The Relationship between Sexual Functioning and Depressive Symptomatology in Postpartum Women: A Pilot Study

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.

Investigating the relationship between menopausal women's health anxiety and sexual performance and attitude towards menopause

BACKGROUND

Menopause is a natural event in the life of women. Women's concerns during menopause and the role of health anxiety in the attitude and sexual performance of women during this period affect the quality of life. Therefore, the present study was conducted with the aim of determining the relationship between health anxiety and sexual performance and attitude towards menopause in postmenopausal women.

MATERIALS AND METHODS

The present study was a cross-sectional study of communication type that was conducted on 200 postmenopausal women with records in Sabzevar Comprehensive Health Centers in 2021-2022. In order to collect information, standard questionnaires of health anxiety, attitude towards menopause, and sexual performance were used. The collected data were analyzed by SPSS version 16 software and descriptive and analytical statistical tests (Spearman). A significance level of less than 0.05 was considered.

RESULT

The results of data analysis showed that health anxiety has a significant relationship with the dimensions of desire (p = 0.045 and r = -0.142) and sexual pain (p < 0.001 and r = 0.274). Also, there was a significant relationship between the attitude towards menopause with sexual performance (p < 0.001 and r = 0.244) and health anxiety with the attitude towards menopause (p < 0.001 and r = 0.27).

CONCLUSION

The results of this study showed that there is an inverse relationship between health anxiety and sexual desire and a significant direct relationship with sexual pain. Also, the attitude towards menopause has a significant direct relationship with sexual behavior and health anxiety. Therefore, it is suggested to pay attention to the mental health of postmenopausal women along with the physical aspect and to pay attention to educational programs to improve the care and health programs of these women.

Longitudinal Associations between Depressive Symptoms and Postpartum Sexual Concerns Among First-time Parent Couples

Most first-time parents experience novel concerns about their sexuality such as worries about the effects of labor and delivery on their sex lives. The link between postpartum depressive symptoms and problems with sexual function is bidirectional; however, associations with postpartum sexual concerns (i.e., worries about one's sexuality that are not necessarily related to sexual function) have not been examined. First-time parent couples (N = 99) completed measures assessing their postpartum sexual concerns and depressive symptoms at 3, 6, and 12 months postpartum. Dyadic latent growth curve modeling revealed that mothers' and partners' initial frequencies of postpartum sexual concerns were positively associated, with significant declines in the frequency of these concerns over time for both partners. Mothers' and partners' initial depressive symptoms were also positively associated; however, mothers' depressive symptoms did not change over time whereas partner's depressive symptoms worsened. Mothers' and partners' higher initial depressive symptoms were associated with partners' higher frequency of postpartum sexual concerns. Mothers' depressive symptoms at 3 months postpartum and the degree to which these symptoms changed over time were associated with a steeper decline in partners' postpartum sexual concerns over time. Results provide preliminary support for depressive symptoms as a risk factor for partners' postpartum sexual concerns.

Evaluation of Psychometric Properties of the Persian Version of Brief Male Sexual Function Inventory: A Cross-Sectional Study

INTRODUCTION

Male sexual dysfunction is a common problem, and there are many self-report questionnaires for measuring sexual function among men; however, the Brief Male Sexual Function Inventory (BSFI) is a tool that has 5 subscales, which is more complete than others. a validated self-report questionnaire, in the local language with modest expressions is required for men.

AIM

To determine the validity and reliability of the Persian version of the BSFI among men.

METHODS

This cross-sectional study was conducted on 200 males. The sampling process was performed in several stages from health centers. After the accomplishment of the standard process of back-translating the questionnaire from English to Persian, its face, content, and construct validity were evaluated. The collected data were analyzed using confirmatory factor analysis, multivariate analysis of variance, and Pearson correlation coefficient. To determine the reliability of the instrument, the test-retest method was used with 2 weeks interval and the Cronbach's alpha coefficient method was applied to check the internal homogeneity.

