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Current Sexual Health Reports

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01-09-2017 | Integrating the Psychosocial (B McCarthy, R Segraves and A Clayton, Section Editors)

Sex After Baby: Women’s Sexual Function in the Postpartum Period

Authors: Hillary L. McBride, Janelle L. Kwee

Published in: Current Sexual Health Reports | Issue 3/2017

Abstract

Purpose of Review

This paper is written to introduce postpartum sexual functioning through a biopsychosocial lens, including challenges and interventions for optimal sexual functioning during the postpartum period, both for women and their partners.

Recent Findings

While considered to be dysfunctional compared to sexual functioning outside of the perinatal period, changes to sexual functioning in the year following childbirth are common. Biological and physiological factors which affect postpartum sexual functioning include method of delivery, breastfeeding and hormonal changes, and sleep. Psychosocial factors impacting postpartum sexual functioning include mental health, identity transition with adjusting to parenting, body image, social support, cultural context, and romantic relationships. Basson’s model of female sexual response is also discussed.

Summary

Sexual functioning during the postpartum year is a biopsychosocial process which is challenging for most couples, although there are exceptions. These challenges need to be pathologized. Healthcare providers need to better support new parents with their sexual health.

Alves M, Vieira R. Facts that influence the feminine sexuality after childbirth. Theol Sex. 2008;17:139–54.

Collier F. When a couple wants a baby: what are the consequences on their sexuality? Theol Sex. 2010;19(3):143–6. doi:10.1016/j.sexol.2010.03.002.

Barrett G, Pendry E, Peacock J, Victor C, Thakar R, Manyonda I. Women’s sexual health after childbirth. BJOG Int J Obstet Gynaecol. 2000;107(2):186–95. doi:10.1111/j.1471-0528.2000.tb11689.x.CrossRef

Johnson CE. Sexual health during pregnancy and the postpartum (CME). J Sex Med. 2011;8(5):1267–84. doi:10.1111/j.1743-6109.2011.02223.x.CrossRefPubMed

Rupp HA, James TW, Ketterson ED, Sengelaub DR, Ditzen B, Heiman JR. Lower sexual interest in postpartum women: relationship to amygdala activation and intranasal oxytocin. Horm Behav. 2013;63(1):114–21. doi:10.1016/j.yhbeh.2012.10.007.CrossRefPubMed

McDonald E, Woolhouse H, Brown SJ. Consultation about sexual health issues in the year after childbirth: a cohort study. Birth. 2015;42(4):354–61. doi:10.1111/birt.12193.CrossRefPubMed

Leeman LM, Rogers RG. Sex after childbirth: postpartum sexual function. Obstet Gynecol. 2012;119(3):647–55. doi:10.1097/AOG.0b013e3182479611.CrossRefPubMed

Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in united states women: prevalence and correlates. Obstet Gynecol. 2008;112(5):970–8. doi:10.1097/AOG.0b013e3181898cdb.CrossRefPubMed

Glazener CMA. Sexual function after childbirth: women’s experiences, persistent morbidity and lack of professional recognition. Obstet Gynecol Surv. 1997;52(9):529–30. doi:10.1097/00006254-199709000-00002.CrossRef

10.

Hicks TL, Goodall SF, Quattrone EM, Lydon-Rochelle MT. Postpartum sexual functioning and method of delivery: summary of the evidence. J Midwifery Women’s Health. 2004;49(5):430–6. doi:10.1016/j.jmwh.2004.04.007.CrossRef

11.

Signorello LB, Harlow BL, Chekos AK, Repke JT. Postpartum sexual functioning and its relationship to perineal trauma: a retrospective cohort study of primiparous women. Am J Obstet Gynecol. 2001;184(5):881–90. doi:10.1067/mob.2001.113855.CrossRefPubMed

12.

O’Malley D, Higgins A, Smith V. Postpartum sexual health: a principle-based concept analysis. J Adv Nurs. 2015;71(10):2247–57. doi:10.1111/jan.12692.CrossRefPubMed

13.

