Psychological Factors and the Sexuality of Pregnant and Postpartum Women

continued

For sexual desire at 12 weeks postpartum, [R.sup.2] = .22, F(4,99) = 6.77, p < .001, with the major predictors being relationship satisfaction and fatigue. For frequency of sexual intercourse at 12 weeks postpartum, [R.sup.2] = .13, F(4,81) = 2.92, p < .05, with the major predictor being depression (women who reported more depressive symptoms reported less frequency of sexual intercourse). For sexual satisfaction at 12 weeks postpartum, [R.sup.2] = .30, F(4,81) = 8.86, p < .001, with the major predictor being fatigue (see Table 2).

For sexual desire at 6 months postpartum, [R.sup.2] = .31, F(4,65) = 7.17, p < .001, with the major predictors being depression, relationship satisfaction, and mother role. For frequency of sexual intercourse at 6 months postpartum, [R.sup.2]= .16, F(4,60) = 2.76, p < .05, with the major predictors being depression and mother role. For sexual satisfaction at 6 months postpartum, [R.sup.2] = .33, F(4,60) = 7.42, p < .001, with the major predictor being mother role (see Table 2).

To test the prediction that psychological and relationship variables would account for some of the changes in women's sexual functioning during pregnancy a series of three hierarchical regressions (sexual desire, frequency of sexual intercourse, and sexual satisfaction as the dependent variables) were performed with the baseline measures of each of the sexual variables entered on the first step, and role-quality, relationship satisfaction, depression, and fatigue entered on the second step.

For sexual desire during pregnancy, on step 1, [R.sup.2] = .41, F(1,132) = 91.56, p < .001. After step 2, F change (6,127) = 1.72, p > .05. For frequency of sexual intercourse during pregnancy, after step 1, [R.sup.2] = .38, F(1,132) = 81.16, p < .001. After step 2, F change (6,127) = 2.33, p < .05. The major predictor of change to frequency of sexual intercourse during pregnancy was fatigue. For sexual satisfaction during pregnancy, after step 1, [R.sup.2] = .39, F(1,132) = 84.71, p < .001. After step 2, F change (6,127) = 3.92, p < .01. Depression was the major predictor of change to sexual satisfaction during pregnancy (see Table 3).

To test the prediction that psychological, relationship, and physical variables would account for changes in women's sexual functioning at 12 weeks and 6 months postpartum, a series of six hierarchical regressions were performed with the baseline measures of each of the sexual variables (sexual desire, frequency of sexual intercourse, and sexual satisfaction) entered on the first step, and breastfeeding, dyspareunia, mother-role quality, relationship satisfaction, depression, and fatigue entered on the second step. (Breastfeeding was a dummy variable, with currently breastfeeding coded 1, not breastfeeding coded 2). Work-role quality could not be included in regression analyses as only 14 women had resumed work at 12 weeks postpartum, and 23 at 6 months postpartum.

At 12 weeks postpartum, for sexual desire at step 1, [R.sup.2]= .32, F(1,102) = 48.54, p < .001. After step 2, F change (6,96) = 4.93, p < .01. Dyspareunia, breastfeeding, and relationship satisfaction were the most important predictors of sexual desire after the baseline measure was taken into account. For frequency of sexual intercourse, at step 1, [R.sup.2] = .04, F(1,84) = 3.76, p > .05. After step 2, F change (6,78) = 4.87, p < .01. Breastfeeding and relationship satisfaction were the main predictors of frequency of sexual intercourse at 12 weeks postpartum after the baseline frequency of sexual intercourse was taken into account. That is, women who were breastfeeding reported a greater reduction in frequency of sexual intercourse compared with their prepregnancy baseline. For sexual satisfaction, at step 1, [R.sup.2] = .46, F (1,84) = 72.13, p < .001. After step 2, F change (6,78) = 4.78, p < .001. Dyspareunia, breastfeeding, and fatigue were the major predictors of women's sexual satisfaction at 12 weeks postpartum (see Table 44).

