Couples and the first baby: responding to new parents' sexual and relationship problems

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.

"Opening up a well of emotions": A qualitative study of men's emotional experiences in the transition to fatherhood

AIM

To explore the emotional changes and reactions men experience in their transition to fatherhood.

DESIGN

This study used a qualitative design.

METHODS

Data were collected through in-depth interviews with 13 Norwegian fathers.

RESULTS

Through thematic analysis, three main themes were developed: (1) from self-focus to family perspective; (2) emotional vulnerability; and (3) from insecurity to self-assurance. The themes describe fathers' emotional process during the child's first year of life, ranging from positive feelings like affection and mastery, to challenging feelings like exclusion, jealousy and exhaustion. Many fathers describe taboos and shame over their own emotional reactions, although these can be considered a natural part of the postnatal period.

Development of a Japanese Version of the Index of Sexual Satisfaction for Use in Couples with Young Children

The occurrence of sexual dysfunction in couples after childbirth is well recognized, yet sexual satisfaction in couples with young children (CYC) has received little research attention. This study sought to enable this construct to be measured by developing and validating a Japanese version of the Index of Sexual Satisfaction (ISS) in CYC. Data were collected using a self-administered questionnaire. Scale construction and validation were conducted using two independent samples drawn from 316 mothers and 272 fathers in Japan who had at least one child aged 6 or younger. Two underlying factors were identified using exploratory factor analysis: sexual satisfaction, measured by eight items, and sexual dissatisfaction, measured by three. Polychoric ordinal alpha coefficients indicated the reliability of the resulting scale (overall: 0.89, factor 1: 0.89, factor 2: 0.78), and confirmatory factor analysis and testing supported its validity, showing good model fit (goodness of fit index: 0.984, root mean square residual: 0.062) and satisfactory composite reliability (scale: 0.93, factor 1: 0.90, factor 2: 0.81) and average variance extracted (all ≥0.5). The Japanese version of the ISS for Couples with Young Children will be useful for investigating sexual satisfaction, which is essential to marital stability.

The effectiveness of "Women's Postpartum Sexual Health Program (WPSHP)" on Iranian women's postpartum sexual health: A randomized clinical trial

In this study, we examined the effectiveness of Women's Postpartum Sexual Health Program (WPSHP) on Iranian women's sexual health in the postpartum period. A single-blinded randomized clinical trial was conducted in 2016 on 80 postnatal women in Iran. We used the Female Sexual Function Index, Sexual Quality of Life - Female questionnaire and Female Sexual Distress Scale. The intervention group received counseling based on WPSHP. After 28 weeks, the mean score of the Female Sexual Function Index and Female Sexual Quality of Life significantly increased in the WPSH group (p < 0.001, p < 0.001), while the mean score of the Female Sexual Distress significantly decreased in the WPSH group (p < 0.001). We concluded that Women's Postpartum Sexual Health Program could promote postnatal women's sexual function and female sexual quality of life and reduces female sexual distress in women suffering from sexual problems in the postpartum period.

Screening for Perinatal Anxiety Using the Childbirth Fear Questionnaire: A New Measure of Fear of Childbirth

Fear of childbirth affects as many as 20% of pregnant people, and has been associated with pregnancy termination, prolonged labour, increased risk of emergency and elective caesarean delivery, poor maternal mental health, and poor maternal-infant bonding. Currently available measures of fear of childbirth fail to fully capture pregnant people’s childbirth-related fears. The purpose of this research was to develop a new measure of fear of childbirth (the Childbirth Fear Questionnaire; CFQ) that would address the limitations of existing measures. The CFQ’s psychometric properties were evaluated through two studies. Participants for Study 1 were 643 pregnant people residing in Canada, the United States, and the United Kingdom, with a mean age of 29.0 (SD = 5.1) years, and 881 pregnant people residing in Canada, with a mean age of 32.9 (SD = 4.3) years for Study 2. In both studies, participants completed a set of questionnaires, including the CFQ, via an online survey. Exploratory factor analysis in Study 1 resulted in a 40-item, 9-factor scale, which was well supported in Study 2. Both studies provided evidence of high internal consistency and convergent and discriminant validity. Study 1 also provided evidence that the CFQ detects group differences between pregnant people across mode of delivery preference and parity. Study 2 added to findings from Study 1 by providing evidence for the dimensional structure of the construct of fear of childbirth, and measurement invariance across parity groups (i.e., the measurement model of the CFQ was generalizable across parity groups). Estimates of the psychometric properties of the CFQ across the two studies provided evidence that the CFQ is psychometrically sound, and currently the most comprehensive measure of fear of childbirth available. The CFQ covers a broad range of domains of fear of childbirth and can serve to identify specific fear domains to be targeted in treatment.

