The Impact of Pregnancy and Childbirth on Sexual Behaviors: A Systematic Review

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.

Sexual quality of life and marital adjustment in pregnant women

In a cross-sectional study, researchers investigated pregnant women's quality of sexual life and marital adjustment. The sample consisted of 312 pregnant women admitted to the gynecology and obstetrics outpatient clinic of State Hospital between June and November 2020. Data were collected using a personal information form, the Quality Scale-Female (SQLQ-F), and Marriage Adjustment Test (MAT). Participants with one child had a significantly higher median SQLQ-F score than those with three or more children. Participants with 8-12 wk of pregnancy had a significantly higher median SQLQ-F score than those with 25 wk of pregnancy or longer (p < 0.05). There was a positive correlation between SQLQ-F and MAT scores (r = 0.447. p < 0.001), suggesting that the higher the quality of sexual life, the better the marital adjustment. Health care professionals should be aware of the effect of sexual life on marital adjustment.

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.

Unmet and Exceeded Expectations for Sexual Concerns across the Transition to Parenthood

Expectations play a key role in shaping sexual and relationship well-being. Across the transition to parenthood, couples navigate many changes to their sexual relationships, yet little is known about their expectations related to sex. This longitudinal study investigated how unmet and exceeded expectations for postpartum sexual concerns - assessed in pregnancy and compared to experiences at 3-months postpartum - affect sexual and relationship well-being. Data were collected from 200 new-parent couples mid-pregnancy and at 3, 6, 9, and 12-months postpartum. Mothers' unmet expectations (i.e., sexual experiences were worse than expected) were associated with their own lower sexual and relationship satisfaction at 3-months postpartum. Partners' unmet expectations were associated with their own lower sexual satisfaction, higher sexual distress and relationship conflict, and mothers' lower sexual satisfaction. Mothers' exceeded expectations (i.e., sexual experiences were not as bad as they expected) were linked to their own and their partners' higher sexual satisfaction and lower sexual distress and relationship conflict at 3-months postpartum. Partners' exceeded expectations were only associated with mothers' lower sexual distress at 3-months postpartum. Expectations did not predict change in outcomes over time. Findings provide novel evidence that expectations for one's sexual relationship are associated with new parents' sexual and relationship adjustment during a vulnerable period for sexuality and well-being.

Attitudes toward Mothers as Sexual Beings (ATMSB): Scale Development and Associations with Satisfaction and Desire among Parents with Young Children

Societal messages about mothers indicate an incompatibility between motherhood and sexuality and women report not feeling like sexual beings after transitioning into parenthood. Research shows that negative sexual attitudes are associated with worse sexual function, indicating that negative attitudes toward mothers as sexual beings may negatively impact the sexual health of mothers and their partners. However, there is no existing tool to measure sexual attitudes about mothers. The aim of this study was to develop a tool to measure attitudes toward mothers as sexual beings (ATMSB) and examine associations with sexual satisfaction, relationship satisfaction, and desire among men and women with small children. Men and women with their first child no older than 5 (N = 481) were recruited from Qualtrics Panels. Results indicated that the ATMSB scale is a reliable and valid 11-item tool for measuring attitudes about mothers as sexual beings. The scale has two subscales, one on sexuality and quality of mothering and another on mothers' sexual interests and behaviors. ATMSB scores were associated with sexual satisfaction, relationship satisfaction and desire for men and women with young children. This scale has implications for sex research and clinical practice addressing issues that are relevant to mothers and their partners.

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

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

The Effect of Sexual Intercourse during Pregnancy on Preterm Birth: Prospective Single-Center Cohort Study in Japan

Several studies in Europe and the United States have shown that sexual intercourse (SI) during pregnancy is not associated with preterm birth. However, it is unclear whether these findings apply to pregnant Japanese women. The aim of this prospective cohort study was to elucidate the influence of SI during pregnancy on preterm birth in Japan. A total of 182 women who underwent antenatal care and delivery were included in this study. The frequency of SI was assessed using a questionnaire, and its association with preterm birth was analyzed. The results showed that SI during pregnancy was associated with a significantly higher cumulative preterm birth rate (p = 0.018), which was more pronounced for SI more than once a week (p < 0.0001). Multivariate analysis showed that SI, bacterial vaginosis in the second trimester, previous preterm birth, and smoking during pregnancy were independent risk factors for preterm birth. The combination of SI and second trimester bacterial vaginosis was associated with a 60% preterm birth rate, whereas either factor alone was associated with a lower rate, suggesting a synergistic effect (p < 0.0001). Future studies are needed to investigate the effect of prohibiting SI in pregnant women with bacterial vaginosis on preterm birth.