LaMarre A, Paterson L, Gorzalka B. Breastfeeding and postpartum sexual functioning: a review. Can J Hum Sex. 2003;12(3–4):151–68.

14.

Dahlen HG, Barclay LM, Homer CSE. Processing the first birth: journeying into ‘motherland’. J Clin Nurs. 2010;19(13–14):1977–85. doi:10.1111/j.1365-2702.2009.03089.x.CrossRefPubMed

15.

Masters WH, Johnson VE. Human sexual response. Boston: Little, Brown; 1966.

16.

Kaplan HS. Hypoactive sexual desire. J Sex Marital Ther. 1979;3:3–9.CrossRef

17.

Basson R. The female sexual response: a different model. J Sex Marital Ther. 2000;26(1):51–65. doi:10.1080/009262300278641.CrossRefPubMed

18.

Klein MC, Gauthier RJ, Robbins JM, Kaczorowski J, Jorgensen SH, Franco ED, et al. Relationship of episiotomy to perineal trauma and morbidity, sexual dysfunction, and pelvic floor relaxation. Am J Obstet Gynecol. 1994;171(3):591–8. doi:10.1016/0002-9378(94)90070-1.CrossRefPubMed

19.

Radestad I, Olsson A, Nissen E, Rubertsson C, Institutionen för vård och natur, & Högskolan i Skövde. Tears in the vagina, perineum, sphincter ani, and rectum and first sexual intercourse after childbirth: a nationwide follow-up. Birth. 2008;35(2):98–106. doi:10.1111/j.1523-536X.2008.00222.x.CrossRefPubMed

20.

Barbara G, Pifarotti P, Facchin F, Cortinovis I, Dridi D, Ronchetti C, et al. Impact of mode of delivery on female postpartum sexual functioning: spontaneous vaginal delivery and operative vaginal delivery vs cesarean section. J Sex Med. 2016;13(3):393–401. doi:10.1016/j.jsxm.2016.01.004.CrossRefPubMed

21.

Rogers RG, Leeman LM, Migliaccio L, Albers LL. Does the severity of spontaneous genital tract trauma affect postpartum pelvic floor function? Int Urogynecol J. 2008;19(3):429–35. doi:10.1007/s00192-007-0458-x.CrossRef

22.

Rogers RG, Borders N, Leeman LM, Albers LL. Does spontaneous genital tract trauma impact postpartum sexual function? J Midwifery Women’s Health. 2009;54(2):98–103. doi:10.1016/j.jmwh.2008.09.001.CrossRef

23.

Faisal-Cury A, Menezes PR, Quayle J, Matijasevich A, Diniz SG. The relationship between mode of delivery and sexual health outcomes after childbirth. J Sex Med. 2015;12(5):1212–20. doi:10.1111/jsm.12883.CrossRefPubMed

24.

Carter CS, Pournajafi-Nazarloo H, Kramer KM, Ziegler TE, White-Traut R, Bello D, et al. Oxytocin: behavioral associations and potential as a salivary biomarker. Ann N Y Acad Sci. 2007;1098:312–22.CrossRefPubMed

25.

Avery MD, Duckett L, Frantzich CR. The experience of sexuality during breastfeeding among primiparous women. J Midwifery Women’s Health. 2000;45(3):227–37. doi:10.1016/S1526-9523(00)00020-9.CrossRef

26.

McBride H, Kwee J. Focusing on the mother in maternal health care: a review of perinatal mental health needs and promising interventions. J Psychol Ther Prim Care. 2016;5:1–25.

27.

Gawley L, Einarson A, Bowen A. Stigma and attitudes towards antenatal depression and antidepressant use during pregnancy in healthcare students. Adv Health Sci Educ. 2011;16(5):669–79. doi:10.1007/s10459-011-9289-0.CrossRef

28.

Goodman JH, Santangelo G. Group treatment for postpartum depression: a systematic review. Arch Women’s Ment Health. 2011;14(4):277–93. doi:10.1007/s00737-011-0225-3.CrossRef

29.

