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Archives of Gynecology and Obstetrics

, Volume 299, Issue 1, pp 69–77 | Cite as

The influence of partnership quality and breastfeeding on postpartum female sexual function

  • Lina Maria Matthies
  • Markus Wallwiener
  • Christof Sohn
  • Corinna Reck
  • Mitho Müller
  • Stephanie WallwienerEmail author
Maternal-Fetal Medicine

Abstract

Introduction

Female sexual dysfunction is known to have a huge impact on quality of life and is highly prevalent during the peripartum period. Several influencing variables were found to be associated with impaired sexual function postpartum, among them breastfeeding and partnership quality. However, little is known about the predictive value of these variables. Therefore, this longitudinal cohort study aimed to examine prospectively the influence of the two variables on sexual function 4-month postpartum.

Materials and methods

Questionnaires were administered to 330 women prenatally (TI, third trimester) and postpartum (TII, 1 week; TIII, 4 months). Medical data were collected from the respondents’ hospital records. The Female Sexual Function Index (FSFI) was used to determine overall sexual function, desire, arousal, lubrication, orgasm, satisfaction, and pain perinatally.

Results

At all timepoints, mean FSFI scores were below the critical FSFI-score of 26.55. Partnership quality, breastfeeding, high maternal education, and maternal depressive symptoms correlated significantly with FSFI scores postpartum. Further analyses confirmed antenatal partnership quality and breastfeeding behavior as strong predictors of sexual function 4-month postpartum, explaining 24.3% of variance. Women who stopped breastfeeding or never breastfed at all showed the highest FSFI scores.

Conclusion

Our findings indicate that exclusively breastfeeding women and those who report low partnership quality have an increased likelihood of sexual functioning problems 4-month postpartum. Health-care providers need to be encouraged to counsel on postpartum sexuality and influencing factors during prenatal classes to de-pathologize those changes and to foster a positive approach to peripartum sexuality.

Keywords

Sexual function Breastfeeding Delivery Pregnancy Partnership quality 

Notes

Author contributions

LMM: data collection and manuscript writing. MW: protocol development. CR: protocol development, data management, and manuscript editing. CS: protocol development and manuscript editing. MM: data collection and management, data analysis, and manuscript writing. SW: protocol development, data collection and management, data analysis, and manuscript writing.

Funding

This study was funded by the German Society of Psychosomatic Gynecology and Obstetrics (Forschungsstipendium).