The Prevalence of the Risk of Sexual Dysfunction in the First and Third Trimesters of Pregnancy in a Sample of Spanish Women

Sexuality is a central aspect for all human beings. Research into the prevalence of sexual dysfunction in pregnant Spanish women is scarce. The aim of this work is to examine the prevalence of risk of sexual dysfunctions in pregnant Spanish women and determine in which trimester the greatest difficulties in sexual response occur. The sample consisted of 180 pregnant Spanish women, with an average age of 32.03 years (SD = 4.93). The participants completed a questionnaire for socio-demographic data, as well as the female sexual function index, the state/trait depression inventory, and the dyadic adjustment scale. The results indicate that the percentage of women with a risk of sexual dysfunction was 65% in the first trimester and 81.11% in the third trimester. Likewise, the highest score on the depression questionnaire was in the third trimester, and the couple's relationship also improved in the third trimester. To improve women's sex lives during pregnancy, it is recommended to increase sexual education and information for both pregnant women and their partners.

The prevalence of sexual dysfunctions in pregnant women and the correlated factors: a systematic review and meta-analysis

BACKGROUND

Sexual functions are negatively affected during pregnancy with the emergence of physical, hormonal, mental, emotional, and behavioral changes; however, there is no cumulative knowledge about the global prevalence of sexual dysfunction (SD) in pregnant women and the correlated factors in SD.

AIM

The study aimed to determine the prevalence of SD among pregnant women and the factors correlated with their SD scores.

METHODS

A systematic review and meta-analysis of studies focusing on SD in pregnant women were conducted in the PubMed, EBSCOhost, Web of Science, Turkish Medline, Scopus, Google Scholar, and Ovid databases by using the following combination of keywords: "pregnant" OR "pregnancy" AND "sexual dysfunction."

OUTCOMES

Nearly 70% of pregnant women were at risk for SD. The age of the pregnant woman, the spouse's age, and the duration of marriage were negatively correlated with the SD score, while the education level was positively correlated with it.

RESULTS

Initially, 5644 studies were identified: 693 studies were evaluated for eligibility and 668 were removed following the exclusion criteria. A total of 25 studies involving 6871 pregnant women were included in the meta-analysis. The pooled SD prevalence in pregnant women was 69.7% (95% CI, 59.9%-77.9%).

CLINICAL IMPLICATIONS

The results of this study can be used in the organization of prenatal care, especially for pregnant women at high risk for SD.

STRENGTHS AND LIMITATIONS

This meta-analysis is the first to reveal the global prevalence of SD and the factors correlated with SD scores in pregnant women. The most important limitation of this study is that it analyzes documents showing pregnant women at risk for SD according to an unconfirmed measurement tool for pregnant women.

CONCLUSION

Most pregnant women experience SD symptoms. More research is needed, specifically on validated tools that assess pregnancy-specific SD symptoms.

Quality of Sexuality during Pregnancy, We Must Do Something-Survey Study

BACKGROUND

The main aim of this study was to describe the changes in sexual desire in pregnant women during the gestation period. We also sought to analyze their sexual habits, how they perceive their partners' attitudes, and determine if they know the importance of sex education during pregnancy.

METHODS

A cross-sectional descriptive observational study was conducted using an existing 32-item questionnaire among pregnant women attending the Fetal Welfare Clinic of a reference hospital. Univariate and bivariate analyses were performed.

RESULTS

One hundred seventeen women participated. 50.4% stated that their sexual interest decreased. Aspects like the number of coitus, feeling orgasm with penetration or with masturbation, or the frequency of oral sex, were significantly reduced during pregnancy. 90.6% of the women stated that they would like to receive more sex education during pregnancy. There were no differences according to their education level, their partners' education level, or whether they believed that sexual intercourse could harm the baby.

CONCLUSIONS

Several advances have been achieved in the healthcare that physicians and midwives provide pregnant women. However, the quality of women's sex lives still declines during pregnancy. Healthcare providers should assume a proactive role, essential in helping future parents to enjoy their sexuality and dispel myths about sexuality, regardless of their education level.

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

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

Sexual Intercourse Frequency During Pregnancy: Weekly Surveys Among 237 Young Women From A Random Population-Based Sample

BACKGROUND

Significant differences in sexual frequency during pregnancy have been documented in cross-sectional and once-per-trimester longitudinal studies, with the highest sexual frequency in the first trimester and the lowest in the third trimester. However, changes in sexual frequency may be more complex than these comparisons suggest; patterns of sexual frequency have not been assessed using frequent (e.g., weekly) assessments throughout a woman's pregnancy.

AIM

To assess changes in the frequency of sexual intercourse across all weeks of pregnancy.

METHODS

We used data from 237 women (54% White; 43% Black) who reported a pregnancy during the Relationship Dynamics and Social Life (RDSL) study. RDSL was based on a random population-based sample of 992 women in the United States, aged 18 or 19, who completed a baseline interview and brief weekly follow-up surveys for 2.5 years. We used generalized multilevel modeling to fit and compare linear, quadratic, and piecewise (via b-splines) models.

OUTCOME

Weekly probability of sexual intercourse.

RESULTS

Sexual intercourse frequency clearly declined across pregnancy, yet the pattern followed the course of common pregnancy symptomology (i.e., nausea, fatigue) more closely than trimester cutoffs. The best fitting model demonstrated that the probability of sexual intercourse declined sharply (∼18% each week) between conception and 11 weeks, subsequently increased by ∼3% each week between weeks 11 and 21, and then declined steadily (∼6% each week) through the end of pregnancy.

