Psychological factors and the sexuality of pregnant and postpartum women - Statistical Data Included

Journal of Sex Research, May, 2002 by Margaret A. De Judicibus, Marita P. McCabe

Sexual desire in the majority of women generally decreases during pregnancy, although there may be a wide range of individual responses and fluctuating patterns (e.g., Barclay, McDonald, & O'Loughlin, 1994; Bustan, Tomi, Faiwalla, & Manav, 1995; Hyde, DeLamater, Plant, & Byrd, 1996). By the third trimester of pregnancy, approximately 75% of primigravidae report a loss of sexual desire (Bogren, 1991; Lumley, 1978.) A decrease in frequency of sexual intercourse during pregnancy is generally associated with a loss of sexual desire (e.g., Bogren, 1991; Lumley, 1978). By the third trimester, between 83% (Bogren, 1991) and 100% (Lumley, 1978) of primigravidae reported a decrease in frequency of sexual intercourse.

The general conclusion from empirical studies and clinical impressions is that many postpartum women continue to report a decline in sexual interest, desire, or libido (Fischman, Rankin, Soeken, & Lenz, 1986; Glazener, 1997; Kumar, Brant, & Robson, 1981). Women's loss of sexual desire generally leads to less sexual activity, and to loss of sexual satisfaction, although the association between these facets is far from linear (Lumley, 1978). Hyde et al. (1996) found that 84% of couples reported reduced frequency of sexual intercourse at 4 months postpartum. Enjoyment of sexual intercourse tends to return gradually after childbirth. Lumley (1978) found that there was a linear increase in the percentage of women who found intercourse enjoyable after birth, from nil at 2 weeks to about 80% at 12 weeks. Similarly, Kumar et al. (1981) found that, at 12 weeks after childbirth, about two thirds of the women found sex "mostly enjoyable," although 40% complained of some difficulties.

It is clear from the above studies that a significant proportion of women experience reduced sexual desire, frequency of intercourse, and sexual satisfaction over the perinatal period. However, less attention has been given to the magnitude of those changes, or to the factors that may contribute to them. This is the focus of this study.

LITERATURE REVIEW

A review of the literature suggests that six factors may be related to reduced sexual desire, frequency of sexual intercourse, and levels of sexual satisfaction during the postpartum period. These factors appear to be adjustment to changes in social roles (work role, mother role) of women during the transition to parenthood, marital satisfaction, mood, fatigue, physical changes associated with the birth of the child and breast-feeding. The role of each of these factors will be discussed in turn.

The perceived quality of social roles has been found to influence individual well-being and relationships (e.g., Baruch & Barnett, 1986; Hyde, DeLamater, & Hewitt, 1998). However, the impact of social roles on women's sexuality over the transition to parenthood has not been the subject of extensive empirical research. Only two published studies were located which examined the influence of women's paid employment on their sexuality during pregnancy and the early postpartum period (Bogren, 1991; Hyde et al., 1998). Bogren (1991) found no relationship between work satisfaction and sexual variables during pregnancy. However, insufficient information was provided regarding how work satisfaction was measured, nor were separate analyses reported for women and men. The larger study of Hyde et al. (1998) found that there were no significant differences between groups of homemakers, women employed part time, and women employed full time in their frequency of decreased sexual desire, nor in overall frequency of intercourse, nor sexual satisfaction at 4 or 12 months postpartum. Women's positive work-role quality was associated with a greater frequency of sexual intercourse during pregnancy, and greater sexual satisfaction and less frequent loss of sexual desire at 4 months postpartum. Nonetheless, work-role quality predicted relatively small amounts of variance in the sexual outcomes.

For most women, motherhood is a very positive experience (Green & Kafetsios, 1997). Recent mothers have reported that the best things about being a mother were watching a child's development, the love they received from children, being needed and responsible for the child, giving love to the child, helping to shape the child's life, having the child's company, and feeling contented (Brown, Lumley, Small, & Astbury, 1994).

The negative aspects of the mother role included confinement or lacking uninterrupted time and freedom to pursue personal interests (Brown et al., 1994). Other concerns were not having an active social life, needing a break from the demands of the child, inability to control or define the use of time, loss of confidence, and difficulties in coping with their infants' feeding and sleeping patterns. By 6 months postpartum, many infants' sleeping and feeding difficulties have been resolved. However, other aspects of infants' behaviors become more challenging (Koester, 1991; Mercer, 1985).

There is little empirical evidence that difficulties in the mother role are directly related to women's sexual functioning in the postpartum. Pertot (1981) found some evidence to tentatively suggest that problems in women's postpartum sexual responsiveness were related to difficulties with the mother role, since one of the adoptive mothers reported definite loss of sexual desire. It was expected that difficulties in the mother role would affect women's sexuality due to a general diminution of their well-being and disruption to their relationship with their partners.