MAIN OUTCOME MEASURES

Reliability (internal consistency and test-retest) and validity were assessed RESULTS: According to the research findings, confirmatory factor analysis had an acceptable fit. By modifying the measurement model and fitting the final model, the fitting indices were obtained as the following: Chi-square statistic = 21.63, NPAR = 36, P = .001 > 0.05; Tucker-Lewis index = 0.956; comparative fit indices = 0.976; Normed Fit Index = 0.952; and root mean square error of approximation = 0.068. These values indicated that the obtained model had a good fit for the data. Moreover, Cronbach's alpha and intra-cluster correlation coefficients of the whole questionnaire were calculated at 0.893 and 0.893, respectively (confidence interval between 0.811-0.950), showing the internal consistency of the items in the whole questionnaire and domain.

CONCLUSION

The BSFI questionnaire showed a 5-factor structure similar to the original structure and the 11-item Persian version of the questionnaire of male sexual function can be considered a valid and reliable tool to assess the level of male sexual function. Rezaei N, Sharifi N, Fathnezhad-Kazemi A, et al. Evaluation of Psychometric Properties of the Persian Version of Brief Male Sexual Function Inventory: A Cross-Sectional Study. Sex Med 2021;9:100409.

Quality of life and sexual function after a pregnancy complicated by placenta accreta spectrum

BACKGROUND AND AIMS

Little is known about the impact of Placenta Accreta Spectrum (PAS) on quality of life (QoL). This study aims to explore QoL and sexual function after a pregnancy complicated by PAS.

METHODS

Women who experienced a pregnancy complicated by PAS were invited to complete an online survey. Two validated surveys were completed: Short Form 36 (SF-36) and Female Sexual Function Index (FSFI). The mean scores were calculated and were compared between women by pregnancy outcomes. Continuous variables were presented as mean (standard deviation (SD)) and were compared to assess for significance between groups using independent t-test and one-way analysis of variance. Categorical variables were compared using χ² test.

RESULTS

A total of 142 women responded to the survey. For the SF-36, physical health was significantly higher for women at 24-36 months postpartum compared to those from 0-6 months postpartum for physical functioning (mean difference 21.9 (95% confidence interval (CI) 10.2, 33.5), role limitation due to physical function (mean difference 32.1 (95% CI 9.4, 54.7)) and pain (mean difference 15.5 (95% CI 3.4, 30.9)). For the mental health domains, only vitality improved at 24-36 months compared to the first six months postpartum (mean difference 12.8 (95% CI 0.2, 25.5)). The mean FSFI score was 24.8 (±5.8), lower than the critical score of 26.5 indicating sexual dysfunction, and 56.8% (n = 75), scored less than 26.5.

CONCLUSION

Women after a pregnancy complicated by PAS had high scores on the physical health domains of SF-36. The mental health scores were lower for all women regardless of time since birth.

#postbabyhankypanky: An Empirically Based Knowledge Sharing Initiative About Sex and the Transition to Parenthood

Despite the many sexual concerns experienced by new parents, and their reported desire for more information on this topic, both parents and healthcare providers remain reticent to broach the subject. The goal of this project was to disseminate evidence-based knowledge from our prior research in a way that was accessible, engaging, and would spark further interest and communication for both new parents and healthcare providers. We convened a multidisciplinary advisory group that also involved community parents who provided feedback at all phases of this project. We developed five brief YouTube videos, each featuring a core research finding. Following an empirically supported strategic knowledge translation plan, we disseminated the videos to our target audiences (i.e., expectant and new parents, healthcare providers, educators, and other stakeholders) using social media from February 2018 to November 2019. Data were collected using YouTube analytics and an online survey (convenience sample: N = 225 parents; N = 161 healthcare providers). From the date of the launch, the videos had a reach of 91,766 views from 14 countries, with viewers watching an average of 90% of a video. Overall, quantitative and qualitative survey results suggested that the videos were acceptable and appropriate, and respondents were more confident and comfortable discussing sexual issues (with their partner/with their patients) and would like more information about postpartum sexuality after watching the videos. YouTube videos are an acceptable and effective way to disseminate evidence aimed at raising awareness of factors affecting sexuality in the transition to parenthood.

