Predictors of Postpartum Sexual Activity and Function in a Diverse Population of Women


  • Lynn M. Yee MD, MPH,

  • Anjali J. Kaimal MD, MAS,

  • Sanae Nakagawa MA,

  • Kathryn Houston MD, MA,

  • Miriam Kuppermann PhD, MPH

    Corresponding author
    • Address correspondence to Miriam Kuppermann, PhD, MPH, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 3333 California St, Suite 335, San Francisco, CA 94143-0856. E-mail:

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The purpose of this study was to identify predictors of postpartum sexual activity and functioning in a diverse population of women using the Sexual Health Outcomes in Women Questionnaire (SHOW-Q).


This was a prospective study of 160 postpartum women assessing relationships between demographic factors, mode of birth, depression, breastfeeding, and sexual activity and function. Questionnaires were administered over the telephone 8 to 10 weeks postpartum and in person 6 to 8 months postpartum. Primary outcomes were sexual activity at 8 to 10 weeks postpartum and global and subscale SHOW-Q scores at 6 to 8 months postpartum; the primary predictor was mode of birth. Associations were assessed using multiple linear and logistic regression analyses.


Seventy-five percent of this population (n = 140 at 8-10 weeks, n = 129 at 6-8 months) gave birth vaginally, and 60.7% resumed sexual activity by 8 to 10 weeks postpartum. Only multiparity was associated with increased odds of having resumed sexual activity by 8 to 10 weeks postpartum (adjusted odds ratio [aOR], 2.44; P = .03), whereas older age was associated with decreased odds (aOR, 0.92; P = .02) of having resumed sexual activity. Women who were depressed (effect estimate, −13.3; P = .01), older (−1.1, P = .01), or exclusively breastfeeding (−16.5, P < .001) had significantly poorer sexual satisfaction, whereas multiparous women reported better sexual satisfaction (11.1, P = .03). A significant relationship between mode of birth and SHOW-Q scores did not emerge, although we did observe a trend toward lower SHOW-Q scores among women who underwent cesarean compared with those giving birth vaginally.


Multiparity and younger age predict early resumption of sexual activity, whereas depression and breastfeeding are associated with poorer postpartum sexual functioning. The relationship between mode of birth and resumed sexual activity or postpartum sexual function remains uncertain.