Document Type : Original Article

Authors

Student of Midwifery Counseling, School of Nursing and Midwifery Zahedan University of Medical Science, Zahedan, Iran

Abstract

INTRODUCTION: A large number of women experience sexual health problems during the postpartum
period. This study aimed to evaluate the effect of sexual health education on sexual function and
time of sexual intercourse resumption after childbirth in primiparous women in Southeast Iran.
MATERIALS AND METHODS: This randomized clinical trial was conducted on 94 primiparous
women randomly divided into two groups of intervention and control. The intervention group was
subjected to three training sessions 3–5, 10–14, and 30–45  days after childbirth  (first session
lasting 20 min and other sessions 60 min). On the other hand, the participants in the control group
only received the routine postpartum training. The Female Sexual Function Index  (FSFI) was
completed by all participants before and 8 weeks after the intervention. Data were analyzed in SPSS
software (version 22) using descriptive and inferential statistics, such as Chi‑square test, independent
t‑test, and paired sample t‑test. P < 0.05 was considered statistically significant.
RESULTS: The mean score of FSFI in the intervention group was increased from 12.70 ± 6.166
before the onset of the intervention to 17.36 ± 5.407 after 8 weeks (P = 0.01). In the control group,
the mean score of FSFI was decreased from 13.09 ± 4.306 to 12.29 ± 3.511 on the 8th  week
postpartum (P = 0.06). The mean times of sexual intercourse resumption in the intervention and
control groups were 5.82 ± 0.17 and 5.81 ± 0.22 weeks, respectively, which were not significantly
different between the two groups (P = 0.879).
CONCLUSION: Sexual health education for women in the postpartum period could improve their
sexual function after childbirth. However, it is recommended to use sexual health education programs
in women during the postpartum period to promote female sexual function.

