclusion in the analysis. There was a significant difference in the sexual function scores of the PLISSIT and EX-PLISSIT groups and the comparison groups (standardized mean difference (SMD): 1.677; 95% CI 0.668, 2.686; p < 0.05) and "sexual and communication satisfaction" sub-dimension of sexual life quality (SMD: 0.748; 95% CI 0.022, 1.475; p < 0.05). There was no difference in the sexual satisfaction (SMD: 0.425; 95% CI - 0.335, 1.184; p > 0.05) and quality of sexual life scores of the PLISSIT and EX-PLISSIT groups and the comparison groups (SMD: - 0.09; 95% CI - 0.211, 0.032; p > 0.05). PLISSIT and EX-PLISSIT models-based sexual counseling on sexual function was affected by the moderator variables of the time of evaluation of the results after the intervention, type of comparison group, the study population, and by whom the intervention was applied. Sexual counseling based on the PLISSIT and EX-PLISSIT models improved sexual function scores and "sexual and communication satisfaction" sub-dimension of sexual life quality.

Intimate partner violence during pregnancy and time to return to sexual activity after childbirth: analysis of the BRISA prenatal cohort

This study aimed to analyze whether there is an association between intimate partner violence during pregnancy and time to return to sexual activity after childbirth in the BRISA cohort in São Luís, Maranhão State, Brazil, between 2010 and 2013. This is a longitudinal study conducted with 665 women. Intimate partner violence during pregnancy was measured using an instrument created and validated by the World Health Organization to measure violence against women. Time to return to sexual activity after childbirth was investigated using a structured questionnaire. Logistic regression models were used to analyze whether there is an association between intimate partner violence during pregnancy and time to return to sexual activity after childbirth. The prevalence of violence by an intimate partner during pregnancy was 24.06%. The prevalence of women who returned to sexual activity within 3 months after childbirth was 67.96%. When analyzing the association between exposure and outcome, no association was found in the crude model (OR = 0.88; 95%CI: 0.60-1.30), nor in the adjusted model (OR = 1.00; 95%CI: 0.61-1.63). The study results highlight the importance of providing comprehensive care to women, considering both physical and psychological aspects, since violence has a significant impact on several aspects of women's lives.

Do perfectionism, body image concerns, and intimacy predict genitopelvic pain in the postpartum? A prospective study of new mothers

BACKGROUND

Genitopelvic pain following childbirth is common and likely to challenge the psychological, relational, and sexual well-being of new mothers. While genitopelvic pain generally decreases during the postpartum period, personal and interpersonal characteristics may explain why genitopelvic pain persists beyond the period of physical recovery in some mothers. Body image concerns, increased stress, and relationship challenges would be particularly salient during pregnancy and the postpartum period, which could put new mothers at greater risk of sexual difficulties. Also, mothers may display a negative appraisal regarding genitopelvic pain and doubt their ability to cope with it, which may contribute to the pain.

AIM

The current study aimed to examine the role of perfectionism, body image concerns, and perceived intimacy in the occurrence and change in genitopelvic pain in new mothers in postpartum.

METHODS

A total of 211 new mothers and their partners were recruited for a larger prospective dyadic study on the transition to parenthood.

OUTCOMES

Mothers completed a single item assessing genitopelvic pain, in addition to brief validated questionnaires measuring perfectionism, body image concerns, and perceived couple intimacy during pregnancy and at 4, 8, and 12 months postpartum.

RESULTS

Five multilevel modeling analyses revealed that adaptive perfectionism, maladaptive perfectionism, and body image concerns were associated with a higher occurrence of genitopelvic pain from 4 to 12 months postpartum. Mothers' and partners' perceived intimacy was not significantly related to new mothers' genitopelvic pain. None of the predictors modified the trajectory of genitopelvic pain over time.

CLINICAL IMPLICATIONS

Raising awareness among health care professionals regarding the role of perfectionism and body image concerns in genitopelvic pain may help them identify new mothers at risk of chronic genitopelvic pain, while offering a new avenue of intervention.