Traviss GD, West RM, House AO. Maternal mental health and its association with infant growth at 6 months in ethnic groups: results from the Born-in-Bradford birth cohort study. PLoS One. 2012;7(2):e30707. doi:10.1371/journal.pone.0030707.CrossRefPubMedPubMedCentral

30.

Zaers S, Waschke M, Ehlert U. Depressive symptoms and symptoms of post-traumatic stress disorder in women after childbirth. J Psychosom Obstet Gynaecol. 2008;29(1):61–71. doi:10.1080/01674820701804324.CrossRefPubMed

31.

Dennis C, Heaman M, Vigod S. Epidemiology of postpartum depressive symptoms among Canadian women: regional and national results from a cross-sectional survey. Can J Psychiatr. 2012;57(9):537–46. doi:10.1177/070674371205700904.CrossRef

32.

Bowen A, Baetz M, McKee N. Optimizing maternal mental health within a primary health care centre: a model program. Can J Commun Ment Health. 2008;27(2):105–16.CrossRef

33.

Bueno J. Life after birth. Ther Today. 2010;21(4):18–21.

34.

Astrachan-Fletcher E, Veldhuis C, Lively N, Fowler C, Marcks B. The reciprocal effects of eating disorders and the postpartum period: a review of the literature and recommendations for clinical care. J Women’s Health. 2008;17(2):227–39. doi:10.1089/jwh.2007.0550.CrossRef

35.

Hung C, Lin C, Stocker J, Yu C. Predictors of postpartum stress. J Clin Nurs. 2011;20(5–6):666–74. doi:10.1111/j.1365-2702.2010.03555.x.CrossRefPubMed

36.

Spooner S, Rastle M, Elmore K. Maternal depression screening during prenatal and postpartum care at a navy and marine corps military treatment facility. Mil Med. 2012;177(10):1208–11.CrossRefPubMed

37.

Kim K, Hong JP, Cho MJ, Fava M, Mischoulon D, Lee D, et al. Loss of sexual interest and premenstrual mood change in women with postpartum versus non-postpartum depression: a nationwide community sample of Korean adults. J Affect Disord. 2016;191:222–9. doi:10.1016/j.jad.2015.11.050.CrossRefPubMed

38.

De Judicibus MA, McCabe MP. Psychological factors and the sexuality of pregnant and postpartum women. J Sex Res. 2002;39(2):94–103. doi:10.1080/00224490209552128.CrossRef

39.

Moel JE, Buttner MM, O’Hara MW, Stuart S, Gorman L. Sexual function in the postpartum period: effects of maternal depression and interpersonal psychotherapy treatment. Arch Women’s Ment Health. 2010;13(6):495–504. doi:10.1007/s00737-010-0168-0.CrossRef

40.

Corona G, Ricca V, Bandini E, Mannucci E, Lotti F, Boddi V, et al. Selective serotonin reuptake inhibitor-induced sexual dysfunction. J Sex Med. 2009;6(5):1259. doi:10.1111/j.1743-6109.2009.01248.x.CrossRefPubMed

41.

Kitzinger S. Screaming inside: a normal response to abnormal stress. Int J Childbirth Educ. 2008;23(3):19–20.

42.

Ogden P, Minton K, Pain C. Trauma and the body. New York: W.W. Norton; 2006.

43.

Rubin R. Attainment of the maternal role. Part I: processes. Nurs Res. 1967;16:237–45.CrossRef

44.

Roth H, Homer C, Fenwick J. “Bouncing back”: how Australia’s leading women’s magazines portray the postpartum ‘body’. Women Birth. 2012;25(3):128. doi:10.1016/j.wombi.2011.08.004.CrossRefPubMed

45.

Insana SP, Costello CR, Montgomery-Downs HE. Perception of partner sleep and mood: postpartum couples’ relationship satisfaction. J Sex Marital Ther. 2011;37(5):428–40. doi:10.1080/0092623X.2011.607053.CrossRefPubMedPubMedCentral

46.

Thomas KA, Spieker S. Sleep, depression, and fatigue in late postpartum. MCN Am J Matern Child Nurs. 2016;41(2):104–9. doi:10.1097/NMC.0000000000000213.CrossRefPubMedPubMedCentral

47.