Keywords

1. Schlagintweit HE, Bailey K, Rosen NO. 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 2016;13:1455‑65.
2. Khajehei M, Doherty M, Tilley PJ, Sauer K. Prevalence and risk
factors of sexual dysfunction in postpartum Australian women.
J Sex Med 2015;12:1415‑26.
3. Abdool Z, Thakar R, Sultan AH. Postpartum female sexual
function. Eur J Obstet Gynecol Reprod Biol 2009;145:133‑7.
4. Lee JT, Tsai JL. Transtheoretical model‑based postpartum sexual
health education program improves women’s sexual behaviors
and sexual health. J Sex Med 2012;9:986‑96.
5. Ghana S, Mahasti Joybari L, Sanago A. The sexual experiences of
women during pregnancy and lactation. J Obstet Gynecol Infertil
2013;60:18‑24.
6. Banaei M, Torkzahrani S, Ozgoli G, Azad M, Mahmoudikohani F,
Pormehr‑Yabandeh A. Addressing the sexual function of women
during first six month after delivery: Aquasi‑experimental study.
Mater Sociomed 2018;30:136‑40.
7. Sayed Ahmed WA, Kishk EA, Farhan RI, Khamees RE. Female
sexual function following different degrees of perineal tears. Int
Urogynecol J 2017;28:917‑21.
8. Meriwether KV, Rogers RG, Dunivan GC, Alldredge JK, Qualls C,
Migliaccio L, et  al. Perineal body stretch during labor does
not predict perineal laceration, postpartum incontinence, or
postpartum sexual function: A cohort study. Int Urogynecol J
2016;27:1193‑200.
9. López‑Lapeyrere C, Serna‑Gómez N, Hernández‑López AB,
Pérez‑García MF, Tejeda‑Esteban A, Solís‑Muñoz M. The
development and validation of a new postpartum sexual function
and dyspareunia assessment tool: The Carol Scale. Midwifery
2018;58:27‑36.
10. Chang SR, Lin WA, Lin HH, Shyu MK, Lin MI. Sexual dysfunction
predicts depressive symptoms during the first 2 years postpartum.
Women Birth 2018;31:e403‑11.
11. Desgrées‑du‑Loû A, Brou H. Resumption of sexual relations
following childbirth: norms, practices and reproductive
health issues in Abidjan, Ivory Coast. Reprod Health Matters
2005;13:155‑63.
12. Anzaku A, Mikah S. Postpartum resumption of sexual activity,
sexual morbidity and use of modern contraceptives among
Nigerian women in Jos. Ann Med Health Sci Res 2014;4:210‑6.
13. Rezaei N, Azadi A, Sayehmiri K, Valizadeh R. Postpartum sexual
functioning and its predicting factors among Iranian women.
Malays J Med Sci 2017;24:94‑103.
14. Dabiri F, Yabandeh PA, Shahi A, Kamjoo A, Teshnizi HS. The
effect of mode of delivery on postpartum sexual functioning in
primiparous women. Oman Med J 2014;29:276‑9.
15. Lee JT, Yen HW. Randomized controlled evaluation of a
theory‑based postpartum sexual health education programme.
J Adv Nurs 2007;60:389‑401.
16. The World Health Organization’s. Postpartum Care of the Mother
and Newborn: Apractical Guide. Available from: http://www.who.int/maternal_child_adolescent/documents/who_rht_
msm_983/en/. [Last accessed on 2019 Dec 10].
17. Lopez LM, Hiller JE, Grimes DA. Education for contraceptive
use by women after childbirth. Cochrane Database Syst Rev
2010;20:CD001863.
18. Lee JT, Tsai JL, Tsou TS, Chen MC. Effectiveness of a theory‑based
postpartum sexual health education program on women’s
contraceptive use: a randomized controlled trial. Contraception
2011;84:48‑56.
19. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R,
et al. The female sexual function index (FSFI): a multidimensional
self‑report instrument for the assessment of female sexual
function. J Sex Marital Ther 2000;26:191‑208.
20. Fakhri A, Pakpour AH, Burri A, Morshedi H, ZeidiIM. The female
sexual function index: translation and validation of an Iranian
version. J Sex Med 2012;9:514‑23.
21. Alimohammadi L, Mirghafourvand M, Zarei F, Pirzeh R. The
effectiveness of group counseling based on Bandura’s self‑efficacy
theory on sexual function and sexual satisfaction in Iranian
newlywed women: A randomized controlled trial. Appl Nurs
Res 2018;42:62‑9.
22. Behboodi Moghadam Z, Rezaei E, Khaleghi Yalegonbadi F,
Montazeri A, Arzaqi SM, Tavakol Z, et al. The effect of sexual
health education program on women sexual function in Iran.
J Res Health Sci 2015;15:124‑8.
23. Zamani M, Latifnejad Roudsari R, Moradi M, Esmaily H. The
effect of sexual health counseling on women’s sexual satisfaction
in postpartum period: A randomized clinical trial. Int J Reprod
Biomed (Yazd) 2019;17. pii: ijrm.v17i1.3819.
24. Alum AC, Kizza IB, Osingada CP, Katende G, Kaye DK. Factors
associated with early resumption of sexual intercourse among
postnatal women in Uganda. Reprod Health 2015;12:107.
25. Saotome TT, Yonezawa K, Suganuma N. Sexual dysfunction
and satisfaction in Japanese couples during pregnancy and
postpartum. Sex Med 2018;6:348‑55.
26. Matthies LM, Wallwiener M, Sohn C, Reck C, Müller M,
Wallwiener S. The influence of partnership quality and
breastfeeding on postpartum female sexual function. Arch
Gynecol Obstet 2019;299:69‑77.
27. Fuentealba‑Torres M, Cartagena‑Ramos D, Fronteira I, Lara LA,
Arroyo LH, Arcoverde MA, et al. What are the prevalence and
factors associated with sexual dysfunction in breastfeeding
women? A Brazilian cross‑sectional analytical study. BMJ Open
2019;9:e025833.
28. Quoc Huy NV, Phuc An LS, Phuong LS, Tam LM. Pelvic floor
and sexual dysfunction after vaginal birth with episiotomy in
Vietnamese women. Sex Med 2019;7:514‑21.
29. Baksu B, Davas I, Agar E, Akyol A, Varolan A. The effect of mode
of delivery on postpartum sexual functioning in primiparous
women. Int Urogynecol J Pelvic Floor Dysfunct 2007;18:401‑6.
30. Zhuang C, Li T, Li L. Resumption of sexual intercourse post
partum and the utilisation of contraceptive methods in China:
A crosssectional study. BMJ Open 2019;9:1‑7.
31. O’Malley D, Higgins A, Begley C, Daly D, Smith V. Prevalence
of and risk factors associated with sexual health issues in
primiparous women at 6 and 12 months postpartum; a
longitudinal prospective cohort study (the MAMMI study). BMC
Pregnancy Childbirth 2018;18:196.
32. Amiri FN, Omidvar S, Bakhtiari A, Hajiahmadi M. Female sexual
outcomes in primiparous women after vaginal delivery and
cesarean section. Afr Health Sci 2017;17:623‑31.
33. Yeniel AO, Petri E. Pregnancy childbirth and sexual function
perceptions and facts. Int Urogynecol J 2014;25:5‑14.
34. Banaei M, Alidost F, Ghasemi E, Dashti S. A comparison of
sexual function in primiparous and multiparous women. J Obstet
Gynaecol 2019 Sep 19:1‑8.