CLINICAL TRANSLATION

Documenting more precise patterns of change in sexual frequency during pregnancy provides important information to many who wish to maintain sexual intimacy while pregnant, or to those who would otherwise find the sexual disruptions particularly challenging.

STRENGTHS & LIMITATIONS

This study is the first to document changes in sexual intercourse frequency throughout all weeks of pregnancy as they naturally occurred among a representative sample of young women. The focus on sexual intercourse limits the findings to only one aspect of human sexuality. The narrow age range of the sample precludes generalization to all pregnant women.

CONCLUSION

Changes in sexual frequency are more complex than the general declines suggested by other studies; within-trimester patterns reveal the shortcomings in understanding sexual behavior changes when aggregated by trimester, such as severely underestimating the degree of fluctuation in the first trimester. Pregnancy symptomology may be most favorable to intercourse towards the end of the first and beginning of second trimesters, and least favorable near the end of the pregnancy. Shari M. Blumenstock, Jennifer S. Barber. Sexual Intercourse Frequency During Pregnancy: Weekly Surveys Among 237 Young Women From A Random Population-Based Sample. J Sex Med 2022;19:1524-1535.

Communication changes the effects of sexual pain on sexual frequency in the pregnancy to postpartum transition

PURPOSE

To evaluate how sexual pain influences changes in sexual frequency from the pregnancy to postpartum transition, and to examine how couple's sexual communication interacts with sexual pain during pregnancy.

METHODS

We explored data following 159 mixed-sex couples across the transition from pregnancy to 6 months postpartum. Couples completed the Relationship Quality Interview and the Marital Satisfaction Inventory-Revised, which assessed their sexual communication, pain and other sexual problems during pregnancy, and frequency of intercourse at pregnancy and postpartum.

RESULTS

Overall, couples reported a decline in sexual activity from pregnancy to postpartum. Women's sexual pain during pregnancy influenced changes in sexual frequency only among couples who reported poorer communication about sex. Among couples reporting sexual pain and good communication, pain did not impact changes in sexual frequency (i.e. they experienced significant declines in sexual activity into the postpartum period, as expected). In contrast, among couples with poor communication, sexual frequency did not significantly decline.

CONCLUSION

Our findings suggest that sexual communication alters the effects of sexual pain on postpartum sexual activity. Future research should examine if sexual communication training during pregnancy improves postpartum sexual wellbeing.

Sexual activity based fears during pregnancy, sexual function and dyadic adjustment in couples who are expecting their first child

Purpose: Sexual activity based fears during pregnancy are common, but very few studies have examined their association with relationship variables. Secondary analysis of associations between these fears during pregnancy and both partners' sexual function and dyadic adjustment were conducted.Materials and Methods: A sample of 67 French-Canadian first-time parenting couples living in Ontario completed online questionnaires on sexual activity based fears, sexual function, and dyadic adjustment as experienced during pregnancy.Results: While one-third of participants reported no fears, other couples experienced one to six fears, the two most common fears among partners being inducing labor and causing a miscarriage. Dyadic path analyses supported indirect associations between sexual activity based fears and lower dyadic adjustment via poorer sexual function. During pregnancy, these fears in women and men are associated with poorer dyadic adjustment in both partners through the women's poorer sexual function.Conclusion: These findings suggest including prenatal sexual activity based fears in perinatal sexuality counseling, education, and interventions.

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.

Changes in the Sexual Behavior of Partners in Each Trimester of Pregnancy in Otwock in Polish Couples

The aim of this study was to improve knowledge regarding pregnant couples by assessing changes in their sexual behavior, the reasons for the frequency and forms of intercourse, and the self-sexuality of partners in each trimester of pregnancy. As a result, 100 couples were qualified to take part in the final study, with 100 men and 100 women examined at intervals equivalent to the trimesters of pregnancy. These women (n = 100) and men (n = 100) were partners. Each of the studied couples was assessed in the trimesters of pregnancy. A prospective examination was conducted based on the observation of the same people, which were heterosexual couples, throughout pregnancy. The data used in the study was obtained using Davies’ Sexual Satisfaction Scale (DSSS), as well as an original survey on the sexuality of people during pregnancy (SARSS). The survey allowed us to obtain sociodemographic (metrics) information along with information regarding the sexual activity, satisfaction, and sexual attraction of the partners. All questionnaire questions were answered in paper form. There was a statistically significant drop in sexual intercourse from the first trimester in the second and third trimesters. The frequency of masturbation increased in men and decreased in women. The most common cause of sexual abstinence during the pregnancy was cited as fear for the fetus by all genders. A statistical analysis indicated that the average overall scores of the DSSS for the examined women in the first trimester of pregnancy were statistically significantly higher than in the two subsequent trimesters (p < 0.05). Sexual satisfaction, measured through both DSSS and SARSS, was also strongly correlated with the level of satisfaction in the assessment of the partner relationship and with the sense of one’s own attractiveness (p < 0.05). Changes in sexual behavior and sexual problems are often exposed or worsened during a first pregnancy and can have negative impacts on a person and the future of relationships. Medical staff should be trained in the assessment of sexual difficulties in people during pregnancy, in order to conduct reliable education and increase the awareness of couples regarding sexual and reproductive health.