Hipp LE, Kane Low L, van Anders SM. Exploring women’s postpartum sexuality: social, psychological, relational, and birth-related contextual factors. J Sex Med. 2012;9(9):2330–41. doi:10.1111/j.1743-6109.2012.02804.x.CrossRefPubMed

48.

Mickelson KD, Joseph JA. Postpartum body satisfaction and intimacy in first-time parents. Sex Roles. 2012;67:300–10. doi:10.1007/s11199-012-0192-9.CrossRef

49.

Schlagintweit HE, Bailey K, Rosen NO. A new baby in the bedroom: frequency and severity of postpartum sexual concerns and their associations with relationship satisfaction in new parent couples. J Sex Med. 2016;13(10):1455–65. doi:10.1016/j.jsxm.2016.08.006.CrossRefPubMed

50.

Piran N, Cormier HC. The social construction of women and disordered eating patterns. J Couns Psychol. 2005;52:549–58. doi:10.1037/0022-0167.52.4.549.CrossRef

51.

Abdool Z, Thakar R, Sultan AH. Postpartum female sexual function. Eur J Obstet Gynecol Reprod Biol. 2009;145(2):133–7. doi:10.1016/j.ejogrb.2009.04.014.CrossRefPubMed

52.

Jha S, Thakar R. Female sexual dysfunction. Eur J Obstet Gynecol Reprod Biol. 2010;153(2):117–23. doi:10.1016/j.ejogrb.2010.06.010.CrossRefPubMed

53.

Babazadeh R, Mirzaii K, Masomi Z. Changes in sexual desire and activity during pregnancy among women in Shahroud, Iran. Int J Gynecol Obstet. 2013;120(1):82–4. doi:10.1016/j.ijgo.2012.07.021.CrossRef

54.

Sok C, Sanders JN, Saltzman HM, Turok DK. Sexual behavior, satisfaction, and contraceptive use among postpartum women. J Midwifery Women’s Health. 2016;61(2):158–65. doi:10.1111/jmwh.12409.CrossRef

55.

Sok C, Sanders JN, Turok DK, Royer PA, Torres L. Sexual behavior and satisfaction of postpartum women. Contraception. 2014;90(3):344. doi:10.1016/j.contraception.2014.05.178.CrossRef

56.

McDonald E, Brown S. Does method of birth make a difference to when women resume sex after childbirth? BJOG Int J Obstet Gynaecol. 2013;120(7):823–30. doi:10.1111/1471-0528.12166.CrossRef

57.

Kwee J, McBride H. Working together for women’s empowerment: strategies for interdisciplinary collaboration in perinatal care. J Health Psychol. 2015; doi:10.1177/1359105315586211.

58.

McBride HL, Olson S, Kwee J, Klein C, Smith K. Women’s postpartum sexual health program: a collaborative and integrated approach to restoring sexual health in the postpartum period. J Sex Marital Ther. 2017;43(2):147–58. doi:10.1080/0092623X.2016.1141818.CrossRefPubMed

59.

Brotto LA, Basson R. Group mindfulness-based therapy significantly improves sexual desire in women. Behav Res Ther. 2014;57:43–54. doi:10.1016/j.brat.2014.04.001.CrossRefPubMed

60.

Brotto LA, Basson R, Luria M. A mindfulness-based group psychoeducational intervention targeting sexual arousal disorder in women. J Sex Med. 2008;5(7):1646–59. doi:10.1111/j.1743-6109.2008.00850.x.CrossRefPubMed

Title: Sex After Baby: Women’s Sexual Function in the Postpartum Period
Authors: Hillary L. McBride
Janelle L. Kwee
Publication date: 01-09-2017
Publisher: Springer US
Published in: Current Sexual Health Reports / Issue 3/2017
Print ISSN: 1548-3584
Electronic ISSN: 1548-3592
DOI: https://doi.org/10.1007/s11930-017-0116-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Sex After Baby: Women’s Sexual Function in the Postpartum Period

Abstract

Purpose of Review

Recent Findings

Summary

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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