Introduction: Pregnancy is a state when body undergoes biopsychosocial and hormonal changes which affect pregnant women and her partner. The aim of this study was assessing the changes in sexual life of pregnant women and their partners. Methods: A descriptive cross-sectional study carried out at 8 public hospitals in Kosovo. Mostly, pregnant women in third trimester attending hospitals between July and December 2017 were eligible. The questionnaires have been distributed and supervised by the Kosovo Midwife Association, while have been fulfilled by pregnant women in the delivery room or in their rest rooms. Categorical data were expressed by percentage and comparisons were made by the T-test. Statistical significance was considered as p < 0.05. Results: Out of 1510 participants, who took part in this study, it is shown that the majority of them were between the age of 18 and 35. Only 7.7% were under 18 years old. The 66.2% of the surveyed women have previously planned their pregnancies. The frequency of sexual intercourse per week shows a considerable changing among participants in the study. The number of women who are not satisfied with their sexual lives has increased from 7.9% before the pregnancy to 18.6% during pregnancy. The number of women who have never or rarely experienced orgasm has increased from 9.6% to 16.4% while the percentage of those who have often experienced orgasm before pregnancy has decreased from 38% to 22.5% during pregnancy. From the analyzed parameters only the sexual desire has not undergone changes before and during pregnancy. Moreover, the sexual desire has shown increase, into the option once a day. Conclusion and Recommendation: Apart of sexual desire which remains the same all other parameters have been decreased during the pregnancy. The role of health professionals in consulting sexual activity problems needs to be improved.
Pregnancy is a state when body undergoes biopsychosocial and hormonal changes which affect pregnant women and her partner. Those changes usually are connected with physical pleasure and sexual activity. Pregnancy and birth mark a very special period in a woman’s life. It is a time of physical and psychological changes that commonly impact women’s physical wellbeing, mood, relationships and sexuality [
This is one of the largest studies about the impact of pregnancy in sexual life using a validated inventory. Many studies concerning sexuality in pregnancy were performed using a different tests and methods. The Pregnancy Sexual Response Inventory (PSRI) is a new validated instrument for evaluating sexuality and sexual activity and related health concerns during pregnancy. It’s designed and validated by the group of experts (Cibele VC Rudge et al.) from São Paulo State University, Brazil.
AimThe aim of this study was assessing the changes in sexual life of pregnant women and their partners.
1) Study design: A descriptive cross-sectional study carried out at 8 public hospitals in Kosovo during the period of five months from July to December 2017.
2) Study population: Mostly, pregnant women in third trimester attending hospitals between were eligible. The reason for this was to include the whole pregnancy period in the study.
3) Sample size: Study included 1510 pregnant women. Sample size calculation was done based on the data from the Agency of Statistics of Kosovo where is found that the number of births in 2015 was 24,594. Based on this number with the bias margins of 2% and with the Confidence Interval of 95%, the sample was found to be 2188 participants. This number has been divided into percentage based on hospitals and according to this we have come up with the precise number of women that have to be interviewed in each hospital (
4) Exclusion criteria: pregnant women with systemic diseases (diabetes, thyroid dysfunction, heart disease), a sexual partner living separately, a history of drug use, and a diagnosis of psychiatric disorders were excluded from the study.
5) Data collection: The tool was a 38-item (12 demographic characteristics and 26 sexual behavior or activity) semi-structured PSRI questionnaire which is a new validated instrument for evaluating sexuality and sexual activity and related health concerns during pregnancy. The eight domains of female feelings included: frequency, desire, arousal, orgasm, pleasure, dyspareunia, intercourse initiation, female difficulties and male sexual pleasure assessed by the female view. The questionnaires have been distributed and supervised by the Kosovo Midwife Association, whose members have been trained in advance for the instructions and the help during completion. The questionnaires have been fulfilled by pregnant women in the delivery room or in their rest rooms. The set time for the completion of the questionnaire was thought to be sufficient to be completed within 3 months. After that, 1510 or 69% of the questionnaires have been in compliance to the criteria and have been added to the database for further analysis.
Approval for the study was given by the local Ethics Committee and an oral
Hospitals | Births (2015) | % from total | Sample size |
---|---|---|---|
Prishtina | 10511 | 42.6 | 932 |
Vushtri | 506 | 2 | 43 |
Gjakove | 2115 | 8.6 | 188 |
Gjilan | 2094 | 8.5 | 186 |
Mitrovice | 1291 | 5.2 | 115 |
Peje | 2426 | 9.9 | 217 |
Prizren | 4020 | 16.6 | 363 |
Ferizaj | 1631 | 6.6 | 144 |
Total | 24594 | 100 | 2188 |
Bias margin 2% while CI 95% |
statement of informed consent was obtained from all participants prior to interview.