A Longitudinal Examination of Common Dyadic Coping and Sexual Distress in New Parent Couples during the Transition to Parenthood

New parents experience significant disruption to their sexual relationships such as lower desire and sexual frequency relative to prepregnancy. Little is known about the sexual distress new parents feel related to these changes, how sexual distress evolves over time, or how coping with stress relates to this distress. New parent couples who engage in more adaptive, joint coping with mutual stressors-common dyadic coping (CDC)-may be better able to manage distress related to their sexuality and thus, experience less sexual distress at 3-months postpartum and experience more marked improvement over time. In 99 first-time parent couples, we examined the link between CDC measured at 3-months postpartum and trajectories of sexual distress across 3-, 6-, and 12-months postpartum. Analyses used dyadic latent growth curve modeling informed by the actor-partner interdependence model. Mothers' sexual distress at 3-months postpartum was clinically elevated and higher than their partner's. Mothers' sexual distress declined significantly over time, whereas partners' sexual distress remained low and stable. An individual's higher perceptions of CDC was significantly associated with their own (but not their partner's) lower sexual distress at 3-months postpartum. No significant associations were found between CDC and change in sexual distress over time. How new parents jointly cope with stressors early in the postpartum period may lessen the distress they have about their sexuality at a time when most couples have just resumed sexual activity. Results identify CDC as a possible novel target for interventions aimed at helping couples manage sexual distress during the transition to parenthood.

Variable Sexual Satisfaction in Pregnancy: A Latent Profile Analysis of Pregnant Wives and Their Husbands

Although not all couples achieve high levels of sexual satisfaction during pregnancy, evidence of variability in couple sexual satisfaction during pregnancy indicates that sexual dissatisfaction in pregnancy does not apply to all. Subsequently, the current study examined whether a nationally representative U.S. sample of wives and husbands (N = 523 couples) fell into subgroups in terms of their sexual satisfaction during pregnancy and to what degree biopsychosocial factors distinguish potential subgroups. Latent profile analyses, adjusted for pregnancy-related biological factors, indicated that couples could be classified into two subsets - a larger subset of couples where wives and husbands were satisfied with sex overall (79%) and a smaller subset where wives and husbands were neutral about satisfaction with sex (21%). Lower depressive symptoms among wives was associated with a greater likelihood of being in the more satisfied subset over the less satisfied subset - the only significant group membership predictor among a variety of other factors. Implications include notions that couples and practitioners should consider women's depressive symptoms throughout pregnancy in addition to the perinatal period, and that most U.S. newly married pregnant couples do well navigating sexual satisfaction challenges during pregnancy.

Is Expectant Couples' Similarity in Attitudes to Sex during Pregnancy Linked to Their Sexual Well-being? A Dyadic Study with Response Surface Analysis

Despite sexual activity being safe for the majority of expectant couples (i.e., the pregnant individual and their partner), negative attitudes toward having sex during pregnancy are common and are related to lower sexual well-being across this vulnerable life period. Using dyadic response surface analysis in a sample of 254 first-time expectant couples, we examined the degree to which expectant partners demonstrated similar versus dissimilar attitudes to sex during pregnancy and whether specific patterns of couples' similarity in attitudes may uniquely contribute to their sexual satisfaction and sexual distress. Couples' more positive attitudes (i.e., the more both partners perceived sexual activity as non-threatening to their pregnancy), rather than partners' similarity in attitudes, were associated with lower sexual distress for both partners and higher sexual satisfaction for male partners. In couples where partners held more dissimilar attitudes, men demonstrated greater distress when their female partner's attitudes were more positive than their own. To promote sexual well-being during pregnancy, interventions should assist couples to attain stronger positive attitudes to sex during pregnancy by targeting concerns about sex in both expectant partners.

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.

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.

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.

To what extent do postpartum contraception policies or guidelines exist in Australia and New Zealand: A document analysis study

Women are susceptible to unintended, rapid repeat pregnancies in the first 12 months postpartum. Access to postpartum contraception, specifically long-acting reversible contraception, enables better planning of pregnancy timing and spacing and allows optimisation of health before the next conception. Clinical Practice Guidelines (CPG), and implementation policies, supported by consumer input, can improve such access. We searched publicly available Australian and New Zealand guidelines and policy documents addressing postpartum contraception. One CPG detailed specific information about postpartum contraception and, although of high quality, requires modification to local contexts to support implementation and policy development.

Perspectives from Highly Religious Families on Boundaries and Rules About Sex

We investigated the intersection of religion and boundaries placed around sex using qualitative data from 198 highly religious Muslim, Christian, and Jewish families. Coding performed by two researchers resulted in six core themes that provide insight into the connection between these two domains. Frequency counts of the core themes, participant quotes, and implications are presented-including the benefits of practitioners inquiring into how clients' faith affects sexual behavior and scripts, how fidelity and vows might serve a protective function for the relationships of highly religious couples, and how religion may empower women in terms of sexual boundary setting.

