Changes to sexual and intimate relationships in the postnatal period: women’s experiences with health professionals
Hannah Woolhouse A B , Ellie McDonald A and Stephanie J. Brown AA Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, WL5, Royal Children’s Hospital, Flemington Road, Parkville, Vic. 3052, Australia.
B Corresponding author. Email: hannah.woolhouse@mcri.edu.au
Australian Journal of Primary Health 20(3) 298-304 https://doi.org/10.1071/PY13001
Submitted: 9 January 2013 Accepted: 19 May 2013 Published: 1 July 2013
Abstract
Women navigate many social changes when they become a mother, often including considerable changes to intimate and sexual relationships. This paper draws on data collected in an Australian multicentre prospective nulliparous pregnancy cohort study and a nested qualitative substudy exploring women’s experiences of sex and intimacy after the birth of their first child. In all, 1507 women were recruited in early pregnancy (mean gestation 15 weeks) and completed self-administered questionnaires at 3, 6 and 12 months and 4.5 years postpartum. Eighteen participants were interviewed 2.5–3.5 years after the birth of their first child regarding sex and intimacy after having a baby. Interviews were transcribed verbatim and analysed using interpretive phenomenological analysis. Cohort data reveal a considerable drop in both emotional satisfaction and physical pleasure in intimate relationships after birth, with emotional satisfaction continuing to fall up until 4.5 years postpartum. Less than one-quarter of participants reported that their general practitioner had asked directly about sexual health or relationship problems in the first 3 months postpartum (23% and 18%, respectively). In contrast, 13% of women reported that a maternal and child health nurse had asked directly about sexual problems since the birth, and 31% had asked directly about relationship problems. In-depth interviews revealed that relationships with intimate partners were important issues for women following childbirth, and women were seeking reassurance from health professionals that their changing experiences of sex and intimacy after childbirth were ‘normal’. Some women felt they had ‘fallen through the gaps’ and there was not an opportunity provided by health professionals for them to discuss changes affecting their sexual and intimate relationships. The findings suggest that intimate relationships are significantly strained in the years following childbirth and women want more information from primary health care professionals regarding changes to intimate and sexual relationships after childbirth.
Additional keywords: adjustment to motherhood, intimacy, postnatal care, qualitative, sexuality.
References
Barrett G, Pendry E, Peacock J, Victor C, Thakar R, Manyonda I (2000) Women’s sexual health after childbirth. BJOG 107, 186–195.| Women’s sexual health after childbirth.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c7ltFaisg%3D%3D&md5=b7c5dacae374b88280586fce9eb0fa46CAS | 10688502PubMed |
Brown S, Lumley J (1998) Maternal health after childbirth: results of an Australian population based survey. British Journal of Obstetrics and Gynaecology 105, 156–161.
| Maternal health after childbirth: results of an Australian population based survey.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c7mt1Cjsg%3D%3D&md5=8094a1ec197b74d0b453341c0ae0aa77CAS | 9501779PubMed |
Brown SJ, Lumley JM, McDonald EA, Krastev AH, Maternal Health Study Collaborative Group (2006) Maternal Health Study: a prospective cohort study of nulliparous women recruited in early pregnancy. BMC Pregnancy and Childbirth 6, 12
| Maternal Health Study: a prospective cohort study of nulliparous women recruited in early pregnancy.Crossref | GoogleScholarGoogle Scholar | 16608507PubMed |
Brown SJ, McDonald EA, Krastev AH (2008) Fear of an intimate partner and women’s health in early pregnancy: findings from the Maternal Health Study. Birth 35, 293–302.
| Fear of an intimate partner and women’s health in early pregnancy: findings from the Maternal Health Study.Crossref | GoogleScholarGoogle Scholar | 19036042PubMed |
Gott M, Galena E, Hinchliff S, Elford H (2004) ‘Opening a can of worms’: GP and practice nurse barriers to talking about sexual health in primary care. Family Practice 21, 528–536.