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

INTRODUCTION

The puerperium is a period of adaptation in which various transformations take place in the lives of women and men on their way to becoming mothers and fathers. These changes can also have repercussions on their sexual relations. How the couple deals with this transition is crucial to the well-being of the couple and affects how parents relate to the baby.

AIM

This study aimed to explore the factors that influence sexuality in both women and men during postpartum.

METHODS

We conducted a bibliographic review of 236 articles found on the PubMed database and published from 2008 to January 2019.

MAIN OUTCOME MEASURE

The main outcome measure was the impact of various physical, psychological, and sociocultural factors on couples' sexual functioning during postpartum.

RESULTS

The main problems that couples face after childbirth can be classified as (i) psychological changes, such as loss of a sense of self, transitioning to parenthood, taking on the new roles of mother and father, and feelings of abandonment among men; (ii) body changes in women that affect their self-image and perineal trauma; (iii) hormonal changes in women and men that can lead to reduced sexual desire in both and vaginal dryness or dyspareunia in women; (iv) changes in the marital relationship, including changes in each other's roles, taking time for intimacy, and initiating sexual intercourse; (v) sociocultural influences, such as social support, culturally expected roles, and beliefs regarding when to resume sex; and (vi) lifestyle changes, especially with regard to baby care.

CONCLUSION

Sexuality during postpartum is influenced by multiple factors: physical, psychological, and sociocultural. Our findings offer a deeper understanding of how the transition to parenthood affects sexual relationships during the postpartum period. Implications regarding caring for and promoting the sexual health of individuals and couples after childbirth are discussed, and some medical recommendations for parents are offered. Serrano Drozdowskyj E, Gimeno Castro E, Trigo López E, et al. Factors Influencing Couples' Sexuality in the Puerperium: A Systematic Review. Sex Med Rev 2020;8:38-47.

The Dyadic Effects of Supportive Coparenting and Parental Stress on Relationship Quality Across the Transition to Parenthood

The transition to first-time parenthood can be challenging for couples. Using a sample of 848 ethnically diverse couples from the Fragile Families and Child Wellbeing Study across the first 3 years of parenthood, we investigated the longitudinal and dyadic associations of each parents' parental stress, supportive coparenting, and relationship quality. Results from an actor-partner interdependence model indicated that supportive coparenting significantly predicted higher relationship quality for both mothers and fathers. Fathers' supportive coparenting significantly buffered the effects of mothers' parental stress on relationship quality. Also, the unique dyadic contexts of each parents' supportive coparenting, and also both partners' parental stress were significantly associated with relationship quality. Clinical implications from these findings are discussed through commonly used clinical theories.

Parenting Stress and Sexual Satisfaction Among First-time Parents: A Dyadic Approach

The present paper reports on longitudinal associations between parenting stress and sexual satisfaction among 169 heterosexual couples in the first year after the birth of a first child. Actor Partner Interdependence Modeling (APIM) was used to model the effects of the mother's and father's parenting stress at 6 months after birth on sexual satisfaction at one year after birth. Based on social constructivist theory and scarcity theory, two hypotheses were posed: (a) mothers' parenting stress will predict their own later sexual satisfaction whereas fathers' parenting stress will not predict their own later sexual satisfaction (actor effects) and (b) mothers' parenting stress will predict fathers' later sexual satisfaction but fathers' parenting stress will not predict mothers' later sexual satisfaction (partner effects). On average, parents were only somewhat satisfied with their sex life. The first hypothesis was supported as greater parenting stress significantly predicted lower sexual satisfaction for mothers but not for fathers. The second hypothesis was also supported as mothers' greater parenting stress significantly predicted less sexual satisfaction in fathers, whereas fathers' parenting stress did not significantly predict mothers' sexual satisfaction. We discuss how our results may be interpreted considering the social construction of gendered family roles.

Perinatal depression in Asian women: prevalence, associated factors, and cultural aspects

Background and Objective: Although perinatal depression is a worldwide problem, most of the studies related to this issue have been conducted in Western countries. This paper summarizes the literature on the prevalence as well as associated factors among Asian countries where the cultural attitudes, customs, and norms are considerably different from those in Western countries.

Methods: We conducted a literature search using MEDLINE (PubMed) from 1968, PsychINFO from 1970, and SCOPUS database from 1982 using keywords “depression”, “antenatal”, “antepartum”, “pregnancy”, “postnatal”, “postpartum”, “perinatal”, “after childbirth” and “Asia”. Only the articles published in English were included.

Results: The overall prevalence of depression during pregnancy and postnatal period are about 20% and 21.8%, respectively. The factors related to perinatal depression can be grouped into the following categories, individual characteristics, husband/marital relationship, pregnancy-related, infant-related, and other psychosocial issues. While there is considerable overlap between Asian and Western countries with respect to risk factors for perinatal depression, premarital pregnancy, conflict with mother in-law, and dissatisfaction with infant’s gender are more specific to Asian cultures.