STRENGTHS AND LIMITATIONS

There has been little research examining the role of perfectionism, body image concerns, and intimacy in postpartum genitopelvic pain. Based on a longitudinal prospective approach, this study identified perfectionism and body image concerns as significant predictors of postpartum genitopelvic pain. However, prepregnancy genitopelvic pain, genitopelvic pain intensity, and sexual distress were not measured.

CONCLUSION

Adaptive and maladaptive perfectionism and body image concerns are associated with new mothers' genitopelvic pain up to 12 months postpartum.

Development of an educational guide for postpartum sexual health promotion: The Delphi method

BACKGROUND

The Promotion of sexual health has been emphasized in Sustainable Development Goals (SDGs). As a primary prevention strategy, the promotion of sexual knowledge can reduce the incidence of postnatal sexual disorders. This study aimed to develop an educational guide for postpartum sexual health promotion.

MATERIALS AND METHODS

This qualitative study was conducted in 2021 in Tehran. The steps of developing the educational guide were based on the model of the National Institute for Health and Clinical Excellence (NICE). First, the related guidelines, books, booklets, and original articles were comprehensively reviewed. Based on the scientific evidence, the educational content was compiled. Then, the quality of this content was evaluated using the Delphi method; It was performed using expert opinions with the Appraisal of Guidelines for Research and Evaluation (AGREE) tool.

RESULTS

The educational content was developed in three chapters as follows: basic sexual education, postpartum changes and prevalent sexual problems of this period, and strategies for solving or adapting to postpartum sexual problems. This guide was developed in two separate sections for healthcare providers and mothers. The content was of excellent quality in all 6 domains of the AGREE tool (>90%); and evaluated to be optimal in terms of scientificity, significance, and feasibility with the consensus of experts (>95%).

CONCLUSIONS

In this research, the steps of developing a comprehensive evidence-based educational guide for sexual health services in postpartum care were described, and its content was presented. The validity of the compiled content was also confirmed.

Romantic Attachment and Sexual Satisfaction Trajectories Among Couples Transitioning to Parenthood

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

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

BACKGROUND

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

METHOD

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

RESULTS

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

CONCLUSION

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

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

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

Body Esteem and Self-Efficacy of Pregnant Women with Gestational Diabetes Mellitus

The diagnosis of gestational diabetes mellitus provokes a change in a pregnant woman's lifestyle, which may affect her well-being and precipitate a sense of loss of self-control over her own body. The perception of "body image" is not only physical appearance and physical attractiveness but also the emotional attitude to the body and beliefs about it. The aim of the study was to analyze the factors affecting body esteem and analyze the relationship between body esteem and self-efficacy in pregnant women with gestational diabetes mellitus. The study was conducted in the period from April 2019 to January 2021 among 287 women with gestational diabetes mellitus with the use of the following research tools: Body Esteem Scale (BES) and Generalized Self-Efficacy Scale (GSES). The explanatory variables for the sexual attractiveness variable were age (β = 0.252; p = 0.006) and education (β = 0.334; p = 0.007), for the weight concern variable were age (β = 0.161; p = 0.005), BMI (β = 0.334; p = 0.005), and education (β = 0.252; p = 0.033), for the physical condition variable, were age (β = 0.096; p = 0.004) and education (β = 0.213; p = 0.006). Positive correlations were found between self-efficacy and body esteem in the aspects of sexual attractiveness (p = 0.350), weight concern (p = 0.296), and physical condition (p = 0.286). Positive correlations were found between self-efficacy and body esteem in the aspects of sexual attractiveness (p = 0.350), weight concern (p = 0.296), and physical condition (p = 0.286). Older women who had better education and a lower BMI rated their bodies better. In women with gestational diabetes mellitus, high self-efficacy determines a better perception of their bodies in all areas: sexual attractiveness, weight concern, and physical condition.

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

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

Evaluation of women's sexual quality of life, depression, and sexual functions in the pregnancy and postpartum periods: A multi-centered study

AIM

This multi-centered, longitudinal, and prospective study aims to identify women's sexual functions, sexual quality of life, and depression and their relationships with each other in the pregnancy and postpartum periods.

