Sexual well-being after pregnancy loss

By Audrey Chu and Grace Schwenck

This blog is a summary of our published article:

Allsop, D. B., Huberman, J. S., Cohen, E., Bagnell, K. B., Péloquin, K., Cockwell, H., & Rosen, N. O. (2024). What does a pregnancy loss mean for sex? Comparing sexual well-being between couples with and without a recent loss. Archives of Sexual Behavior53(1), 423-438. https://doi.org/10.1007/s10508-023-02697-1

One in four women experience one or more pregnancy losses (unintended loss of pregnancy) in their lives [1]. Pregnancy loss can be traumatic and damaging to individuals’ psychological and relational well-being, especially for the individual who was pregnant when the loss occurred [1]. Despite the prevalence of pregnancy loss, and the importance of sexual well-being for promoting couples’ intimacy and supporting coping, few studies have examined the impacts of pregnancy loss on a couple’s sexual well-being.

Our study aimed to expand on previous research and investigate how pregnancy loss may be linked to changes in sexual well-being.

 

What did we do?

We studied two samples of couples. One sample included 103 couples who experienced a pregnancy loss within the previous four months and the  comparison sample included 120 couples who had never experienced a pregnancy loss.

We asked couple members to independently complete surveys asking about their sexual satisfaction, sexual desire, sexual functioning (such as genital responses), sexual distress, and frequency of sexual activity. We then compared these results across the two groups to better understand how sexual well-being may change after pregnancy loss.

What did we find and what does it mean?

We found that couples who experienced a recent pregnancy loss reported lower sexual satisfaction than couples who had not experienced a pregnancy loss. It is possible that the sexual satisfaction of couples who experienced a recent loss is impacted by grief and memories of the loss arising during sex [2, 3].  

However, couples who experienced a recent pregnancy loss did not report poorer sexual desire, sexual functioning, sexual distress, or sexual frequency, compared to the couples who had not experienced a recent loss. It may be that these aspects of sexual well-being relate more to one’s personal experiences and feelings (sexual desire, functioning, and distress) or are an objective behaviour (frequency of sex), whereas sexual satisfaction is a more relational factor that may be more sensitive to the impacts of navigating pregnancy loss and grief.

Unexpectedly, partners who were not pregnant when the loss occurred reported lower sexual distress than partners in the comparison group
It is possible that the non-pregnant partners who experienced loss may be less focused on sex following the loss, and directing their energy towards managing their grief and supporting their partner [2].

Notably, individuals who were pregnant when the loss occurred reported lower sexual desire than their partners who were not pregnant. These differences in desire may be linked to the greater physical [4] and psychological [5] burdens experienced by individuals who were pregnant at the time of the loss.

Overall…

Our findings suggest that, aside from reduced sexual satisfaction and differences in sexual desire, pregnancy loss does not broadly affect other areas of couples’ sexual well-being.

This information can be used by couples and clinicians alike to better understand and contextualize how pregnancy loss can affect sexual well-being and offer hope that couples can maintain intimacy during times of grief.

References

 [1] Diamond, D. J., & Diamond, M. O. (2016). Understanding and treating the psychosocial consequences of pregnancy loss. In A. Wenzel (Ed.), The Oxford handbook of perinatal psychology (pp. 487-523). Oxford University Press.

[2] Patterson, J. M. (1988). Families experiencing stress: I. The Family Adjustment and Adaptation Response Model: II. Applying the FAAR model to health-related issues for intervention and research. Family Systems Medicine, 6(2), 202–237. https://doi.org/10.1037/h0089739

[3] Jaffe, J., & Diamond, M. O. (2011). Reproductive trauma: Psycho-therapy with infertility and pregnancy loss clients (1st ed.). American Psychological Association.

[4] Jurkovic, D., Overton, C., & Bender-Atik, R. (2013). Diagnosis and management of first trimester miscarriage. British Medical Journal, 346(7913), 34–37. https://doi.org/10.1136/bmj.f3676

[5] Markin, R. D. (2016). What clinicians miss about miscarriages: Clinical errors in the treatment of early term perinatal loss. Psychotherapy, 53(3), 347–353. https://doi.org/10.1037/pst0000062