#postbabyhankypanky: An Empirically Based Knowledge Sharing Initiative About Sex and the Transition to Parenthood

Despite the many sexual concerns experienced by new parents, and their reported desire for more information on this topic, both parents and healthcare providers remain reticent to broach the subject. The goal of this project was to disseminate evidence-based knowledge from our prior research in a way that was accessible, engaging, and would spark further interest and communication for both new parents and healthcare providers. We convened a multidisciplinary advisory group that also involved community parents who provided feedback at all phases of this project. We developed five brief YouTube videos, each featuring a core research finding. Following an empirically supported strategic knowledge translation plan, we disseminated the videos to our target audiences (i.e., expectant and new parents, healthcare providers, educators, and other stakeholders) using social media from February 2018 to November 2019. Data were collected using YouTube analytics and an online survey (convenience sample: N = 225 parents; N = 161 healthcare providers). From the date of the launch, the videos had a reach of 91,766 views from 14 countries, with viewers watching an average of 90% of a video. Overall, quantitative and qualitative survey results suggested that the videos were acceptable and appropriate, and respondents were more confident and comfortable discussing sexual issues (with their partner/with their patients) and would like more information about postpartum sexuality after watching the videos. YouTube videos are an acceptable and effective way to disseminate evidence aimed at raising awareness of factors affecting sexuality in the transition to parenthood.

A phenomenological study of Jordanian women's experience of sexual intercourse after giving birth

AIM

to explore the sexual experiences of Jordanian women on the first occasion after giving birth.

METHODS

phenomenological qualitative research. Twenty-five Jordanian women were purposively recruited from two maternal health centres and interviewed.

FINDINGS

four themes emerged: "culture and religion v/s health professionals in resumption of sexual intercourse"; "enduring physical and psychological discomforts"; "husbands' role in resumption of sexual intercourse"; and "newborn babies' role in the experience of sexual intercourse".

CONCLUSION

health professionals need to adopt appropriate maternal clinical guidelines to meet women's needs. There is a need to give greater emphasis on sexual health care provided to women during pregnancy and after giving birth.

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.

Resumption of sexual intercourse post partum and the utilisation of contraceptive methods in China: a cross-sectional study

OBJECTIVE

This is a cross-sectional study that aimed to examine the resumption of sexual intercourse post partum, the utilisation of contraceptive methods and the influencing factors among Chinese women at a tertiary teaching hospital.

DESIGN

This is a questionnaire survey by written and online interview for participants.

PARTICIPANTS

Based on medical records, we sent online questionnaires about postpartum sexual intercourse and contraception plans to 550 eligible women.

MAIN OUTCOME MEASURES

Potential factors affecting postpartum sexual intercourse and utilisation of contraception were determined by analysis of epidemiological and clinical factors and sexual experiences during and after pregnancy.

RESULTS

Of 550 eligible participants, 406 women (73.8%) with a postpartum period of 8.5 months (range 6-10) completed the questionnaires; 146 of 406 (36.0%) resumed sexual intercourse within 3 months, and 259 of 279 (92.8%) used contraceptive methods. In univariate and multivariate analyses, sexual intercourse during pregnancy (adjusted OR 4.4, 95% CI 2.8 to 6.9) and resumption of menstruation (adjusted OR 2.5, 95% CI 1.5 to 4.3) were significant influencing factors in resumption of sexual intercourse within 3 months after childbirth. No factor was found to be associated with using contraceptive methods or the general resumption of sexual intercourse post partum. The questionnaire had good reliability and validity.

CONCLUSIONS

Having sexual intercourse during pregnancy and resuming menstruation earlier were independent factors for resumption of sexual intercourse within 3 months after delivery. Almost all women who had postpartum sexual intercourse used various contraceptive methods.

Sexuality and Sexual Identity Across the First Year of Parenthood Among Male-Partnered Plurisexual Women

Women who (a) hold plurisexual identities (e.g., bisexual, pansexual) and (b) are male-partnered are understudied. Of interest is how these women construct their sexual identities across the transition to parenthood-a period associated with intensified heteronormative expectations, and changes in women's roles and identities. This longitudinal study of 28 plurisexual, male-partnered women examined women's sexual identity construction across the first year of parenthood, using four waves of data. Most women were White, bisexual-identified, and first-time parents. The majority of women described decreases in the salience or centrality of their sexuality more generally. Almost all women continued to hold plurisexual identities across the first year of parenthood, although many described these as private identities amidst public assumptions of heterosexuality. Some, though, sought to maintain a connection to their plurisexual identities through sexual identity disclosure, same-gender fantasies, and involvement in consensual nonmonogamy. Although only one woman articulated a shift in sexual identity label (from bicurious to heterosexual), others increasingly distanced themselves from their same-gender behaviors and desires. Our findings illustrate how women engage in an active process of sexual identity construction amidst heteronormative pressures, and how they navigate tensions amongst their partnership and parenthood statuses and their private identities and past behaviors.

