Background
Sexual health is a multidimensional phenomenon constructed by personal, social, and cultural factors but continues to be studied with a biomedical approach. During the postpartum the woman transitions to mother, as well as partner to parent and couple to family. There are new realities in life in the postpartum, including household changes and new responsibilities that can impact the quality of sexual health. This phenomenon is understudied especially in the context of Spain. The purpose of this study was to describe the lived experience of postpartum sexual health among primiparous women giving birth in Catalonia (Spain).
Methods
This was a phenomenological study with a purposive sample of women within the first postpartum year. Data was collected through semi-structured interviews until saturation was achieved. Analysis followed Colaizzi's seven-step process with an eighth translation step added to limit cross-cultural threats to validity. Also, the four dimensions of trustworthiness were established through strategies and techniques during data collection and analysis.
Results
Ten women were interviewed from which five themes emerged, including: Not feeling ready, inhibiting factors, new reality at home, socio-cultural factors, and the clinician within the health system. The process of returning to sexual health was “figured out” as women engaged in experiential learning through trial and error. Most participants reported reduced libido after childbirth, experienced altered body image, and resumed sexual activity before feeling ready. A common finding was fatigue and feeling overloaded by the demands of the newborn. Partner support was described as essential to returning to a normal relationship. Discussions about postpartum sexual health with clinicians were described as taboo, and largely absent from the care model.
Conclusion
Evidence-based practices should incorporate the best evidence from research, consider the preferences of the woman, and use clinician expertise to make decisions. As such, human caring practices should be incorporated into clinical guidelines to recognize the preferences of women regarding their sexual health. Clinicians need to be authentically present, engage in active communication, and tailor their care. More qualitative studies are needed to understand postpartum sexual health in different contexts, cultures, and countries and to identify similarities and differences through metasynthesis.