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Abstract

Pregnancy and the puerperium herald dramatic and complex physiological, psychological, interpersonal, and sexual changes in a woman and in the marital process. Pregnancy tends to have an increasingly negative effect on sexual desire, expression, and satisfaction as term approaches. Clinical variables discussed include anatomic and physiological changes, puerperal sexual response patterns, marital adjustment, body image, dyspareunia related to episiotomy, lactation, and traditional taboos and cautions regarding coitus for the new mother. Most research respondents reported gradual return to prepregnancy levels of sexual desire, enjoyment, and coital frequency, with a minority in most cited studies indicating sexual interest and coitus levels below prepregnancy levels up to 1 year after delivery. The most frequently listed reasons for poor postpartum sexual adjustment include episiotomy discomfort, fatigue, vaginal bleeding or discharge, dyspareunia, insufficient lubrication, fears of awakening the infant or not hearing him/her, fear of injury, and decreased sense of attractiveness. Postpartum counseling should be offered prior to hospital discharge.

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Most cited references 58

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A Study of the Psychological Processes in Pregnancy and of the Earliest Mother-Child Relationship

Grete L. Bibring, Thomas F. Dwyer, Dorothy Huntington … (2017)

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Maternal sexuality during first pregnancy and after childbirth.

Kelly Brant, R. Kumar, Simon Robson (1981)

Information about sexual activity, enjoyment and libido was obtained at intervals from 119 primiparous women during a longitudinal survey of maternal emotional health in pregnancy and for a year after delivery. Most subjects described some reduction in the frequency of sexual intercourse and a diminution of libido and sexual enjoyment during pregnancy; this was most marked in the third trimester. After delivery, about a third of subjects had resumed intercourse by six weeks and nearly everyone had done so by three months. Nevertheless, 77% and 57% of the women were having intercourse less often at three and 12 months after delivery respectively, in comparison with the month before they became pregnant. Selected variables were examined for relationship with a low, or reduced frequency of intercourse and with a lack of enjoyment. Significant associations were found with aspects of maternal personality and childhood relationships, marital conflict, maternal depression, previous miscarriages, difficulties in conceiving and fears of harming the fetus. Nausea and vomiting during pregnancy, the mode of delivery and related obstetric and medical variables, breast-feeding and characteristics of the baby, did not appear to significantly influence maternal sexuality.

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Changes in breast sensitivity at puberty, during the menstrual cycle, and at parturition.

Peter Robinson, Kevin R. Short (1977)

Sensitivity to pain and touch was measured in the nipple, areola, and cutaneous breast tissue of prepubertal boys and girls, postpubertal men and nuliparous women before and after delivery. Before puberty there were no differences between the sexes, but after puberty the tactile sensitivity of all areas of the women's breast was significantly greater than the men's. Tactil sensitivity of all areas also varied during the menstrual cycle, with maximal sensitivity at midcycle and at menstruation; the mid-cycle peak was absent when the women were taking oral contraceptives. But the most dramatic changes occured within 24 hours of parturition, when there was a great increase in breast sensitivity. This may be the key event for activating the suckling-induced discharge of oxytocin and prolactin and inhibiting ovulation during lactation.