Sexual health after childbirth in Dutch women: prevalence, associated factors and perceived need for information: a cross-sectional study

Abstract

Background: After childbirth, women often experience changes in sexual health. Little is known about the associated factors for the development of sexual health problems. Therefore, in this study we aim to investigate (1) how many women report changes in sexual health; (2) the prevalence and associated factors of women's postpartum sexual health problems and (3) whether women want to be better informed about postpartum sexual health after childbirth.

Methods: From March to May 2021, 641 postpartum Dutch women participated in a cross-sectional study through an online survey, distributed via social media. At a mean time of 11.6 months (SD = 6.23) after birth, women reported information on maternal, pregnancy and childbirth characteristics and childbirth experience, sexual dysfunction (Female Sexual Function Index), sexual distress (Female Sexual Distress Scale), relationship satisfaction (Relationship Assessment Scale) and "perceived need for information" to discuss sexual health with their maternity care provider.

Results: Postpartum changes in sexual health were found in 88% of women. Of the women who participated, 43.7% reported sexual dysfunction and 52.3% reported sexual distress. Overall, 46% of women perceived more need for information. Multivariable logistic regression analyses showed that negative sexual experiences were associated with increased odds of sexual dysfunction (odds ratio (OR) 1.58, 95% CI 1.04-2.40) and sexual distress (OR 1.70, 1.17-2.46). Perineal damage (OR 1.54, 1.03-2.29) was associated with increased odds of sexual dysfunction, and a BMI ≥ 30 kg/m² (OR 0.46, 0.28-0.70) was associated with decreased odds of sexual dysfunction. A higher level of relationship satisfaction was associated with decreased odds of sexual dysfunction (OR 0.36, 0.25-0.51) and sexual distress (OR 0.47, 0.35-0.63). A positive childbirth experience was associated with decreased odds of sexual distress (OR 0.88, 0.81-0.96) and decreased odds of "perceived need for information" (OR 0.86, 0.79 to 0.94).

Conclusion: Sexual health problems are experienced by half of postpartum women. Midwives should inform women and their partners about these possible problems, taking into account birth-related factors, e.g. birth experience and perineal damage. Care providers should pay special attention to women with negative sexual experiences.

Keywords: Associated factors; Birth experience; Childbirth; Postpartum; Sexual distress; Sexual dysfunction; Sexual health.