How Empathy Moderates Associations Between Sexual and Relational Satisfaction

Those with low sexual satisfaction tend to have low relational satisfaction. However, literature provides examples of those who maintain satisfying relationships despite low sexual satisfaction yet provides few clues as to what factors protect these individuals. Using U.S. nationally representative data from 1569 newlywed couples, we investigated if empathy for one's partner buffers individuals and couples from low relational satisfaction due to low sexual satisfaction. The positive connection between sexual satisfaction and relational satisfaction was weak for those reporting high empathy but was strong for those reporting low empathy. Empathy may protect against poor relational satisfaction when sexual satisfaction is low.

Prevalence of female sexual dysfunction during pregnancy in Eastern Mediterranean Regional Office Countries (EMRO): a systematic review and meta-analysis

BACKGROUND

Sexual dysfunction is potential abnormality in the ability of a person to sexual respond or enjoy sexual experience. During pregnancy, sexual function is at risk and disorder due to physical, hormonal and psychological changes. The prevalence of female sexual dysfunction is very variable during pregnancy.

OBJECTIVE

The aim of this study was to determine the prevalence of sexual dysfunction in pregnant women in the Eastern Mediterranean Regional Office Countries (EMRO) by meta-analysis and systematic methods.

MATERIALS AND METHODS

This study was reported based on the PRISMA checklist for systematic review and meta-analysis. This study investigated all articles with full English text in the EMRO region, from the international databases from 2000 to January 2019, which examined the prevalence of the sexual dysfunction in pregnant women. Statistical analysis was performed by using STATA12.1software.

RESULTS

The results reveal that the prevalence of the sexual dysfunction in pregnant women is65% (95% CI: 54-75%). The mean of total sexual dysfunction in women was 22.71 (95% CI: 18.52-28.51%) and for the first, second and third trimester of pregnancy were obtained as 23.77 (95% CI: 28.56-28.96%), 23.80 (95% CI: 23.78-23.82%) and 22.60 (95% CI: 22.58-22.62%), respectively.

CONCLUSION

The prevalence rate of sexual dysfunction is high in pregnant women in the EMRO region. The high rate of sexual dysfunction can be due to the difference in sexual performance scoring using the female sexual function questionnaire and on the other hand, pregnant women may be due to incorrect beliefs about sexual activity and cultural, religious and social restrictions and taboos, they have been avoiding to express their sexual function correctly.

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.

Correlation between depressive symptoms and sexual dysfunction in postpartum women during the COVID-19 pandemic

OBJECTIVE

To evaluate the relation between sexual function and depressive symptoms in puerperal women during the pandemic period.

STUDY DESIGN

Prospective cohort with 125 women evaluated in the immediate postpartum period (before the pandemic - T1) in Hospital de Clínicas de Porto Alegre, 3 months (pandemic onset - T2) and 6 months (pandemic peak - T3) after birth by email and WhatsApp. The Female Sexual Function Index (FSFI) and the Edinburgh Postnatal Depression Scale (EPDS) were applied.

RESULTS

Fifty puerperal women participated in the three periods of the study. The median age was 25 years. There was an inverse correlation between the ​​ FSFI and EPDS values at T2 (p < 0.001) and T3 (p < 0.001), demonstrating that the worsening sexual response was secondary to the higher prevalence of depressive symptoms in the puerperium in the COVID-19 pandemic. There was an increase in EPDS scores in the three periods: at T1, the EPDS scores ​​were 5.0 (2.0-9.0), increasing to 7.0 (4.0-14.0) at T2 and 6.5 (3.0-13.0) at T3 (p = 0.004). There was no difference between the FSFI index at the three evaluated times.

CONCLUSIONS

Puerperal women are a susceptible subgroup for sexual dysfunction and depressive symptoms, which are correlated to each other and worsen in periods of stress, therefore, it is mandatory to investigate depressive symptoms in puerperal women with sexual complaints, especially during the COVID-19 pandemic.

Effectiveness of postpartum sexual health education programme structured according to Levine's conservation model: An interventional study

AIM

This study aimed to determine the effects of a postpartum sexual health education programme structured according to Levine's conservation model on postpartum women.

METHODS

The interventional study was completed with 67 postpartum women. The intervention group was given the postpartum sexual health education programme structured according to Levine's conservation model. The control group received routine discharge training. The data were collected using a personal information form, The Index of Female Sexual Function, Arizona Sexual Experience Scale and Golombok-Rust Inventory of Sexual Satisfaction.

RESULTS

It has been determined that the decrease in sexual arousal and desire is the first among postpartum sexual problems experienced by women. This study demonstrated that sexual function, sexual satisfaction and sexual response were higher in nonbreastfeeding women, women who had sexual intercourse one to three times a week and women who could talk to health care professionals on sexual matters. After the programme, the intervention group had more adequate sexual function, and they developed a strong, easy and satisfactory sexual response than the control group (p < 0.05).

CONCLUSION

This programme was effective in increasing the sexual functions and satisfaction of the postpartum women. Models provide guidance to nurses for provision of care in a systematic manner.

