Women’s experiences of sex and intimacy after childbirth: making the adjustment to motherhood

Abstract

The aim of this study was to explore women’s experiences of changes to their sexual relationship, sexuality and intimacy, as a result of pregnancy, childbirth and parenting. A sub-sample of women was purposively selected from a larger prospective pregnancy cohort study of nulliparous women in Melbourne, Australia. Eighteen women (including a mixture of parity, birth methods and relationship status) were interviewed 2.5–3.5 years after a first birth. Interviews were transcribed verbatim and analyzed using interpretive phenomenological analysis. Women identified numerous factors affecting sexual and intimate relationships including extreme tiredness, changing lifestyles and body image issues, leading to changes in libido and intimacy in relationships. Of particular note were feelings of guilt and failure women experienced as a result of a lowered libido. Finding ways to stay connected – whether through sex, quality time together or working as a team – helped women and their partners navigate the transition to parenthood. This study demonstrates that pregnancy, childbirth and parenting can bring about significant changes to women’s experiences of sex and intimacy. Women who experience significant reductions in their libido may be vulnerable to feelings of guilt and failure, connected with high expectations that they should be able to “do it all”.

Keywords::

• Sexuality
• intimacy
• postnatal
• qualitative
• adjustment to motherhood

Acknowledgements

We are extremely grateful to all of the women who generously agreed to take part in the interviews, contributing their time and energy, and to members of the Healthy Mothers Healthy Families research group at Murdoch Childrens Research Institute who assisted with follow-up of the main cohort and with data management.

Contribution to authorship

All authors have significantly contributed to this article and approved the final version of the manuscript. HW was involved in data collection, conducted literature searches, completed data analyses and interpretation, and wrote the paper. EM was responsible for the sub-study concept and design, purposive recruitment strategies, data collection, data analysis and interpretation, and manuscript revision. SB was responsible for the study concept and design, data analysis and interpretation, and co-wrote the paper.

Declaration of Interest: The authors report no declarations of interest. This work was supported by grants from The National Health and Medical Research Council (NHMRC), and the William Buckland Foundation, and the Victorian Government’s Operational Infrastructure Support Program.The National Health and Medical Research Council (NHMRC) funded the establishment of the cohort with a 5 year epidemiology grant (2002–2006). SB held an NHMRC Career Development Award (2008–2011) and currently holds an ARC Future Fellowship (2012–2015). The funding organizations had no involvement in the conduct of the study, and the authors are independent of the funding sources. All authors had full access to the study data and were responsible for the decision to submit the paper for publication. The Sexual Health sub-study was approved by the La Trobe University Human Research Ethics Committee.(HEC 07-125). Written informed consent was obtained from all participants.

Current knowledge on the subject

• Limited attention has been given to the social challenges women face following pregnancy and childbirth

• Navigating changes to intimate relationships after pregnancy and childbirth is a significant challenge faced by women

• Women’s voices remain relatively absent in the literature around sex and sexuality after childbirth

What this study adds

• Extreme tiredness and dramatic lifestyle changes appear to be the most significant challenges posed to sexual and intimate relationships after birth

• Women who experience a loss of libido after childbirth may be vulnerable to feelings of “guilt” or “failure” linked with high expectations

• Finding ways to stay connected, either through sex, teamwork or quality time together can help couples make the transition to parenthood more smoothly