Prevalence of and risk factors associated with sexual health issues in primiparous women at 6 and 12 months postpartum; a longitudinal prospective cohort study (the MAMMI study)

BACKGROUND

Many women are not prepared for changes to their sexual health after childbirth. The aim of this paper is to report on the prevalence of and the potential risk factors (pre-pregnancy dyspareunia, mode of birth, perineal trauma and breastfeeding) for sexual health issues (dyspareunia, lack of vaginal lubrication and a loss of interest in sexual activity) at 6 and 12 months postpartum.

METHODS

A longitudinal cohort study of 832 first-time mothers who were recruited in early pregnancy and returned postnatal surveys at 3, 6, 9 and 12 months postpartum were assessed for sexual health issues and associated risk factors.

RESULTS

Nearly half of the women (46.3%) reported a lack of interest in sexual activity, 43% experienced a lack of vaginal lubrication and 37.5% of included women had dyspareunia 6 months after birth. On univariate analysis, vacuum-assisted birth, 2nd degree perineal tears, 3rd degree perineal tears and episiotomy were all associated with dyspareunia 6 months postpartum, but, of these only 3rd degree tears, in association with breastfeeding and pre-existing dyspareunia, remained significant on multivariable analysis. Breastfeeding, in combination, with other significant factors, was associated with dyspareunia, a lack of vaginal lubrication and a loss of interest in sexual activity 6 months postpartum, and, dissatisfaction with body image emerged as a significant factor associated with lack of interest in sexual activity at 12 months postpartum. Pre-pregnancy dyspareunia and breastfeeding emerged as common factors associated with all three outcomes of dyspareunia, a lack of vaginal lubrication and a loss of interest in sexual activity at 6 months postpartum.

CONCLUSION

Breastfeeding and pre-existing dyspareunia are associated with sexual health issues at 6 months postpartum. Pre-existing dyspareunia is associated with a lack of vaginal lubrication at 12 months postpartum and breastfeeding is associated with dissatisfaction with body image. Preparing women and their partners during the antenatal period and advising on simple measures, such as use of lubrication to avoid or minimise sexual health issues, could potentially remove stress, anxiety and fears regarding intimacy after birth. Introducing the topic of pre-existing sexual health issues antenatally may facilitate appropriate support, treatment or counselling for women.

The Relationship Between Body Image, Female Genital Self-Image, and Sexual Function Among First-Time Mothers

The purpose of this cross-sectional study was to examine the extent to which perceived changes in weight, body satisfaction, body-image self-consciousness, and genital self-image could be used to predict sexual function scores. A total of 168 primiparous women completed the cross-sectional, web-based survey. Significant correlations were found between body satisfaction, body-image self-consciousness, and female genital self-image and sexual function. Multivariate regression analysis suggests body image and genital self-image combined account for 14.1% of the variance in overall sexual function. Women should have opportunities to discuss body changes throughout pregnancy.

Sexual activity and sexual dysfunction of women in the perinatal period: a longitudinal study

PURPOSE

Reduced sexual activity and dysfunctional problems are highly prevalent in the perinatal period, and there is a lack of data regarding the degree of normality during pregnancy. Several risk factors have been independently associated with a greater extent of Female Sexual Dysfunction (FSD). Therefore, this study aimed to assess the prevalence of sexual inactivity and sexual dysfunctions in German women during the perinatal period and the verification of potential risk factors.

METHODS

Questionnaires were administered to 315 women prenatally (TI 3rd trimester) and postpartum (TII 1 week, TIII 4 months), including the Female Sexual Function Index (FSFI), the Edinburgh Postnatal Depression Scale (EPDS), and the Questionnaire of Partnership (PFB).

RESULTS

The frequency of sexual inactivity was 24% (TI), 40.5% (TII), and 19.9% (TIII). Overall, 26.5-34.8% of women were at risk of sexual dysfunction (FSFI score <26.55) at all measurement points. Sexual desire disorder was the most prevalent form of Female sexual dysfunction. Furthermore, especially breastfeeding and low partnership quality were revealed as significant risk factors for sexual dysfunctional problems postpartum. Depressive symptoms having a cesarean section and high maternal education were correlated with dysfunctional problems in several subdomains.

