Abstract
Couples with relationship problems during pregnancy and after the birth of their first child may be reluctant to seek help and, even if they want help, have to surmount many barriers, both their own and those created by health professionals. The emphasis on evidence-based practice in the NHS and current divorce statistics in the UK have led to a rash of support schemes for new parents and of trainings for health professionals in the detection of, and appropriate interventions in, relationship and sexual problems. Internationally there is a wide body of evidence that the transition to parenthood is a serious drain on the emotional, physical and material resources of a substantial number of couples and potentially a trigger of discontent for mother and father, with detrimental consequences for parents and baby. This paper explores the factors contributing to decline in relationship quality for new parents in the light of healthcare initiatives and socio-economic changes, including the changing roles of men, who have been largely ignored in studies of prenatal and postnatal sexuality. It highlights the complexity of first-time parents' experience in the 21 months following conception.