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VanWiel L, Unke M, Samuelson RJ, Whitaker KM. Associations of pelvic floor dysfunction and postnatal mental health: a systematic review. J Reprod Infant Psychol 2024:1-22. [PMID: 38357811 DOI: 10.1080/02646838.2024.2314720] [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: 09/14/2023] [Accepted: 01/25/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Postpartum mental health conditions are common and can have devastating effects for both mother and infant. Adverse birth outcomes increase the risk of postnatal mental health conditions. Pelvic floor dysfunction (PFD) is a common adverse pregnancy outcome that may be a risk factor for postnatal mental health conditions. There are many studies reporting associations between PFD and postnatal mental health conditions, but no reports have synthesised the current literature as it relates to pregnancy and the postpartum period. METHODS A research librarian conducted systematic literature searches using terms concerning PFD, postnatal mental health conditions, and pregnancy. Searches were conducted within PubMed, Embase, CINAHL, Cochrane, and Scopus. Two reviewers independently rated each study for inclusion and study quality. No studies were excluded based on quality. RESULTS A total of 47 studies were included for review. Articles addressed sexual dysfunction (n = 11), incontinence (n = 21), perineal laceration (n = 13), pelvic organ prolapse (n = 2), and general pelvic floor symptoms (n = 2) and associations with postnatal mental health conditions. Two articles addressed more than one type of PFD. The majority (44 studies) reported associations between PFD and adverse postnatal mental health conditions. DISCUSSION Most studies included for review found consistent associations between PFD and adverse mental health conditions. Healthcare providers should screen for PFD and postnatal mental health conditions early in the postpartum period. Future research should investigate whether the treatment of PFD can modify the associations between PFD and postnatal mental health conditions.
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Affiliation(s)
- Lisa VanWiel
- Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | - Mackenzie Unke
- Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | | | - Kara M Whitaker
- Health and Human Physiology, University of Iowa, Iowa City, IA, USA
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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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Gokyildiz Surucu S, Avcibay Vurgec B, Kaya Senol D, Gozuyesil E, Bilgic D, Onat Koroglu C, Daglar G, Avci N, Cayir G, Haliloglu Peker B, Kizilkaya Beji N, Peker H, Yalcin O. Evaluation of women's sexual quality of life, depression, and sexual functions in the pregnancy and postpartum periods: A multi-centered study. J Obstet Gynaecol Res 2022; 48:1379-1389. [PMID: 35315957 DOI: 10.1111/jog.15227] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Sule Gokyildiz Surucu
- Midwifery Department, Faculty of Health Sciences, Cukurova University, Adana, Turkey
| | - Burcu Avcibay Vurgec
- Midwifery Department, Faculty of Health Sciences, Cukurova University, Adana, Turkey
| | - Derya Kaya Senol
- Midwifery Department, Faculty of Health Sciences, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Ebru Gozuyesil
- Midwifery Department, Faculty of Health Sciences, Cukurova University, Adana, Turkey
| | - Dilek Bilgic
- Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - Cemile Onat Koroglu
- Nursing Department, Faculty of Health Sciences, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Gulseren Daglar
- Midwifery Department, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey
| | - Nilgun Avci
- Midwifery Department, Faculty of Health Sciences, Biruni University, Istanbul, Turkey
| | - Gulsen Cayir
- Midwifery Department, Faculty of Health Sciences, Biruni University, Istanbul, Turkey
| | - Berna Haliloglu Peker
- Obstetric and Gynecology Department, Maltepe University Faculty of Medicine, Istanbul, Turkey
| | | | - Hakan Peker
- Vocational School, Nisantasi University, Istanbul, Turkey
| | - Onay Yalcin
- Department of Health Sciences, Kyrenia University, Kyrenia, Northern Cyprus
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Fernandes J, Tavares I, Bem-Haja P, Barros T, Carrito ML. A Longitudinal Study on Maternal Depressive Symptoms During the COVID-19 Pandemic: The Role of Strict Lockdown Measures and Social Support. Int J Public Health 2022; 67:1604608. [PMID: 35356264 PMCID: PMC8959081 DOI: 10.3389/ijph.2022.1604608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/21/2022] [Indexed: 01/01/2023] Open
Abstract
Objectives: This study examined the trajectory of perinatal depressive symptoms in Portuguese women during the COVID-19 pandemic and the role of individual, relational, and contextual risk and protective factors.Methods: This 3-wave longitudinal study followed 290 pregnant women from the third trimester of pregnancy until 6-months postpartum. Women self-reported on depressive symptoms, psychological (anxiety, perceived stress, mindfulness), relational (perceived social support, dyadic adjustment, sexual wellbeing), and contextual (lockdown status) factors.Results: Women who were under strict lockdown presented significantly higher scores of depressive symptoms at baseline (by 1.38 EPDS points) than women who were not under strict lockdown measures. Mixed Growth Models showed that trajectories of depressive symptoms were explained by differences in women’s baseline depression. Differences in women’s depressive symptoms at baseline were mainly explained by higher anxiety and lower social support (22% and 24% for women under lockdown; 39% and 6% for women not on lockdown, respectively).Conclusion: Preventative interventions targeted at pregnant women should aim to reduce anxiety and enhance women’s social support to prevent depression in pregnancy and postpartum during the COVID-19 pandemic.