6) Statistical Analysis: All statistical analyses were performed using the Statistical Package for Social Sciences for Windows Version 20.0 (SPSS 20.0). Categorical data were expressed by percentage and comparisons were made by the T-test. Statistical significance was considered as p < 0.05.
According to the demographic data of 1510 participants, who took part in this study, it is shown that the majority of them were between the age of 18 and 35. Only 117 (7.7%) were under 18 years old. There were 88.4% (1335) of the surveyed women in the third trimester of pregnancy. 41.1% (620) of them have only got one child, whereas 509 (33.7%) have not got children. It is worth mentioning that 66.2% (1000) of the surveyed women have previously planned their pregnancies. The use of condoms is not a common phenomenon because 61.1% (922) of them have declared that they have not used condoms, whereas only 193 (12.8%) have stated that they use condoms often or very often (
The frequency of sexual intercourse per week shows a considerable changing among participants in the study. The number of women who before the pregnancy have not had any sexual intercourse for a week has been 11.3%, in the first trimester this number has increased up to 29.8%, and during the moment of interview has marked 25.2%. In the second option, 1 - 2 times a week there has not
Mother’s age | Nr | % | p |
---|---|---|---|
<18 | 117 | 7.7 | <0.05 |
18 - 25 | 603 | 39.9 | |
26 - 35 | 594 | 39.3 | |
35+ | 174 | 11.5 | |
Gestational age | <0.01 | ||
II trimester | 145 | 9.6 | |
III trimester | 1335 | 88.4 | |
Do you have children | NS | ||
No | 509 | 33.7 | |
Just one | 620 | 41.1 | |
Two or more | 377 | 25.0 | |
Did you plan your pregnancy | <0.05 | ||
Yes | 1000 | 66.2 | |
No | 501 | 33.2 | |
Do you use condoms | <0.05 | ||
No | 922 | 61.1 | |
Yes, but stopped before pregnancy | 386 | 25.6 | |
Yes, often or very often | 193 | 12.8 |
been any significant difference of the state before and during pregnancy. Women who claimed to have sexual intercourse 3 or more times before pregnancy declared a considerable decrease in the first trimester and in the moment of interview (
The number of women who are not satisfied with their sexual lives has increased from 7.9% (120) before the pregnancy to 18.6% (281) during pregnancy whilst the number of those who have been satisfied before the pregnancy has decreased during pregnancy, 59.5% vs. 31.3%. The sexual arousal has also undergone significant statistical changes during the phase of pregnancy. The number of those who had poor sexual intercourse before pregnancy has increased from 8.7% to 23.2%, whereas the number in percentage of those who have had an excellent sexual arousal before pregnancy has decreased from 31.7% to 18.8%. From the analyzed parameters only the sexual desire has not undergone changes before and during pregnancy. Moreover, the sexual desire has shown increase, into the option once a day. The orgasm as a sexual cycle response has had changes during pregnancy. The number of women who have never or rarely experienced orgasm has increased from 9.6% to 16.4% while the percentage of those who have often experienced orgasm before pregnancy has decreased from 38% to 22.5% during pregnancy. Dyspareunia to the participants included in this study did not prove to have important statistical changes comparing to their state before and during the pregnancy. The increase of this phenomenon goes from 30.4% to 39.5%. The initiation of sexual intercourse is another phenomenon included in PSRI. This study shows a slight increase in number of cases where the partner has persuaded this intercourse from 7.6% to 8.1%, whereas the number of cases where this intercourse happens impromptu or after stimulation has decreased during pregnancy from 51.3% ne 45% (
PSRI also contains questions that are intertwined with partner’s difficulties during sexual intercourse from woman’s perspective. There is not any significant change in statistics from the answers for the situation before and during
Satisfaction with sexual life | Before pregnancy n (%) | During pregnancy n (%) | p value |
---|---|---|---|
No | 120 (7.9) | 281 (18.6) | |
Somewhat | 474 (31.4) | 733 (48.5) | <0.05 |
Yes | 899 (59.5) | 473 (31.3) | |
How would you rate your arousal | |||
Poor/very poor | 132 (8.7) | 350 (23.2) | |
Regular | 877 (58.1) | 853 (56.5) | <0.05 |
Excellent | 478 (31.7) | 284 (18.8) | |
How often did you experience sexual desire | |||
A few times a week | 544 (36.0) | 489 (32.4) | |
Once a day | 272 (18.0) | 288 (19.1) | NS |
Other (depending on the occasion ) | 671 (44.4) | 723 (47.9) | |
How often did you achieve orgasm | |||
Never/rarely | 145 (9.6) | 248 (16.4) | |
Sometimes | 764 (50.6) | 891 (59.0) | <0.05 |
Often or very often | 574 (38.0) | 340 (22.5) | |
Pain during sexual intercourse | |||