CONCLUSIONS

Findings indicated that women at risk of FSD differed significantly in aspects of partnership quality, breastfeeding, mode of delivery, maternal education, and depressive symptoms. Aspects of perinatal sexuality should be routinely implemented in the counseling of couples in prenatal classes.

For new mothers, the relationship matters: Relationship characteristics and postpartum sexuality

Postpartum sexuality has traditionally been studied using a biomedical framework, which focuses on how the physical and biological changes that occur during pregnancy and childbirth affect the resumption of pain-free intercourse. The current study sought to use a more inclusive and contextual approach by investigating how relationship characteristics are related to postpartum sexual desire and predict the resumption of a variety of sexual activities. A total of 188 new mothers who were within one year postpartum completed an online study. The Sexual Desire Inventory was used to measure solitary and dyadic sexual desire. Relationship satisfaction was measured using the Relationship Assessment Scale and perception of partner's sexual desire was measured using three modified questions from the Sexual Desire Inventory. New mothers were also asked to report when they resumed a variety of sexual activities in the postpartum period. Relationship satisfaction and perceptions of partner's desire were negatively correlated with solitary sexual desire, and relationship satisfaction was positively correlated with dyadic sexual desire. Birth-related factors were not related to postpartum sexual desire. New mothers' perception of their partner's desire predicted the resumption of most sexual activities in the postpartum (i.e., manual stimulation of new mother's and partner's genitals, oral stimulation of partner's genitals, penile-vaginal intercourse). Relationship satisfaction predicted the resumption of oral stimulation of the new mother's genitals. The results of this study support the incorporation of contextual factors, such as relationship characteristics, and the inclusion of non-penetrative sexual activities in the study of postpartum sexuality.

[What do we know about perinatal sexuality? A scoping review on sexoperinatality - Part 2]

The intimate and sexual dimension of future and new parenting couples' relationship is the most affected and the most vulnerable during the transition to parenthood. The purpose of this scoping review is to present the portrait of perinatal sexuality through 123 empirical articles published in the last 15 years. This second article in a series of two is about sexuality during labor and birth, during the postpartum, and in relation to breastfeeding. A total of 29 sexual variables were analyzed. Sexuality during the intrapartal and postnatal periods is very diversified. Some recurring items, however, can be identified: a period of non-sexuality in the first postnatal months, followed by a gradual return of sexuality from 3 to 6 months postpartum and continuing until 12 months or more. Sexuality during the intrapartum is considered taboo and couples' experiences can be at opposite ends: some couples' experiences are sensual and erotic during childbirth, while others experience birth trauma with a negative sexual impact postnatally. Sexuality during breastfeeding is also taboo with a negative impact on women's sexuality. In all of these circumstances, women's and men's sexuality are affected and a multitude of simultaneous physiological and psychological factors affect their experiences. Fluctuations in the intimate and sexual dimensions of the conjugal relationship are considered as a natural phenomenon but temporary. Sexoperinatal interventions should be part of holistic perinatal health care in order to help couples maintain a positive intimate and sexual relationship.

Postpartum sexual health: a principle-based concept analysis

AIM

The aim of this study is to report an analysis of the concept of postpartum sexual health.

BACKGROUND

Postpartum sexual health is a minimally understood concept, most often framed within physical/biological dimensions or as a 'checklist' task in postpartum information provision. This has the potential to leave women unprepared to manage transient or normative sexual health changes after childbirth. For meaningful discussions, clarity and understanding of postpartum sexual health is required.

DESIGN

A principle-based method of concept analysis.

DATA SOURCES

The databases of PubMed, CINAHL, Maternity and Infant Care, PsychInfo, Web of Science, EMBASE, SCOPUS and Social Science Index were systematically searched, from their earliest dates, using a combination of key terms, including; 'sexual health', 'sexual function', 'dyspareunia', 'sexuality', 'sexual desire', 'sexual dysfunction', 'postnatal' and 'postpartum', resulting in a final included dataset of 91 studies.

METHODS

Using the principle-based approach, postpartum sexual health was analysed under the four philosophical principles of epistemological, pragmatic, linguistic and logical.