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Affiliation(s)
- Joana Fernandes
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Inês Tavares
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- *Correspondence: Inês Tavares,
| | - Pedro Bem-Haja
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Tânia Barros
- Centro Materno-Infantil do Norte, Porto, Portugal
| | - Mariana L. Carrito
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Dawson SJ, Strickland NJ, Rosen NO. Longitudinal Associations between Depressive Symptoms and Postpartum Sexual Concerns Among First-time Parent Couples. JOURNAL OF SEX RESEARCH 2022; 59:150-159. [PMID: 33118837 DOI: 10.1080/00224499.2020.1836114] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Most first-time parents experience novel concerns about their sexuality such as worries about the effects of labor and delivery on their sex lives. The link between postpartum depressive symptoms and problems with sexual function is bidirectional; however, associations with postpartum sexual concerns (i.e., worries about one's sexuality that are not necessarily related to sexual function) have not been examined. First-time parent couples (N = 99) completed measures assessing their postpartum sexual concerns and depressive symptoms at 3, 6, and 12 months postpartum. Dyadic latent growth curve modeling revealed that mothers' and partners' initial frequencies of postpartum sexual concerns were positively associated, with significant declines in the frequency of these concerns over time for both partners. Mothers' and partners' initial depressive symptoms were also positively associated; however, mothers' depressive symptoms did not change over time whereas partner's depressive symptoms worsened. Mothers' and partners' higher initial depressive symptoms were associated with partners' higher frequency of postpartum sexual concerns. Mothers' depressive symptoms at 3 months postpartum and the degree to which these symptoms changed over time were associated with a steeper decline in partners' postpartum sexual concerns over time. Results provide preliminary support for depressive symptoms as a risk factor for partners' postpartum sexual concerns.
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Affiliation(s)
| | | | - Natalie O Rosen
- Department of Psychology & Neuroscience, Dalhousie University
- Department of Obstetrics & Gynecology, Dalhousie University
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Grover B, Einerson BD, Keenan KD, Gibbins KJ, Callaway E, Lopez S, Silver RM. Patient-Reported Health Outcomes and Quality of Life after Peripartum Hysterectomy for Placenta Accreta Spectrum. Am J Perinatol 2022; 39:281-287. [PMID: 32819016 DOI: 10.1055/s-0040-1715465] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Short-term morbidity of placenta accreta spectrum (PAS) is well described, but few data are available regarding long-term outcomes and quality of life. We aimed to evaluate patient-reported outcomes after hysterectomy for PAS. STUDY DESIGN This is a prospective cohort study of women with risk factors for PAS who were enrolled antenatally. Exposed women were defined as those who underwent cesarean hysterectomy due to PAS. Unexposed women were those with three or more prior cesareans or placenta previa, but no PAS, who underwent cesarean delivery without hysterectomy. Two surveys were sent to patients at 6, 12, 24, and 36 months postpartum: (1) a general health questionnaire and (2) the SF-36, a validated quality of life survey. Aggregate scores for each questionnaire were calculated and responses were analyzed. RESULTS At 6 months postpartum, women with PAS were more likely to report rehospitalization (odds ratio [OR] 5.83, 95% confidence interval [CI] 1.40-24.3), painful intercourse (OR 2.50, 95% CI 1.04-6.02), and anxiety/worry (OR 3.77, 95% CI 1.43-9.93), but were not statistically more likely to report additional surgeries (OR 3.39, 95% CI 0.99-11.7) or grief and depression (OR 2.45, 95% CI 0.87-6.95). At 12 months, women with PAS were more likely to report painful intercourse, grief/depression, and anxiety/worry. At 36 months, women with PAS were more likely to report grief/depression, anxiety/worry, and additional surgeries. Women with PAS reported significantly lower quality of life in physical functioning, role functioning, social functioning, and pain at 6 months postpartum, but not in other quality of life domains. Decreased quality of life was also reported at 12 and 36 months in the PAS group. CONCLUSION Women with PAS are more likely to report ongoing long-term health issues and decreased quality of life for up to 3 years following surgery than those undergoing cesarean for other indications. KEY POINTS · Long-term placenta accreta spectrum data to guide peripartum patient education.. · This study addresses a critical knowledge gap.. · Women affected by PAS report long-term morbidity..
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Affiliation(s)
- Bryan Grover
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
| | - Brett D Einerson
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah.,Intermountain Healthcare, Salt Lake City, Utah
| | - Karissa D Keenan
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah.,Intermountain Healthcare, Salt Lake City, Utah
| | - Karen J Gibbins
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah.,Intermountain Healthcare, Salt Lake City, Utah
| | - Emily Callaway
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
| | - Sarah Lopez
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
| | - Robert M Silver
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah.,Intermountain Healthcare, Salt Lake City, Utah
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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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Ollivier RA, Aston ML, Price SL. Exploring postpartum sexual health: A feminist poststructural analysis. Health Care Women Int 2019; 41:1081-1100. [PMID: 31373883 DOI: 10.1080/07399332.2019.1638923] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Postpartum sexual health has historically been viewed and discussed in specific ways, often dominated by biomedical discourse. There is a need to expand understandings of sexual health for postpartum women in the context of interdisciplinary health care. Research surrounding postpartum sexual health is largely focused on physical measures, such as vaginal lubrication or initiation of intercourse, without accounting for the diverse and subjective ways that sexuality and sexual health are experienced during the postpartum period. This critical analysis uses feminist post-structuralism to critique and analyze current health research and practice surrounding postpartum sexual health. Agency, subjectivity, gender and sex considerations, relations of power, and discourse are essential to understanding postpartum sexual health in a more holistic, woman-centered way. This includes awareness of dominant discourses that have shaped how health researchers, practitioners, postpartum women, and health institutions care for, support, and promote postpartum sexual health. There is a need to move beyond physically focused, reductionist, heteronormative understandings of sexual health to better promote overall postpartum health and wellbeing.
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Affiliation(s)
- Rachel A Ollivier
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Megan L Aston
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sheri L Price
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
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