Conclusions: Studies conducted in Asian countries suggest that the prevalence of perinatal depression is slightly higher than in Western countries. There are several unique culturally related issues that clinicians treating pregnant and postpartum Asian women should be aware as they contribute to an increased risk of depression in these women.

Factors associated with relationship dissolution and post-dissolution adjustment among lesbian adoptive couples

Same-sex adoptive couples are increasingly visible, yet few studies have addressed relationship stability and dissolution among these couples. In this study, using a theoretical framework based on Investment Models and Vulnerability-Stress-Adaptation Theory, factors associated with dissolution and post-dissolution adjustment among 27 lesbian adoptive couples were examined across two points. At Wave 1, all 27 couples were together; children were on average 3 years old. Results revealed that nearly one third broke up over 5 years (between Waves 1 and 2). Factors related to shorter relationship length and undermining coparenting at Wave 1 distinguished women who later broke up versus stayed together. Worse mental health at Wave 2 characterized women in dissolved rather than sustained relationships, even with comparable individual adjustment at Wave 1. Weaker parenting alliance and greater dissatisfaction with childcare divisions were reported by women no longer with their partners at Wave 2 as compared with those in enduring partnerships. This research has implications for understanding lesbian relationship dynamics and associations with individual adjustment.

A New Baby in the Bedroom: Frequency and Severity of Postpartum Sexual Concerns and Their Associations With Relationship Satisfaction in New Parent Couples

INTRODUCTION

New parents are faced with many novel stressors, including possible changes to their sexual relationships. Although postpartum sexual concerns appear to be pervasive in new parents, little is known about the severity of these concerns or how they relate to new mothers' and fathers' relationship satisfaction.

AIM

To describe the frequency and severity of postpartum sexual concerns and examine associations between frequency and severity of postpartum sexual concerns and relationship satisfaction in new-parent couples.

METHODS

Participants were 239 new-parent couples of a healthy infant 3 to 12 months old. Both members of the parenting couple completed an online survey within 1 month of each other.

MAIN OUTCOME MEASURES

Frequency and severity of postpartum sexual concerns were assessed using a 20-item Likert-type questionnaire adapted from a previously validated measurement. Relationship satisfaction was assessed with the Couples Satisfaction Index.

RESULTS

A wide range of postpartum sexuality concerns was highly prevalent and moderately distressing in new mothers and fathers alike. New fathers' greater severity of postpartum sexual concerns was associated with their own and new mothers' decreased relationship satisfaction, whereas new mothers' greater severity of postpartum sexual concerns was associated only with lower relationship satisfaction in new fathers. In addition, new mothers' greater frequency of postpartum sexual concerns was associated with their own and new fathers' lower relationship satisfaction, whereas new fathers' frequency of postpartum sexual concerns was unrelated to the couples' relationship satisfaction.

CONCLUSION

Postpartum sexual concerns are pervasive and moderately distressing in new parents. The increased frequency and severity of these concerns were associated with decreased relationship well-being in both members of the couple. New mothers might need more assistance adjusting to the number of sexual concerns that they are experiencing, whereas new fathers might need more help adjusting to distress related to sexual issues.

The Emotional Experience of Motherhood in Planned Lesbian Families in the South African Context: "… Look How Good a Job I'm Doing, Look How Amazing We Are"

This article focuses on lesbian mothers' emotional experience of motherhood. It forms part of a larger qualitative and exploratory study with 10 lesbian couples in South Africa on their lived experience of planned motherhood. The study is located in a feminist phenomenological framework. Semi-structured interviews were conducted and interview transcripts were analyzed using thematic analysis. Participants described many different emotions associated with new motherhood: hope, joy, love, anxiety, helplessness, exhaustion, and feeling companionship and togetherness as well as feeling compromised and deprived. Mothers described these emotions but also focused on the development of a new identity, that of being a mother.

