Sexual experiences of women during and after pregnancy: a survey-based study

Pregnancy and postpartum are critical phases with major physical, psychological, and relational changes. Sexuality, though central to well-being, is underexplored in clinical practice and clouded by social taboos. Literature mainly focuses on dysfunctions, overlooking the interplay of psychological and relational factors shaping women's sexual satisfaction. Little is known about why women may engage in sex to satisfy their partner. We investigated self-reported sexual health experiences during pregnancy and postpartum, focusing on psychological, relational, and physical factors. We explored factors associated with reporting intercourse for a partner's pleasure.

A cross-sectional online survey was conducted in Italy (September 2024-March 2025). Women ≥ 18, pregnant or within six months postpartum, anonymously completed a questionnaire on six domains: sexual activity and desire, relationship dynamics, physical and psychological changes, fears and difficulties, the gynecologist's role, and puerperium. The primary outcome was having sex for the partner's pleasure. Multivariate logistic regression was used to explore the associations with the primary outcome.

Among 629 respondents (246 pregnant, 383 postpartum), sexual behavior changed markedly across pregnancy and postpartum. During pregnancy, 56% of women in the first trimester and 50% in the third reported sex only to satisfy their partner, rising to 69% postpartum. Pain during intercourse was reported by 28% in the first/second trimester and 45% in the third, while fear of vaginal penetration increased from 60% to 75%. Postpartum, 47% reported difficulty in sexual intercourse within two months of delivery, rising to 63% within six months. Having sex for the partner's pleasure was associated to being postpartum (OR 1.9) and reporting decreased physical energy (OR 2.0). Among pregnant women, dyspareunia and fear of jeopardizing the relationship were significant predictors; after childbirth, resuming sex within two months was associated with the same outcome.

Findings highlight a gap in perinatal care, where sexual health is often neglected. Integrating counseling into routine obstetric care, and addressing fatigue, pain, body image, and partner dynamics, could foster healthier and more autonomous sexual experiences. Proactive counseling and greater clinical attention to fatigue, pain, and relational dynamics are needed to promote women's sexual well-being perinatally.