Yes | 459 (30.4) | 596 (39.5) | NS |
No | 1022 (67.7) | 886 (58.7) | |
The initiation of intercourse | |||
Forced, without any desire | 115 (7.6) | 123 (8.1) | |
Partner usually made the first move | 584 (38.7) | 665 (44.0) | NS |
Spontaneously or spontaneously with stimuli | 775 (51.3) | 687 (45.5) |
pregnancy. Women in 18.3% of cases think that the partner had sexual obstacles before the pregnancy and this number is slightly increased to 24% during pregnancy (
This study is a rare one in which PSRI questionnaire has been used. It is the only one designed and structured test to assess specifically the impact of pregnancy in the sexual life between women and their partners. Then, the sample chosen with up to 1500 participants, distinguishes this study from the others. The PSRI was developed over a series of stages, including pre-selection of the initial items, pretesting on volunteer pregnant women and then validation of the internal consistency reliability and content validity by a panel of expert consultants. The results from the present investigation demonstrated that the PSRI has good internal consistency and reliability over its entire scale (Cronbach’s α = 0.79) and is suitable for use in assessing sexual function during pregnancy in obstetric
clinical samples [
Psychological aspects and physiological changes in pregnant women strongly correlate with sexual function during that specific period. It is believed that sexual function diminishes over the course of pregnancy. Before conceiving women mostly had intercourses 1 - 2 times during the week (53.7%).
Only 1 in 4 respondents had intercourse 1 to 3 times in a month [
Women often wonder about the safety of sexual intercourse while pregnant and also seem not to discuss it openly with their caregivers [
The number of women participants in our study, who have not been satisfied with their sexual lives before pregnancy, has been 7.9%. This number has shown increase to 18.6% while the number of women that have been satisfied with their sexual lives before the pregnancy has evidently been decreased during pregnancy from 59.5% to 31.3%, which shows that pregnancy affects negatively to sexual satisfaction. Different scholars have come up to different results related to this phenomenon. Sexual satisfaction was unchanged in 48.4% of the subjects and decreased in 27.7%, [
According to the literature, the sexual arousal hasn’t been widely studied so far. In our study the percentage of women who have had poor/very poor arousal has increased from 8.7% to 23.2%, while the percentage of those who had excellent arousal before pregnancy has decrease from 31.7% to 18.8%.
According to most authors, sexual function worsens throughout pregnancy, with desire being the most affected phase of the sexual response. A perceived tendency toward improvement of the sexual pattern occurs during the second trimester [
A substantial number of women have notable problem in reaching orgasm. In our study the number of women who have never or rarely had orgasm is increased during pregnancy from 9.6% to 16.4%. Pregnancy has obviously worsened the reach of orgasms to women who before pregnancy have claimed to have often or very often orgasms (38% vs. 22.5%). The percentages of pregnant women who had never had an orgasm in the first trimester, the second trimester and the third trimester were 25%, 18%, and 28% respectively. Trimester comparison showed that orgasms were statistically increased in the second trimester however, orgasms were significantly decreased in all trimesters compared to the pre-pregnancy period [
Şule Gökyildiz determined that pregnant women felt more pain during the coitus as the pregnancy progressed. In our study, we could not find any important statistical differences related to the pain during sexual intercourse. Libido and sexual satisfaction may also be negatively affected by a woman’s self-perception of decreased attractiveness. Typically, as pregnancy progresses, there is a decrease in the achievement of orgasm and sexual satisfaction, and an increase in painful intercourse [
Sexual intercourse is mostly initiated by men, both in pre-pregnancy and pregnancy periods. There were no statistically significant differences in the rate of initiation of sexual intercourse before pregnancy, between trimesters or during pregnancy [
After those interpretations we can conclude that apart of sexual desire which remains the same all other parameters have been decreased during the pregnancy. The role of health professionals in consulting sexual activity problems needs to be improved.
Fejza, H., Icka, E., Alilaj, M., Elezi, M., Fejza, A. and Jemini, L. (2018) Assessing the Impact of Pregnancy on Sexuality Using the Pregnancy Sexual Response Inventory. Advances in Sexual Medicine, 8, 15-24. https://doi.org/10.4236/asm.2018.82002