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

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

Factors Affecting the Variation in Sexual Activity and Response before and During Pregnancy among Pregnant Women in Rasht City, Northern Iran

BACKGROUND

Pregnancy is one of the most sensitive periods in a woman's life, which sexual activity and intercourse are affected by the variations in physical, hormonal, and mental conditions. This study aimed to investigate the factors affecting the variations in sexual response before and during pregnancy.

MATERIALS AND METHODS

This cross-sectional study was conducted on pregnant women at Rasht city (northern Iran), 2018. The data were collected using the pregnancy sexual response inventory (PSRI). Statistical analysis was performed using descriptive and inferential tests by SPSS 25 at a significance level of P<0.05.

RESULTS

The mean total score of sexual activity and response of the subjects before and during pregnancy were 73.04 ± 14.81 and 46.88 ± 16.51, respectively. The variations in the total score of sexual activity and response during pregnancy decreased by 26.16 points during pregnancy compared to before pregnancy. There was a positive correlation between the number of children and the score of the variations in sexual activity and response before and during pregnancy (r=0.143).

CONCLUSION

Couples with a higher level of education and a lower number of children had fewer variations in their sexual response. Therefore, it is possible to enhance the couples' sexual health through encouraging them to appropriately plan for childbearing, to share the responsibilities of taking care of their children, and to continue their education at higher levels.

Prevalence and Incidence of Human Papillomavirus (HPV) Infection Before and After Pregnancy: Pooled Analysis of the Control Arms of Efficacy Trials of HPV-16/18 AS04-Adjuvanted Vaccine

Objective

Data on human papillomavirus (HPV) prevalence around pregnancy were inconsistent. We assessed HPV prevalence before and after pregnancy, HPV incidence after pregnancy, and risk factors for HPV infection.

Method

Data from 15 754 women in control arms of 5 AS04-HPV-16/18 vaccine efficacy trials were analyzed, including 3001 women with at least 1 pregnancy. Results of HPV deoxyribonucleic acid testing on cervical samples were available. We analyzed risk factors, including age, region, pregnancy and its outcomes, duration from pregnancy resolution to collection of first postresolution cervical sample, previous HPV infection, cigarette smoking, and number of sexual partners with Cox regression.

Results

Prevalence of high-risk oncogenic (hr)-HPV types was similar before and after pregnancy (20.8% vs 19.8%). Incidence of hr-HPV was 40.1 per 1000 person-years (95% confidence interval [CI], 23.4–64.2) at 0–3 months, 266.7 (95% CI, 217.4–323.7) at 3–6 months, and 95.7 (95% CI, 83.9–108.7) at >6 months after pregnancy. Risk factors associated with HPV infection after pregnancy are previous HPV infection, elective abortion, and younger age at pregnancy resolution.

Conclusions

Pregnancy could not be confirmed as a risk factor for HPV infection in this population despite an increased incidence detected 3–6 months after pregnancy resolution. Most women remained HPV negative after pregnancy.

Clinical Trial Registration

NCT001226810 (HPV-008 trial), NCT00294047 (HPV-015 trial), NCT00316693 and NCT00929526 (HPV-032/063 trials), and NCT00779766 (HPV-039 trial).

Impact of Gestational Diabetes Mellitus on Sexual Function: A Case-Control Study

Background: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide, and this condition may be compromising female sexual function. However, there are controversial findings regarding the impact of GDM diagnosis and proposed treatments on sexual function during pregnancy. Therefore, this study seeks to elucidate the impact of GDM on sexual function in pregnant women by making a comparison between GDM and non-GDM groups using pregnancy sexual response inventory (PSRI). Materials and Methods: A case-control study involved 303 [168 women without GDM (control group) and 108 women diagnosed with GDM (case group)] Brazilian pregnant women at the Perinatal Diabetes Research Centre-Universidade Estadual Paulista, Brazil. PSRI was used to collect the data. The sexual function was scored in 10 domains as composite and specific scores by domains, categorized into quartiles (0 < 25 "very low," 25 < 50 "low," 50 < 75 "high," and 75-100 "very high"), for "before pregnancy" and "during pregnancy." The obtained data were subjected to statistical analysis using Student's t-, F-, and chi-square tests. Results: GDM women (PSRI composite score <50) are at risk of decreased sexual function during pregnancy, while non-GDM women are not at risk (PSRI composite score >50). There were no significant differences in the sexual functions between the two groups before pregnancy (p > 0.0001). After GDM diagnosis and proposed treatment, the differences were significant (p < 0.0001), notably in the frequency, arousal, orgasm, satisfaction, and dyspareunia score. Conclusions: This study showed that GDM diagnosis and proposed treatment resulted in decreased sexual functions during pregnancy.

