Sexual behaviour in pregnancy, after childbirth and during breast-feeding
Alder, E.M.
Bailliere's Clinical Obstetrics and Gynaecology 3(4): 805-821
1989
ISSN/ISBN: 0950-3552 PMID: 2700144 DOI: 10.1016/s0950-3552(89)80066-5Document Number: 372543
The birth of the 1st child constitutes a psychosocial crisis for most couples, and significant marital and sexual changes occur during the childbearing years. Most women report a decline in sexual activity and interest as their pregnancy progresses, although an association with prepregnancy sexual behavior is apparent. Prospective studies of sexual behavior in the 1st postnatal year reveal resumption of intercourse by the 6th-8th week after delivery and a slow return to prenatal levels of sexual frequency. Pain and tenderness in the episiotomy scar, fear of another pregnancy, changes in body image, and fatigue all have been cited by women for the avoidance or dislike of sexual intercourse in the postpartum period. There is some evidence that breastfeeding, too, has an adverse effect on sexuality in the 1st year postpartum. Lactating women experience raised levels of prolactin and prolonged hypo-estrogenization. In addition, lactating women with diminished sexual desire have been found to have significantly lower levels of androstenedione and testosterone than their counterparts whose sexual interest was not severely reduced. Unclear is whether the generally negative association between prolonged breastfeeding and resumption of prepregnancy levels of sexual activity reflects hormonal changes linked to lactation or psychosocial characteristics that determine whether a women breastfeeds or bottlefeeds. Marriage counselors have observed that sexual problems often have their origins in the year after the birth of the 1st child. Thus, more research on the association between infant feeding and sexual behavior, mood, and morbidity is needed so clinicians can try to avert the development of marital conflicts.