This study examined the influence of role quality, relationship satisfaction, fatigue, and depression on women s sexuality during pregnancy and after childbirth. Questionnaire data were obtained from 138 women pregnant with their first child, of whom 104 responded at 12 weeks postpartum, and 70 responded at 6 months postpartum. Women reported significant reductions in sexuality during pregnancy and postpartum. Relationship satisfaction explained levels of sexual satisfaction during pregnancy, and was a predictor of sexual desire in the postpartum. Depression was an important predictor of reduced sexual desire and sexual satisfaction during pregnancy, and of reduced frequency of intercourse at 12 weeks postpartum. At 6 months postpartum, the quality of the mother role strongly related to measures of sexuality. Throughout the perinatal period, fatigue impacted on measures of sexuality, either directly or/and indirectly. The implications of these results in terms of the impact of pregnancy and childbirth on relationships and sexuality are discussed.