Changes to sexual and intimate relationships in the postnatal period: women's experiences with health professionals

Women navigate many social changes when they become a mother, often including considerable changes to intimate and sexual relationships. This paper draws on data collected in an Australian multicentre prospective nulliparous pregnancy cohort study and a nested qualitative substudy exploring women's experiences of sex and intimacy after the birth of their first child. In all, 1507 women were recruited in early pregnancy (mean gestation 15 weeks) and completed self-administered questionnaires at 3, 6 and 12 months and 4.5 years postpartum. Eighteen participants were interviewed 2.5-3.5 years after the birth of their first child regarding sex and intimacy after having a baby. Interviews were transcribed verbatim and analysed using interpretive phenomenological analysis. Cohort data reveal a considerable drop in both emotional satisfaction and physical pleasure in intimate relationships after birth, with emotional satisfaction continuing to fall up until 4.5 years postpartum. Less than one-quarter of participants reported that their general practitioner had asked directly about sexual health or relationship problems in the first 3 months postpartum (23% and 18%, respectively). In contrast, 13% of women reported that a maternal and child health nurse had asked directly about sexual problems since the birth, and 31% had asked directly about relationship problems. In-depth interviews revealed that relationships with intimate partners were important issues for women following childbirth, and women were seeking reassurance from health professionals that their changing experiences of sex and intimacy after childbirth were 'normal'. Some women felt they had 'fallen through the gaps' and there was not an opportunity provided by health professionals for them to discuss changes affecting their sexual and intimate relationships. The findings suggest that intimate relationships are significantly strained in the years following childbirth and women want more information from primary health care professionals regarding changes to intimate and sexual relationships after childbirth.