Sexual pleasure and emotional satisfaction in the first 18 months after childbirth

•Women experience markedly lower levels of sexual pleasure and emotional intimacy after childbirth.•Partner involvement in household tasks makes a difference to sex and intimacy after childbirth.•Regular 'time for self' is important for the health of couple relationships.

Objectiveto investigate the experiences of first time mothers with regard to emotional and sexual intimacy in the period from birth to 18 months postpartum.Designprospective pregnancy cohort, with follow-up at 3, 6, 12 and 18 months postpartum.Setting and participantsfirst-time mothers were recruited in early pregnancy at 6 public maternity hospitals in Melbourne, Australia.Findings1239 women who completed the baseline questionnaire and all follow up questionnaires were included in the sample for analysis: 78% resumed vaginal sex by 3 months postpartum, 94% by 6 months and 98% by 12 months postpartum. Emotional satisfaction with intimate partner relationships declined over time, from 67.3% reporting high satisfaction at 3 months to 53.9% at 18 months postpartum. In contrast, sex was described as extremely or very pleasurable by 40.1% of women at 3 months postpartum, compared with 49.1% at 18 months postpartum. There was a strong association between emotional satisfaction and the degree to which women experienced physical pleasure in their sexual relationship. Women who were happy with their partner's contribution to household tasks were markedly more likely to report high emotional satisfaction (OR 10.31, 95% CI6.7-15.9) and somewhat more likely to report greater physical pleasure in their sexual relationship (OR 2.32, 95% CI 1.5-3.5).Key conclusionswomen experience profound changes in their sexual and intimate relationships in the first 18 months postpartum. While sex appears to improve over time, emotional satisfaction appears to decline. Partner involvement in household tasks is associated with greater emotional satisfaction.Implications for practicepregnant women and their partners may benefit from information and discussion about the likelihood of changes to their emotional and sexual relationships after childbirth.