Understanding women's postpartum sexual experiences

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

Breastfeeding and Sexual Activity and Sexual Quality in Postpartum Women

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

Sexual communal motivation in couples coping with low sexual interest/arousal: Associations with sexual well-being and sexual goals

Women coping with female sexual interest/arousal disorder (FSIAD) report lower sexual and relationship satisfaction compared to healthy controls. In community samples, high sexual communal strength (i.e., the motivation to meet a partner's sexual needs) is associated with higher sexual desire and satisfaction, but high unmitigated sexual communion (i.e., the prioritization of a partner's needs to the exclusion of one's own needs) is associated with lower sexual satisfaction. People higher in sexual communal strength report engaging in sex for approach goals (i.e., to enhance intimacy in their relationship), but not for avoidance goals (i.e., to avert conflict or a partner's disappointment) and this is one reason why they report greater sexual desire. In the current sample of 97 women diagnosed with FSIAD and their partners we investigated the association between sexual communal strength and unmitigated sexual communion and sexual well-being (i.e., sexual desire, sexual satisfaction and sexual distress) and sexual goals (i.e., approach and avoidance goals). Women who reported higher sexual communal strength were more likely to pursue sex for approach goals and their partner reported greater sexual satisfaction. When partners reported higher sexual communal strength, they reported higher sexual desire, but when they reported higher unmitigated sexual communion, they reported higher sexual distress. Additional associations emerged for couples who engage in sex more (compared to less) frequently. Our findings demonstrate that being motivated to meet a partner's sexual needs is associated with greater sexual well-being for couples coping with FSIAD, but when this motivation involves neglecting one's own needs, people do not report greater sexual well-being and instead, partners report higher sexual distress.

Sexual Motivation in Couples Coping with Female Sexual Interest/Arousal Disorder: A Comparison with Control Couples

A lack of interest in sex is a common sexual issue, especially among women, and can be associated with lower relationship satisfaction and greater psychological distress. Research on sexual motivation has demonstrated that, in both community and clinical samples, people higher in sexual communal strength (motivated to meet their partner's sexual needs) and approach sexual goals (motivated to engage in sex to pursue positive outcomes) report higher desire and relationship satisfaction; whereas people higher in avoidance sexual goals (motivated to engage in sex to avert negative outcomes) tend to report lower desire and satisfaction. In the current study, we compared the sexual motivation of women diagnosed with female sexual interest/arousal disorder (FSIAD), who report chronic low desire and arousal accompanied by distress, and their partners (N = 97 couples) with couples without a sexual dysfunction (N = 108 couples). Women with FSIAD reported lower sexual communal strength and approach goals and higher avoidance sexual goals compared with control women and their own partners. However, the partners of women with FSIAD did not report differences in sexual motivation compared with control partners. Sexual motivation may be a target for future intervention studies with couples coping with low desire and arousal.

First-time parents' experiences of proximity and intimacy after childbirth - A qualitative study

OBJECTIVE

To explore first-time parents' experiences of proximity and intimacy after childbirth.

METHODS

This was a qualitative study. Individual interviews with a sample of six women and six men were conducted in December 2017. The data were analysed using systematic text condensation.

RESULTS

In the first theme, the parents described that their mutual attraction was affected by the female body changes during pregnancy and childbirth. The second theme described how the baby represented a new focus, resulting in a form of intimacy that was more sensual than sexual. The third theme described how pain, fear and new priorities changed couples' intimacy, making their sex life a challenge.

CONCLUSION

First-time parents had varied experiences of proximity and intimacy after the birth. When they chose to prioritize each other, attraction increased, strengthening their relationship and even when busy, those who wanted to be intimate with their partner found sufficient time. During this process, there was sometimes an imbalance between the partners' sexual needs. Intimacy was then challenged, but not necessarily weakened. New parents need information and guidance on changes that may affect proximity and intimacy in their relationship after childbirth, but receive very little information.

Sexual Activity and Attitudes as Predictors of Sexual Satisfaction During Pregnancy: A Multi-Level Model Describing the Sexuality of Couples in the First 12 Weeks

The sexual satisfaction of couples during pregnancy is an under-researched area of study. Several limitations exist within the current literature, including a lack of inquiry into attitudes about sex during pregnancy, analysis of the relationship between sexual satisfaction and sexual behaviors, and analysis of dyadic interactions within the couple. The purpose of the current study was to examine the relationships between attitudes toward having sex during pregnancy, various sexual behaviors, and sexual satisfaction among expectant couples via multilevel structural equation modeling. Recruitment focused on mixed-gender monogamous couples where the pregnant individual was between 8 and 12 weeks of gestation, and both partners were soon-to-be first time parents. Touching, hugging, or holding, kissing, vaginal and oral sex, and rubbing each other's genitals were all common behaviors among the 116 couples in the current investigation. Anal sex and sex toy use were less common, but far from absent. According to our model, attitudes toward having sex during pregnancy significantly predicted sexual satisfaction by operating through specific sexual behaviors: kissing, vaginal fingering, and vaginal intercourse, while use of a toy alone and use of a toy with partner were independent predictors of sexual satisfaction. Gender had a direct relationship with satisfaction (men were more satisfied), as well as indirect relationship with satisfaction through an interaction with vaginal fingering and use of a sex toy alone. While multiple past month sexual behaviors were likely to increase satisfaction among pregnant and non-expectant couples alike, this improvement might depend on which behaviors are included and the gender of the individual.

