By Samantha Dawson, PhD

This blog is a summary of our published article: Dawson, S. J., Vaillancourt-Morel, M-P., Pierce, M., & Rosen, N. O. (in press). Biopsychosocial predictors of trajectories of postpartum sexual function in first-time mothers. Health Psychology. doi: 10.1037/hea0000861

Sexual function, which includes things like desire, arousal, orgasm, and satisfaction, is a core component of sexual health. Although problems with sexual function are relatively common, affecting up to 55% of women in the general population [1], the postpartum period is a particularly vulnerable time for women’s sexual function. Indeed, such problems can newly emerge or peak following the birth of a child, likely due to the biological, psychological, and social changes that occur [2].

Previous research finds between 20% to 68% of first-time mothers experience problems with their sexual function at 3-months postpartum, with 5% to 37% of mothers reporting continued problems at 12-months postpartum [2]. Although these estimates suggest that mothers’ sexual function improves over time, it doesn’t say anything about what these patterns of improvement look like or if all new mothers show similar patterns. 

The literature is mixed in terms of what factors contribute to sexual function problems postpartum. Some research finds that postpartum sexual function is negatively associated with biomedical factors related to labor and delivery (e.g., vaginal versus caesarean, episiotomy, epidural, induction, the degree of tearing, and breastfeeding). Other research suggests that problems with sexual function postpartum are more strongly linked to psychosocial factors (e.g., sexual frequency or sexual problems during pregnancy, fatigue, depression, distress, and relationship dissatisfaction) [1].

We had two main goals for the present study:

(1) Is postpartum sexual function captured by one or multiple trajectories?

 

(2) Are the biomedical and psychosocial factors listed above linked with these trajectories?

 

What did we do?

We recruited 646 first-time mothers from the IWK Health Centre in Halifax, Nova Scotia during their 20-week ultrasound. Mothers completed surveys online where they reported on their sexual function in pregnancy and at 3-, 6-, and 12-months postpartum. Biomedical and psychosocial factors were assessed at delivery and 3-months postpartum.

 

What did we find?

Our data revealed three unique trajectories of postpartum sexual function.

(1) Minimal sexual function problems group: 52% of mothers fell into this group. Mothers in this group had sexual function scores that were above clinical cut-off at 3-months postpartum suggesting that they were experiencing minimal sexual function problems and their sexual function continued to improve postpartum.

(2) Moderate sexual function problems group: 35% of mothers fell into this group. Mothers in this group had sexual function scores that were below the clinical cut-off at 3-months postpartum suggesting that they were experiencing moderate sexual function problems, and their sexual function improved the most postpartum.

(3) Marked sexual function problems group: 13% of mothers fell into this group. Mothers in this group had sexual function scores that were well below the clinical cut-off at 3-months suggesting that they were experiencing marked sexual function problems, and their sexual function improved somewhat over time.

Biomedical factors were not related to whether or not a first-time mother was in the moderate or marked problems groups.

Psychosocial factors were related to membership in the moderate and marked problems groups. Mothers reporting higher sexual distress at 3-months postpartum were more likely to be in the moderate and marked sexual function problems subgroups, whereas mothers reporting higher sexual function in pregnancy were less likely to be in these groups. Mothers reporting lower depressive symptoms and higher relationship satisfaction at 3-months postpartum were less likely to be in the marked problems group.

What does it mean?

Given that pregnancy and childbirth is one of the most universal experiences of women worldwide, and that changes to sexual function commonly accompany this experience, understanding what change looks like and the factors associated with changes in sexual function is critically important. Our data suggest that changes to women’s sexual function are not uniform and that some women are at greater risk of continued problems than others. Importantly, our data suggest that psychosocial, but not biomedical, factors are important for understanding who is at risk of continued difficulties.

This information can be used to educate new parents about what to expect with regard to their postpartum sexual function, as well as identify mothers at risk of continued sexual function problems who would benefit from early intervention. Unlike biomedical factors that cannot be changed, psychosocial factors can be targeted in treatments. Our data may be used to inform the development of new treatments that target improving sexual function in pregnancy and strengthening couples’ connection, as well as lowering distress and depressive symptoms.

References

 [1] McCabe, M. P., Sharlip, I. D., Lewis, R., Atalla, E., Balon, R., Fisher, A. D., . . . Segraves, R. T. (2016). Incidence and prevalence of sexual dysfunction in women and men: a consensus statement from the Fourth International Consultation on Sexual Medicine 2015. The Journal of Sexual Medicine, 13, 144-152.

[2] McBride, H. L., & Kwee, J. L. (2017). Sex after baby: Women’s sexual function in the postpartum period. Current Sexual Health Reports, 9, 142-149.

 

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