At 6 months postpartum, for sexual desire at step 1, [R.sup.2] = .50, F(1,68) = 69.14, p < .001. After step 2, F change (6,62) = 4.29, p < .01. Dyspareunia and depression contributed significantly to the prediction of the change to sexual desire. However, the contribution of depression was not in the direction expected, likely because of the group of women who scored very low on the EPDS and who reported low sexual desire. For frequency of sexual intercourse, at step 1 [R.sup.2] = . 12, F(1,63) = 8.99, p < .01. After step 2, F change (6,57) = 3.89, p < .001. Dyspareunia was the main predictor of change to frequency of sexual intercourse at 6 months postpartum. For sexual satisfaction at step 1, [R.sup.2] = .48, F(1,63) = 58.27, p < .001. After step 2, F change (6,57) = 4.18, p < .01. Dyspareunia and mother role were the major predictors of change to sexual satisfaction (see Table 55).

DISCUSSION

Our results support previous findings that during the third trimester of pregnancy women generally report reduced sexual desire, frequency of intercourse, and sexual satisfaction (Barclay et al., 1994; Hyde et al., 1996; Kumar et al., 1981). An interesting finding from the current study is that the quantum of change in women's sexual functioning, although statistically significant, was generally not of a great magnitude. Very few women reported total loss of sexual desire and sexual satisfaction, or complete avoidance of sexual intercourse during the third trimester of pregnancy.

Relationship satisfaction also increased slightly during pregnancy (Adams, 1988; Snowden, Schott, Awalt, & Gillis-Knox, 1988). For most couples, the anticipation of the birth of their first child is a happy time, during which there is likely to be an increased emotional closeness as they prepare their relationship and their home for the arrival of their baby.

Women who were more satisfied with their relationships reported higher sexual satisfaction; however, relationship satisfaction did not appear to directly influence changes to any of the sexual measures during pregnancy. However, it must be noted that women with higher relationship satisfaction were more positive about their anticipated mother role, and had lower rates of fatigue and depressive symptomatology.

Work-role quality was largely unrelated to women's sexual functioning during pregnancy. The differences between the findings in this study and that of Hyde et al. (1998), who found a small association between women's work-role quality and their frequency of intercourse in midpregnancy, may be due to the larger sample size surveyed by Hyde et al. (1998). Women surveyed by Hyde et al. (1998) were also at an earlier stage of pregnancy, when potential deterrents to intercourse may differ from those in the third trimester.

By 12 weeks postpartum, the majority of women had resumed sexual intercourse; however, many experienced sexual difficulties, particularly dyspareunia and lowered sexual desire (Glazener, 1997; Hyde et al., 1996). Relationship satisfaction was at a low point at 12 weeks postpartum (Glenn, 1990), and more than half of the women reported lower relationship satisfaction at this time than during prepregnancy. However, the level of change in relationship satisfaction was small, and consistent with previous research (e.g., Hyde et al., 1996): most women were moderately satisfied with their relationships.

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Relationship satisfaction influenced women's level of sexual desire, and those with higher relationship satisfaction reported less decrease in sexual desire and frequency of intercourse. Depression was also associated with a lower frequency of intercourse, and fatigue negatively affected women's sexual functioning at 12 weeks postpartum (Glazener, 1997; Hyde et al., 1998; Lumley, 1978). Women with higher levels of dyspareunia also reported greater decreases in sexual desire, frequency of intercourse, and sexual satisfaction compared with prepregnancy (Glazener, 1997; Lumley, 1978). Similarly, women who were breastfeeding reported greater decreases in each of these sexual variables than women who were not breastfeeding (Glazener, 1997; Hyde et al., 1996). The reason for this reduction should be explored in future research. It is possible that breastfeeding provides sexual fulfillment for some women, which may generate guilt feelings in these women and lead to decreased level of sexual functioning in their relationship.

These results would suggest that there are a broad range of factors that have a detrimental impact on sexuality at 12 weeks postpartum--most particularly depression, fatigue, dyspareunia, and breastfeeding. This appears to be a stage of adjustment for many mothers, and depending upon adjustments in the above areas, they may or may not experience a fulfilling sexual relationship.

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Last reviewed: 11/05

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