| ‘Opening a can of worms’: GP and practice nurse barriers to talking about sexual health in primary care.Crossref | GoogleScholarGoogle Scholar | 15367475PubMed |
Hartley S, Sutherland G, Brown S, Yelland J (2012) ‘You’re more likely to tell the GP if you’re asked’: women’s views of care from general practitioners in the first postpartum year. Australian Journal of Primary Health 18, 308–312.
| ‘You’re more likely to tell the GP if you’re asked’: women’s views of care from general practitioners in the first postpartum year.Crossref | GoogleScholarGoogle Scholar | 22950969PubMed |
Kingsberg S (2004) Just ask! Talking to patients about sexual function. Sexuality, Reproduction and Menopause 2, 199–203.
| Just ask! Talking to patients about sexual function.Crossref | GoogleScholarGoogle Scholar |
Larkin M, Watts S, Clifton E (2006) Giving voice and making sense in interpretative phenomenological analysis. Qualitative Research in Psychology 3, 102–120.
| Giving voice and making sense in interpretative phenomenological analysis.Crossref | GoogleScholarGoogle Scholar |
MacArthur C, Winter HR, Bick DE, Knowles H, Lilford R, Henderson C, Lancashire RJ, Braunholtz DA, Gee H (2002) Effects of redesigned community postnatal care on womens’ health 4 months after birth: a cluster randomised controlled trial. Lancet 359, 378–385.
| Effects of redesigned community postnatal care on womens’ health 4 months after birth: a cluster randomised controlled trial.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD387htlCrsQ%3D%3D&md5=41f7f09dadaac48ce076559b65ce21fdCAS | 11844507PubMed |
McDonald E, Brown SJ (2013) Does method of birth make a difference to when women resume sex after childbirth? BJOG 120, 823–830.
| Does method of birth make a difference to when women resume sex after childbirth?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3svhsV2hug%3D%3D&md5=1a50593c40b5e3a013c04fff2c43a8acCAS | 23442053PubMed |
Olsson A, Lundqvist M, Faxelid E, Nissen E (2005) Women’s thoughts about sexual life after childbirth: focus group discussions with women after childbirth. Scandinavian Journal of Caring Sciences 19, 381–387.
| Women’s thoughts about sexual life after childbirth: focus group discussions with women after childbirth.Crossref | GoogleScholarGoogle Scholar | 16324063PubMed |
Richters J, Grulich A, de Visser R, Smith A, Rissell C (2003) Sex in Australia: sexual and emotional satisfaction in regular relationships and preferred frequency of sex among a representative sample of adults. Australian and New Zealand Journal of Public Health 27, 171–179.
| Sex in Australia: sexual and emotional satisfaction in regular relationships and preferred frequency of sex among a representative sample of adults.Crossref | GoogleScholarGoogle Scholar | 14696708PubMed |
Smith JA (1996) Beyond the divide between cognition and discourse: Using interpretative phenomenological analysis in health psychology. Psychology & Health 11, 261–271.
| Beyond the divide between cognition and discourse: Using interpretative phenomenological analysis in health psychology.Crossref | GoogleScholarGoogle Scholar |
Smith JA, Osborn M (2008) Interpretative phenomenological analysis. In ‘Doing social psychology research’. (Ed. GM Breakwell) Ch. 10. (The British Psychological Society and Blackwell Publishing Ltd: Oxford, UK)
StataCorp. (2009) Stata Statistical Software. Release 11. StataCorp LP, College Station, TX.
Woolhouse H, Gartland D, Hegarty K, Donath S, Brown S (2012a) Depressive symptoms and intimate partner violence in the 12 months after childbirth: a prospective pregnancy cohort study. BJOG 119, 315–323.
| Depressive symptoms and intimate partner violence in the 12 months after childbirth: a prospective pregnancy cohort study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC387ktVaitQ%3D%3D&md5=0ac0653789fc76e419b28d0e1d4ff456CAS | 22145631PubMed |
Woolhouse H, McDonald E, Brown SJ (2012b) Women’s experiences of sex and intimacy after childbirth: making the adjustment to motherhood. Journal of Psychosomatic Obstetrics and Gynaecology 33, 185–190.
| Women’s experiences of sex and intimacy after childbirth: making the adjustment to motherhood.Crossref | GoogleScholarGoogle Scholar | 22973871PubMed |