METHODS

The participating pregnant women (n = 113) were interviewed six times: once in each trimester, and once in the eighth week third month, and sixth month postpartum. This study was conducted in three regions of Turkey including Marmara, Mediterranean, and Central Anatolia regions. Data were collected through the "Socio-demographic Form," "Female Sexual Function Index (FSFI)," Sexual Quality of Life-Female Questionnaire (SQLQ-F), and "Center for Epidemiologic Studies-Depression Scale (CES-D)." While the first interviews were administered face to face, successive ones were administered via phone.

RESULTS

The sexual dysfunction rates of the participants were found to be high in the pregnancy and postpartum periods, and their sexual quality of life, which decreased as the pregnancy months progressed, was found to increase significantly with the progress in the postpartum period. The sexual dysfunction increased and sexual quality of life decreased significantly with the increase in depression symptoms in the pregnancy and postpartum periods. When the depressive symptoms decreased especially in the sixth month postpartum, sexual quality of life was also found to increase.

CONCLUSIONS

As a result, in the pregnancy and postpartum periods, it is highly important to provide women with diagnosis through a holistic approach by creating available environments to assess their psychological health and sexual functions and refer them to the related physicians when necessary.

Improving women's experiences of perineal suturing: A pragmatic qualitative analysis of what is helpful and harmful

BACKGROUND

Perineal trauma requiring suturing is increasing, along with the associated physiological and psychological morbidities for women. Provider training appears to focus more on technical aspects rather than respectful, relational care for women. Studies exploring women's experiences have identified that how women are cared for can significantly impact upon overall experiences.

AIM

To identify areas of improvement to the perineal suturing process and provide robust recommendations for urgent change by investigating what aspects are most traumatic to women and which are most supportive.

METHODS

A pragmatic qualitative analysis of data generated from 15 in-depth interviews with women who were sutured following birth.

FINDINGS

Regardless of tear severity, what was identified as helpful included anything that made the process better by increasing feelings of trust and reassurance, and providing women with a sense of being seen and heard. Harmful experiences were identified as those that worsened the experience, by increasing feelings of fear and vulnerability and leaving women with a sense of being disregarded or disrespected.

CONCLUSION

The study confirmed that how the suturing process is conducted can have a significant detrimental impact upon women's short- and longer-term physical and psychological well-being.

IMPLICATIONS FOR PRACTICE

An improved experience for women is most likely with kind professionals who explain the process as it goes along, check-in regularly and validate how the women feel. Women prefer to be sutured by a known professional, only if this provider is also kind and respectful.

Recovering Sexuality after Childbirth. What Strategies Do Women Adopt? A Qualitative Study

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.

New Motherhood Concepts, Implications for Healthcare. A Qualitative Study

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.

Does Bed Sharing with an Infant Influence Parents’ Sexual Life? A Scoping Review in Western Countries

Bed sharing—the sharing of a sleeping surface by parents and children—is a common, yet controversial, practice. While most research has focused on the public health aspect of this practice, much less is known regarding its effect on the marital relationship. The aim of the present study was to conduct a scoping review on the impact of parent–infant bed sharing sleeping practices on the sexual and marital relationship of couples. The qualitative synthesis of six studies on this topic suggests that overall, bed sharing does not exert a significant negative impact on family functioning; when it does, it appears to be related to incongruent parental beliefs and expectations, especially when bed sharing is not an intentional choice of sleep arrangement, and there are other confounding factors such as fatigue and psychological distress. Suggestions for future studies and clinical implications are discussed.

Sexuality in the perinatal period: A systematic review of reviews and recommendations for practice