Daily Sexual Desire and Its Impact on Next-Day Desire and Behavior in Mixed Sex Couples

Sexual desire contributes to overall sexual and relational health among long-term romantic partnerships. However, little research has examined the nuances of partner-level sexual desire and behavior on a daily level, despite evidence that it ebbs and flows and is more of a state than a static characteristic. Additionally, daily sexual behavior and desire may impact women differently than men. Therefore, understanding individual and partner-level dynamics among men and women may provide a more nuanced understanding of sexual desire as a situational state in the context of long term couples. A sample of 87 mixed-sex couples (174 individuals; M age = 33 years) in long-term relationships (M = 9.33 years) completed a daily electronic report for 30 days and reported on their daily sexual desire and sexual behavior. A series of four stability influence actor partner interdependence models were conducted to investigate the individual and partner-level link between men and women's daily levels of sexual desire and their sexual behavior and desire the following day. Findings indicated that daily sexual desire fuels sexual desire on the following day, particularly for men, regardless of whether sexual behavior was engaged in. Additionally, sexual desire on one day impacts next-day desire for partners, particularly on days when sexual behavior occurred. Contextual, partner-level contributing factors seem to have the largest impact on daily levels of sexual desire among long-term couples. Implications and future research directions are discussed.

Resumption of sex after a second birth: An Australian prospective cohort

BACKGROUND

Few longitudinal studies have examined women's experiences of sex after childbirth. Much of the advice given to couples about what to expect in relation to sex after childbirth is based on cross-sectional studies.

OBJECTIVE

To investigate timing of resumption of sex after a second birth and assess associations with obstetric factors (method of birth and perineal trauma) and time interval between first and second births.

METHOD

Prospective cohort of 1507 nulliparous women recruited before 25 weeks' gestation in Melbourne, Australia followed up at 3, 6, 9, and 12 months after first births, and 6 and 12 months after second births. Measures include: obstetric factors and resumption of vaginal sex after first and second births.

RESULTS

By 8 weeks after their second birth, 56% of women had resumed vaginal sex, compared with 65% after their first birth. Women were more likely to resume sex later than 8 weeks postpartum if they had a spontaneous vaginal birth with episiotomy or sutured perineal tear (aOR: 2.21, 95% CI: 1.5-3.2), operative vaginal birth (aOR: 2.60, 95% CI: 1.3-5.3) or cesarean delivery (aOR: 2.15, 95% CI: 1.4-3.3) compared with a vaginal birth with minimal or no perineal trauma. There was no association between timing of resumption of sex and the time interval between births.

CONCLUSION

For almost half of the cohort, sex was not resumed until at least 8 weeks after the second birth. Timing of resumption of sex was influenced by obstetric factors, but not the time interval between births.

Personality and Postpartum Sexual Functioning in Israeli Women: The Mediating Role of Body Image

In this study, we aimed to measure the association between the postpartum personality and sexual functioning. This association was examined in light of the possible mediation effect of body image measures, that is, body satisfaction and body exposure during sexual activity. This cross-sectional study employed a web-based questionnaire for women who had given birth in the previous year ( N = 382). Key outcome measures included sexual functioning after birth, body image satisfaction, neuroticism, and extraversion personality dimensions. Among the key findings, increased anxiety regarding body exposure during sexual activity and lower body satisfaction were associated with lower postpartum sexual functioning. Higher neuroticism, but not extraversion, was associated with lower postpartum sexual functioning; however, this association was mediated by the body image measures. Given this mediation by body image variables, it may be beneficial to address body image issues when treating women with postpartum sexual difficulties.

Dificuldades relacionadas ao aleitamento materno: análise de um serviço especializado em amamentação

Resumo Objetivo Analisar a associação entre o tipo de aleitamento e as dificuldades relacionadas à essa prática entre mulheres e crianças assistidas em um ambulatório especializado em amamentação. Métodos Estudo transversal retrospectivo realizado por meio da análise de prontuários de crianças e mulheres atendidas entre 2004 e 2016 em um ambulatório especializado em aleitamento materno. Foram excluídos os registros referentes às mulheres com gestação múltipla e àqueles não realizados em formulário padrão, totalizando 1.608 prontuários. Utilizaram-se os testes Qui-Quadrado e Kruskal-Wallis para comparar o tipo de aleitamento materno com variáveis categóricas; e com os dias de vida e idade materna, respectivamente. O teste Mann-Whitney utilizou-se para comparar a frequência do aleitamento materno exclusivo. Resultados O aleitamento materno exclusivo foi praticado por 72,6% das mulheres atendidas, nos primeiros 30 dias após o parto. Houve associação significativa entre esta prática e as dificuldades: percepção materna quanto à quantidade de leite produzida, de mamas cheias antes das mamadas, de vazamento de leite e extração manual do leite com facilidade; posicionamento materno e da criança, preensão, sucção e deglutição da criança adequados; além das variáveis: maior escolaridade, situação conjugal estável; ter tido experiência prévia com aleitamento materno, ter mamilos protrusos, ter realizado contato precoce pele a pele, ter filhos com menor média de dias de idade e que faziam uso de chupeta. Conclusão O aleitamento materno exclusivo foi o mais prevalente nos primeiros 30 dias pós-parto e diversas variáveis maternas e neonatais estiveram associadas à essa prática no primeiro atendimento em ambulatório especializado.