Does relationship status matter for sexual satisfaction? The roles of intimacy and attachment avoidance in sexual satisfaction across five types of ongoing sexual relationships

Are individuals more sexually satisfied in casual sexual relationships or more serious, long-term romantic ones? How are intimacy and attachment styles related to sexual satisfaction in different types of sexual relationships? The present study explored sexual satisfaction across five different types of ongoing sexual relationships: friends with benefits, casual dating, exclusive dating, engaged, and married. A sample of 475 individuals (24 males and 71 females in each group) completed online measures of sexual satisfaction, relationship intimacy, and attachment style. First, engaged individuals reported higher sexual satisfaction than all other relationship types except exclusive dating; no other significant differences emerged. Second, intimacy and sexual satisfaction were positively correlated within each relationship type; however, correlations were stronger for exclusive dating, engaged, and married relationships compared to friends with benefits and casual dating relationships. Third, attachment avoidance, but not attachment anxiety, emerged as a significant predictor for sexual satisfaction in all relationship types except casual dating. These results suggest that there may be different underlying processes involved in sexual satisfaction in different relationship types. Despite similar levels of sexual satisfaction across relationship types, there was variability in the roles of intimacy and attachment avoidance for sexual satisfaction. This variability, however, was not limited to “casual” vs. “serious” sexual relationships, as important differences also emerged between friends with benefits and casual dating relationships. Implications, limitations, and possible directions for future research are discussed.

The relation between prepregnancy sexuality and sexual function during pregnancy and the postpartum period: a prospective study

This study examined the relation between sexual functions of women in prepregnancy (before conception) and during pregnancy and the postpartum period. This study was conducted on 59 healthy pregnant women. Participants were followed from the eighth week of gestation to 6 months after delivery. Sexual function during pregnancy and the postpartum period was shown to have a significant linear correlation with prepregnancy sexuality. There was no relation between pregnancy and postpartum sexuality. All of the participants who had prepregnancy sexual dysfunction continued to experience it during pregnancy, and the majority of them had a significant level of sexual dysfunction in the postpartum period. Our results showed that prepregnancy sexuality plays an important role in maintaining sexuality during pregnancy and the postpartum period.

Sexuality following the loss of a child

The aim of study was to increase our understanding of sexuality and intimacy following the loss of a child. A questionnaire on intimacy and sexuality was sent to 1,027 members of the 2 major bereavement support organizations for parents who have lost children in Norway. A total of 321 (33%) were returned. In addition, 10 couples were interviewed in depth about their experiences. The final sample (n = 285) consisted of 169 women (59.3%) and 116 men (40.7%) who represented 175 couples. Parents who were neither married nor cohabitants were excluded, as were nonbiological parents. Around 2/3 of the parents had resumed sexual contact within the first 3 months after their child's death. The activity of about 1/3 had been reduced. Significantly fewer mothers than fathers experienced sexual pleasure and close to 30% of the mothers reported that this had been reduced since the death. Only 11% noted that sexuality as an issue was raised in follow-up conversations. Many parents have only a few sexuality-related problems following a child's death, but a fairly large minority, especially women, experience major problems, There are clear gender differences in reactions and perceptions, often agreed upon by the 2 genders. Men are ready to resume activity in the sexual area much earlier than women. Women suffer much more from grief that in different ways intrudes on the sexual act and they more often perceive sex as somehow being wrong. Men also easily misunderstand women's need for closeness as a wish for sex.

Correlates of depressive symptomatology during the second trimester of pregnancy among Hong Kong Chinese

The study investigated the correlates of antenatal depressive symptoms among Hong Kong Chinese women during their second trimester of pregnancy. A total of 2178 women were recruited at five regional public hospitals in Hong Kong to participate in a study with a cross-sectional design. Associations were examined between depressive symptoms (using the Edinburgh Postnatal Depression Scale) and socioeconomic, obstetric, and Chinese family relations. Logistic regression analysis revealed that younger age, a personal or family psychiatric history, an unplanned pregnancy, a history of menstruation discomfort or premenstrual mood change, high marital conflict, and high mother-in-law conflict were found to be associated with more severe depressive symptoms. Antenatal depression is important because of its association with risk of adverse consequences for mothers and their families. There is a consensus that depression is most treatable when detected early. These findings therefore provide important information for the prevention of antenatal depressive symptoms among the Hong Kong population, amongst whom depression is rarely talked about. The implications and limitations of these findings and directions for future research are discussed.

A vivência da gravidez do primeiro filho à luz da perspectiva paterna

Este estudo descreve a vivência do homem na gravidez do seu primeiro filho. Utilizou-se como método o estudo de caso instrumental (Stake, 1994), partindo de entrevistas com cinco homens que estavam à espera do primeiro filho, analisando-as através da análise de conteúdo (Moraes, 1999; Olabuénaga, 1996). Foi realizada uma análise vertical e horizontal dos casos, ressaltando suas idiossincrasias e seus aspectos comuns. Suas experiências variaram desde a percepção da gravidez como um período de transição ao exercício da paternidade ao sentimento de inclusão e participação na gestação. Valores e prioridades foram redimensionados na relação conjugal. A preocupação com a malformação fetal, as adversidades do mundo contemporâneo e o período adolescente são seus maiores temores. A questão financeira apareceu como principal preocupação no exercício da paternidade, seguida do desejo de envolvimento no desenvolvimento dos filhos.