| dc.description.abstract | Background: Prevalence rates of postpartum sexual health issues and associated factors vary greatly in the published literature. There is a focus on biophysical measures of postpartum sexual health and a lack of women's voices on the topic. The aim of this study is to identify the prevalence of and risk factors for postpartum sexual health issues and to explore women's experience of their sexual health after the birth of their first baby. Methods: A mixed methods explanatory sequential study design with connected integration was utilised which had an initial quantitative phase (longitudinal cohort survey design) with 832 nulliparous women from one maternity site in Ireland. Data were collected in early pregnancy and at three, six, nine and twelve months postpartum. In the second phase (qualitative descriptive approach) a subsample of twenty-one women were interviewed using semi-structured interviews which were analysed using the constant comparative analysis method. Results: Most women had resumed sexual activity three months postpartum (77.5%). Prevalence rates of sexual health issues (e.g. dyspareunia, lack of vaginal lubrication and problems with orgasm) increased immediately postpartum but returned to pre-pregnancy levels or less twelve months postpartum. With the exception of loss of interest in sex, which was still experienced by 40% of women twelve months after birth. Pre-existing dyspareunia (AOR 2.6, CI 95% 1.8-3.6, p<0.001), 3rd degree perineal tears (AOR 4.1, CI 95% 1.3-12.3, p=0.013) and breastfeeding (AOR 1.9, CI 95% 1.3-2.7, p<0.001) were identified as risk factors for experiencing dyspareunia six months postpartum. Twelve months postpartum, being older (>35 years) and experiencing pre-pregnancy dyspareunia remained predictive for dyspareunia. Loss of interest in sex six months postpartum was associated with pre-existing dyspareunia (AOR 1.4, CI 95% 1.0-1.9, p=0.05), breastfeeding (AOR 2.2, CI 95% 1.6-3.0, p<0.001) and being never satisfied with one?s body image (AOR 2.8 CI 95% 1.6-4.6 p<0.001). Twelve months postpartum, breastfeeding (AOR 1.6, CI 95% 1.0-2.4, p=0.029) and being never happy with one?s body image (AOR 3.6, CI 95% 1.9-6.7, p<0.001) remained risk factors for experiencing a loss of interest in sex. Despite prevalence rates of postpartum sexual health issues, a high proportion of women reported being satisfied (68%) with their overall sexual life twelve months after birth. Six themes emerged from the interviews about women's experience of their sexual health after the birth of their first baby. Intimacy and sexual activity were important aspects of a couple?s relationship. Women described ongoing challenges to intimacy and sexual activity (physical and psychological). They also described the strategies they developed to overcome sexual health issues, such as, planning sexual activity and communicating their fears, anxieties, altered interest in sex and associated feelings of guilt. In the absence of information and support from healthcare professional around changes to sexual health after birth, women sought alternative sources of help and support from peers and the internet. Conclusion: The findings of this study demonstrate the complex nature of postpartum sexual health. While sexual health issues are commonly experienced after birth, many women remain satisfied with their overall sexual life one year after birth. Pre-existing dyspareunia, breastfeeding and a poor perception of one's body image were risk factors for experiencing postpartum sexual health issues. Women were unprepared for the changes to their intimate relationship but they became positive agents in findings solutions for their sexual health issues. Examining postpartum sexual health from a biophysical perspective only, does not take into account the relational and psychological issues that this study has identified as being important to women with regards their intimate relationship and sexual health after the birth of their first baby. | en |