Compliance with ethical standards

Conflict of interest

We declare that we have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Bossini L, Fortini V, Casolaro I, Caterini C, Koukouna D, Cecchini F, Benbow J, Fagiolini A (2014) Sexual dysfunctions, psychiatric diseases and quality of life: a review. Psychiatr Pol 48(4):715–726PubMedGoogle Scholar
  2. 2.
    World Health Organization (2006) Sexual and reproductive health-defining sexual health. http://www.who.int/reproductivehealth/topics/sexual_health/sh_definitions/en/. Accessed 12 Feb 2018
  3. 3.
    Abedi P, Jorfi M, Afshari P, Fakhri A (2017) How does health-promoting lifestyle relate to sexual function among women of reproductive age in Iran?. Health Promot, Glob, p 1757975917706831Google Scholar
  4. 4.
    Millheiser L (2012) Female sexual function during pregnancy and postpartum. J Sex Med 9(2):635–636CrossRefGoogle Scholar
  5. 5.
    Tosun Guleroglu F, Gordeles Beser N (2014) Evaluation of sexual functions of the pregnant women. J Sex Med 11(1):146–153CrossRefGoogle Scholar
  6. 6.
    Lutfey KE, Link CL, Rosen RC, Wiegel M, McKinlay JB (2009) Prevalence and correlates of sexual activity and function in women: results from the Boston Area Community Health (BACH) Survey. Arch Sex Behav 38(4):514–527CrossRefGoogle Scholar
  7. 7.
    Robson KM, Brant HA, Kumar R (1981) Maternal sexuality during first pregnancy and after childbirth. Br J Obstet Gynaecol 88(9):882–889CrossRefGoogle Scholar
  8. 8.
    Rezaei N, Azadi A, Sayehmiri K, Valizadeh R (2017) Postpartum sexual functioning and its predicting factors among Iranian women. Malays J Med Sci 24(1):94–103PubMedPubMedCentralGoogle Scholar
  9. 9.
    Leeman LM, Rogers RG (2012) Sex after childbirth: postpartum sexual function. Obstet Gynecol 119(3):647–655CrossRefGoogle Scholar
  10. 10.
    Rogers RG, Borders N, Leeman LM, Albers LL (2009) Does spontaneous genital tract trauma impact postpartum sexual function? J Midwifery Womens Health 54(2):98–103CrossRefGoogle Scholar
  11. 11.
    Anzaku A, Mikah S (2014) Postpartum resumption of sexual activity, sexual morbidity and use of modern contraceptives among nigerian women in jos. Ann Med Health Sci Res 4(2):210–216CrossRefGoogle Scholar
  12. 12.
    Yeniel AO, Petri E (2014) Pregnancy, childbirth, and sexual function: perceptions and facts. Int Urogynecol J 25(1):5–14CrossRefGoogle Scholar
  13. 13.
    Avery MD, Duckett L, Frantzich CR (2000) The experience of sexuality during breastfeeding among primiparous women. J Midwifery Womens Health 45(3):227–237CrossRefGoogle Scholar
  14. 14.
    Galazka I, Drosdzol-Cop A, Naworska B, Czajkowska M, Skrzypulec-Plinta V (2015) Changes in the sexual function during pregnancy. J Sex Med 12(2):445–454CrossRefGoogle Scholar
  15. 15.
    Johnson CE (2011) Sexual health during pregnancy and the postpartum. J Sex Med 8(5):1267–1284 (quiz 1285-6) CrossRefGoogle Scholar
  16. 16.
    Khajehei M (2016) Prevalence and risk factors of relationship dissatisfaction in women during the first year after childbirth: implications for family and relationship counseling. J Sex Marital Ther 42(6):484–493CrossRefGoogle Scholar
  17. 17.
    Ahlborg T, Strandmark M (2001) The baby was the focus of attention—first-time parents’ experiences of their intimate relationship. Scand J Caring Sci 15(4):318–325CrossRefGoogle Scholar
  18. 18.
    Hipp LE, Kane Low L, van Anders SM (2012) Exploring women’s postpartum sexuality: social, psychological, relational, and birth-related contextual factors. J Sex Med 9(9):2330–2341CrossRefGoogle Scholar
  19. 19.
    Yee LM, Kaimal AJ, Nakagawa S, Houston K, Kuppermann M (2013) Predictors of postpartum sexual activity and function in a diverse population of women. J Midwifery Womens Health 58(6):654–661CrossRefGoogle Scholar
  20. 20.
    Wambach KA (1998) Maternal fatigue in breastfeeding primiparae during the first nine weeks postpartum. J Hum Lact 14(3):219–229CrossRefGoogle Scholar
  21. 21.
    Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D’Agostino R Jr (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26(2):191–208CrossRefGoogle Scholar
  22. 22.
    Berner MM, Kriston L, Zahradnik HP, Rohde A (2004) Validity and reliability of the german female sexual function index (FSFI-d). Geburtshilfe und Frauenheilkunde 64(3):293–303CrossRefGoogle Scholar
  23. 23.
    Fletcher RJ, Matthey S, Marley CG (2006) Addressing depression and anxiety among new fathers. Med J Aust 185(8):461–463PubMedGoogle Scholar
  24. 24.
    Hahlweg K (1996) Fragebogen zur Partnerschaftsdiagnostik. Hogrefe, GöttingenGoogle Scholar
  25. 25.
    Hinz A, Stöbel-Richter Y, Brähler E (2001) Der Partnerschaftsfragebogen (PFB). Diagnostica 47:132–141CrossRefGoogle Scholar
  26. 26.
    Little RJA (1988) A test of missing completely at random for multivariate data with missing values. J Am Stat Assoc 83:1198–1202.  https://doi.org/10.2307/2290157 CrossRefGoogle Scholar
  27. 27.
    Dunn O (1961) Multiple comparisons among means. J Am Stat Assoc 56:52–64CrossRefGoogle Scholar
  28. 28.
    Cohen J (1977) Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates, New YorkGoogle Scholar
  29. 29.
    Wallwiener S, Muller M, Doster A, Kuon RJ, Plewniok K, Feller S, Wallwiener M, Reck C, Matthies LM, Wallwiener C (2017) Sexual activity and sexual dysfunction of women in the perinatal period: a longitudinal study. Arch Gynecol Obstet 295(4):873–883CrossRefGoogle Scholar
  30. 30.
    Wallwiener S, Muller M, Doster A, Plewniok K, Wallwiener CW, Fluhr H, Feller S, Brucker SY, Wallwiener M, Reck C (2016) Predictors of impaired breastfeeding initiation and maintenance in a diverse sample: what is important? Arch Gynecol Obstet 294(3):455–466CrossRefGoogle Scholar
  31. 31.
    Signorello LB, Harlow BL, Chekos AK, Repke JT (2001) Postpartum sexual functioning and its relationship to perineal trauma: a retrospective cohort study of primiparous women. Am J Obstet Gynecol 184(5):881–888 (discussion 888-90) CrossRefGoogle Scholar
  32. 32.
    Alder EM (1989) Sexual behaviour in pregnancy, after childbirth and during breast-feeding. Baillieres Clin Obstet Gynaecol 3(4):805–821CrossRefGoogle Scholar
  33. 33.
    Alligood-Percoco NR, Kjerulff KH, Repke JT (2016) Risk factors for dyspareunia after first childbirth. Obstet Gynecol 128(3):512–518CrossRefGoogle Scholar
  34. 34.
    Byrd JE, Hyde JS, DeLamater JD, Plant EA (1998) Sexuality during pregnancy and the year postpartum. J Fam Pract 47(4):305–308PubMedGoogle Scholar
  35. 35.
    Hackel LS, Ruble DN (1992) Changes in the marital relationship after the first baby is born: predicting the impact of expectancy disconfirmation. J Pers Soc Psychol 62(6):944–957CrossRefGoogle Scholar
  36. 36.
    McCabe MP, Connaughton C (2017) Sexual dysfunction and relationship stress: how does this association vary for men and women? Curr Opin Psychol 13:81–84CrossRefGoogle Scholar
  37. 37.
    Schlagintweit HE, Bailey K, Rosen NO (2016) A new baby in the bedroom: frequency and severity of postpartum sexual concerns and their associations with relationship satisfaction in new parent couples. J Sex Med 13(10):1455–1465CrossRefGoogle Scholar
  38. 38.
    Doss BD, Rhoades GK, Stanley SM, Markman HJ (2009) The effect of the transition to parenthood on relationship quality: an 8-year prospective study. J Pers Soc Psychol 96(3):601–619CrossRefGoogle Scholar
  39. 39.
    Forbes MK, Baillie AJ, Schniering CA (2014) Critical flaws in the female sexual function index and the international index of erectile function. J Sex Res 51(5):485–491CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyUniversitätsfrauenklinik Heidelberg, University of HeidelbergHeidelbergGermany
  2. 2.Department of PsychologyLudwig Maximilian UniversityMunichGermany

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