Which factors determine the sexual function 1 year after childbirth?


Dr HJ van Brummen, Department of Perinatology and Gynaecology, University Medical Centre Utrecht, Room F05.216, Heidelberglaan 100, PO Box 85500, 3508 GA Utrecht, the Netherlands. Email hbrummen@zonnet.nl


Objective  To evaluate which factors determine sexual activity and satisfaction with the sexual relationship 1 year after the first delivery.

Design  Prospective longitudinal cohort study.

Setting  Ten midwifery practices.

Population  Three hundred and seventy-seven nulliparous women were included.

Methods  The Maudsley Marital Questionnaire is a standardised and validated questionnaire with 15 items relating to marital and sexual adjustment, with a nine-point (0–8) scale appended to each question. Scores on the sexual scale (MMQ-S) range from 0 to 40. Higher scores are indicative of greater dissatisfaction. Sexual intercourse was dichotomised into having sexual intercourse or not having sexual intercourse. Several obstetric and maternal factors were analysed.

Main outcome measurements  Sexual intercourse at 1 year postpartum and dissatisfaction with the sexual relationship as assessed by the MMQ-S scale.

Results  In multiple logistic regression analysis, the main predictive factor for no sexual intercourse 1 year postpartum was no sexual intercourse at 12 weeks of gestation (β 11.0 [4.01–30.4]). Women were five times less likely to be sexually active after a third/fourth degree anal sphincter tear as compared with women with an intact perineum (β 0.2 [0.04–0.93]). Dissatisfaction with the sexual relationship 1 year after childbirth, assessed with the MMQ-S scale, is associated with not being sexually active at 12 weeks of gestation (β– 0.208, P= 0.004) and with an older maternal age at delivery (β 0.405, P= 0.032).

Conclusion  An important prognostic factor for dissatisfaction with the sexual relationship 1 year postpartum was not being sexually active in early pregnancy. Satisfaction with the sexual relationship seems not to depend on pregnancy- and parturition-associated factors.