In the time of transition to parenthood, many physical, psychological and social changes may affect the multidimensional theme of sexuality. This area plays a significant role in the overall well-being of the individual, the couple and the family. The aim of this systematic review is to consider current and emerging trends in the study of sexual function during pregnancy and after childbirth, evaluating the available evidence in the literature reported in specific reviews, and pulling together the suggestions that various authors have brought forward as being useful for daily clinical practice. A total of 4 databases were searched on EBSCOhost: MEDLINE, Cochrane reviews, CINAHAL, and PsychInfo. A systematic search strategy was formulated using the key terms Sexuality, Sexual, Pregnancy, Postpartum, Puerperium, Perinatal, and Review. Eleven articles were included. The results revealed a gradual decline in the frequency of sexual behaviour throughout pregnancy, sharper in the third trimester. Sexual activity started to be resumed around 6-8 weeks after childbirth, to fully recover only after 6 months. A simultaneous change in sexual function was also found, such as less orgasm, sexual desire and satisfaction, more dyspareunia. Many aspects are related to these changes: physical, psychological and social factors, fears about negative consequences of sexual intercourse, inadequate or absent professional counselling about sexuality, method of delivery and breastfeeding. Healthcare professionals need to adequately inform couples about the common fluctuations in sexual activity, interest, desire, and responsiveness over the course of the pregnancy and following childbirth. Joint counselling, if possible, is preferred.

Relationship of the type of breastfeeding in the sexual function of women

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.

Dispareunia en mujeres después de parto vaginal. Prevalencia en dos clínicas de Armenia, Colombia, 2012-2017

Se realizó un estudio de corte transversal que tuvo como objetivo determinar la prevalencia de la dispareunia en mujeres con parto vaginal, evaluar posibles factores de riesgo y la asociación con la episiotomía. Ingresaron mujeres atendidas por parto vaginal entre 2012 y 2017 en dos clínicas de alta complejidad en Armenia (Colombia). Se utilizó el cuestionario Índice de Función Sexual Femenina (IFFS-6) para evaluar la función sexual. Los resultados reportan una prevalencia de dispareunia del 59,37%, siendo más prevalente en mujeres sometidas a episiotomía (OR: 68,17; IC95 %: 60,57-79,15). Respecto a la asociación de la episiotomía con la presencia de dispareunia se encontró asociación significativa con la episiotomía medio-lateral (OR: 8,17; IC95%: 2,15-56,32), lesión del esfínter (OR: 7,32; IC95%: 4,86-12,75) y dehiscencia de la sutura (OR: 6,48; IC95%: 4,92-14,28). Se observaron como factores de riesgo: antecedente de endometriosis (OR: 11,6; IC95 %: 9,15-17,52), dolor pélvico crónico (OR: 3,56; IC95%: 2,21–6,32) e ITS (OR: 2,67; IC95%: 1,54–5,14), p=0,003). Se concluye que la prevalencia de dispareunia en mujeres con parto vaginal, atendidas en Armenia, varía en función de la realización de episiotomía, asociándose tanto a las complicaciones de esta como a otros antecedentes.

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

BACKGROUND

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

AIM

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

METHODS

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

OUTCOMES

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

RESULTS

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

CLINICAL IMPLICATIONS

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

STRENGTHS & LIMITATIONS

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

CONCLUSION

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

Body image during sexual activity in the population of Polish adult women

Introduction

Recently it has been shown that body image during sexual activities is a better predictor of the diversity of sexual experience than body image as a psychological trait. To measure contextual body image (as a state) the Body Exposure During Sexual Activity Questionnaire (BESAQ) was developed.

Material and methods

845 women aged 18-55 years were included in the study. The original model was first translated into Polish and consulted to create the version to be further validated. The original model was tested using confirmatory factor analysis (CFA). The population was divided in two equal groups – group 1 was used for exploratory factor analysis. Discriminant and convergent validity were checked. Sexual function was assessed by the Changes in Sexual Function Questionnaire.

Results

The Polish model of BESAQ (BESAQ-PL) consisted of 28 items with 2 lower-order factors. It had a satisfactory goodness of fit – comparative fit index (CFI) = 0.93, Tucker-Lewis index (TLI) = 0.94, root-mean-square error of approximation (RMSEA) = 0.06 and χ² = 1360.0, df = 337, p< 0.001, excellent internal consistency measured by Cronbach’s α = 0.88 and satisfactory discriminate validity. State body image (BESAQ-PL) did not predict sexual functioning. Face was the most important for self-consciousness during sexual contact in the population of Polish women.

Conclusions

State body image correlates with sexual functions but is not a major factor influencing sexual performance. Women in Poland are not anxious about body exposure during sexual activity. The BESAQ-PL may be used in the population of Polish women between 18 and 55 years of age.