RESULTS

Philosophically, postpartum sexual health is underdeveloped as a concept. A precise theoretical definition remains elusive and, presently, postpartum sexual health cannot be separated theoretically from sexuality and sexual function. Identified antecedents include an instrument free birth, an intact perineum and avoidance of episiotomy. Attributes include sexual arousal, desire, orgasm, sexual satisfaction and resumption of sexual intercourse. Outcomes are sexual satisfaction and a satisfying intimate relationship with one's partner.

CONCLUSION

Postpartum sexual health is conceptually immature with limited applicability in current midwifery practice.

Prevalence and risk factors of sexual dysfunction in postpartum Australian women

INTRODUCTION

Female sexual dysfunction is highly prevalent and reportedly has adverse impacts on quality of life. Although it is prevalent after childbirth, women rarely seek advice or treatment from health care professionals.

AIM

The aim of this study was to assess the sexual functioning of Australian women during the first year after childbirth.

METHODS

Postpartum women who had given birth during the previous 12 months were invited to participate in this cross-sectional study. A multidimensional online questionnaire was designed for this study. This questionnaire included a background section, the Female Sexual Function Index, the Patient Health Questionnaire (PHQ-8), and the Relationship Assessment Scale. Responses from 325 women were analyzed.

RESULTS

Almost two-thirds of women (64.3%) reported that they had experienced sexual dysfunction during the first year after childbirth, and almost three-quarters reported they experienced sexual dissatisfaction (70.5 %). The most prevalent types of sexual dysfunction reported by the affected women were sexual desire disorder (81.2%), orgasmic problems (53.5%), and sexual arousal disorder (52.3%). The following were significant risk factors for sexual dysfunction: fortnightly or less frequent sexual activity, not being the initiator of sexual activity with a partner, late resumption of postnatal sexual activity (at 9 or more weeks), the first 5 months after childbirth, primiparity, depression, and relationship dissatisfaction.

CONCLUSION

Sexual satisfaction is important for maintaining quality of life for postpartum women. Health care providers and postpartum women need to be encouraged to include sexual problems in their discussions.

Depressive symptoms, pain, and sexual dysfunction over the first year following vaginal or cesarean delivery: A prospective longitudinal study

BACKGROUND

Childbirth has a significant impact on maternal health, and the high rate of cesarean delivery is a global health concern. Few studies have used validated measures to explore depression, pain, and sexual dysfunction following vaginal or cesarean delivery over a prolonged time period.

OBJECTIVE

We examined the associations between vaginal and cesarean delivery and depressive symptoms, pain, and sexual function during the 1-year postpartum period.

DESIGN

A prospective, five-time-point longitudinal study.

SETTING

Maternity unit at a medical center.

PARTICIPANTS

A total of 351 of 736 women completed a questionnaire that described demographic characteristics, depressive symptoms, and pain levels at 3-5 days postpartum, and updated personal data, depressive symptoms, pain levels, and sexual function at 4-6 weeks and at 3, 6, and 12 months after delivery.

METHODS

Differences between the vaginal and cesarean groups in depressive symptoms, pain, and sexual function and trends of changes in these factors over the first postpartum year were examined.

RESULTS

Compared with the vaginal birth group, the cesarean birth group had a significantly higher prevalence of depressive symptoms at 3 months (p=0.03); higher scores for non-localized pain at 3-5 days (p<0.001), 4-6 weeks (p=0.03), and 3 months (p=0.046); higher scores for abdominal pain at 3-5 days (p<0.001), 4-6 weeks (p<0.001), and 6 months (p=0.01); lower perineal pain scores at 3-5 days (p <0.001); and higher sexual desire scores (p=0.04) but lower sexual satisfaction scores (p=0.02) at 4-6 weeks. Differences between the vaginal and cesarean groups were significant (p=0.01, p=0.049, respectively) in terms of the decrease in non-localized pain from 3-5 days to 4-6 weeks postpartum and the increase in sexual desire from 4-6 weeks to 3 months postpartum.

CONCLUSIONS

Cesarean delivery was associated with an increased prevalence of depressive symptoms at 3 months and higher pain levels that persisted at 6 months postpartum in Taiwan. We found no difference in sexual function between vaginal and cesarean delivery after 6 weeks postpartum, and no differences in the trends related to depressive symptoms or in sexual functioning (except for desire) within 1 year postpartum.

[Female sexuality and parenthood]

From the child conception to the early years of life, couples generally present less sexual activity. Parenthood constraints are a burden for the couple's relationships. Generally, persistent sexual difficulties six months after delivery, despite those generated by depression or altered health raise the question of an alteration in the quality of the couple's relationships and lack of satisfaction of the mother with her partner's involvement in family life. Numerous parameters can be implied, especially with persistent trouble of desire, such as fatigue, body image problems and libido lessening of the partner due to modifications of his status. Women who presented sexual difficulties before pregnancy remain the same. In all cases, appropriate information can avoid the intimacy's difficulties and contribute to maintain pleasure and intimacy even when vaginal penetration remains difficult.

The relationship between depressive/anxiety symptoms during pregnancy/postpartum and sexual life decline after delivery

INTRODUCTION

Several factors have been found to be independently associated with decline in sexual activity after delivery. However, the association between depression in pregnancy/postpartum and sexual problems is less clear.

AIM

To prospectively evaluate the relationship between depressive/anxiety symptoms (DAS) during the perinatal period and sexual life in the postpartum period.

METHODS

A prospective cohort study conducted between May 2005 and March 2007 included 831 pregnant women recruited from primary care clinics of the public sector in São Paulo, Brazil. Four groups with DAS during antenatal and postpartum periods were identified using the Self Report Questionnaire (SRQ-20): absence of both antenatal and postpartum DAS; presence of antenatal DAS only; presence of postpartum DAS only; and presence of both antenatal and postpartum DAS. The primary outcome was perception of sexual life decline (SLD) before and after pregnancy/delivery. Crude and adjusted risk ratios (RR), with 95% confidence intervals (95% CI), were calculated using Poisson regression to examine the associations between DAS and SLD.

MAIN OUTCOME MEASURE

The main outcome measure of this study is the perception of SLD before and after pregnancy/delivery.

RESULTS

SLD occurred in 21.1% of the cohort. In the multivariable analysis, the following variables were independently associated with SLD: DAS during both pregnancy and postpartum (RR: 3.17 [95% CI: 2.18-4.59]); DAS during only the postpartum period (RR: 3.45 [95% CI: 2.39-4.98]); a previous miscarriage (RR: 1.54 [95% CI: 1.06-2.23]); and maternal age (RR: 2.11 [95% CI: 1.22-3.65]).

CONCLUSIONS

Postpartum women with DAS have an increased likelihood for SLD up to 18 months after delivery. Efforts to improve the rates of recognition and treatment of perinatal depression/anxiety in primary care settings have the potential to preserve sexual functioning for low-income mothers.

Depressive symptoms as a predictor of sexual function during pregnancy

INTRODUCTION

Biopsychological and sociocultural factors have been reported to be associated with sexual function in pregnancy. To date, very few studies have focused on the relationship between sexual function and depression during pregnancy.

AIM

To determine whether depressive symptoms predict overall sexual function, desire, arousal, lubrication, orgasm, satisfaction, and pain during pregnancy by using the Female Sexual Function Index (FSFI).

METHODS

Pregnant women undergoing prenatal examinations were randomly selected for this cross-sectional investigation. The study included 555 pregnant women who completed the Taiwanese versions of the Center for Epidemiologic Studies Depression Scale (CES-D), FSFI, and a demographic questionnaire during pregnancy.

MAIN OUTCOME MEASURES

CES-D scores for depressive symptoms, scores for overall sexual function on the FSFI, and the FSFI domains: desire, arousal, lubrication, orgasm, satisfaction, and pain.

RESULTS

After adjusting for demographic factors, CES-D scores during the first trimester negatively predicted overall sexual function (P=0.0004), arousal (P=0.0104), lubrication (P=0.0016), orgasm (P=0.0022), and pain (P<0.0001). Moreover, CES-D scores during the third trimester negatively predicted sexual desire (P=0.0005) and satisfaction (P<0.0001). Furthermore, gestational age negatively predicted overall sexual function, arousal, lubrication, orgasm, and pain (all P<0.0001). Parity was a positive predictor of overall sexual function, arousal, lubrication, and orgasm (all P<0.0005). Medical conditions were positive predictors of sexual desire (P=0.0023).

CONCLUSIONS

The present study revealed that depressive symptom scores during early and late pregnancy were significant negative predictors of sexual function during pregnancy.