Research On Sexual Activity And Sexual Function Of Pregnant Women

BackgroundThe world health organization (WHO) has pointed out that sexual health refers to the reproductive system in its function and behavior involved in the physical, emotional, mental and social aspects of health. Sex is one of the basic needs of human physiological and psychological. But pregnancy is a special and significant period in a woman’s life, in which husband and wife during the pregnancy may still have sexual demands. Incorrect sexual activity during pregnancy will cause vaginal bleeding, abortion, infection, rupture of membranes, as well as the fetal distress. So women’s sexual health during pregnancy is the most important part of health care, and with the advanced gynecology development more and more attention are paid to pregnant women.Many researches about the sex of pregnant women are conducted in Abroad in the 1950s, and scholars have found that sexual intercourse frequency gradually decrease with the increase of gestational, but not disappeared, even keep always still delivery. According to the report,82% of women said that sex is very necessary in pregnant period. Because of Fears about the safety of the fetus and changesof body shape change, the quality of sex during pregnancy is not ideal,22-50% of women feel difficult on sexual intercourse during pregnancy,35 to 88% of the pregnancy women complain about low sexual satisfaction, even fear about the "marriage loyalty" of husband. Therefore, the concerns about sex during pregnancy will seriously affect the mental health of women, such as emotionally unstable, irritability, good tears, anxiety, depression, and to things too sensitive, vulnerable. These severe psychological disorders, will eventually pose a threat to fetal health and safety. Safe and satisfying sexual activity during pregnancy can enhance women’s personal identity, promote the relationship and stable family relationship, even keep good mood for the delivery.Sex during pregnancy should be for maternal and child safety first, so to understand women’s sexual attitude and cognition during pregnancy have important guiding significance to improve the quality of marriage and to ensure maternal and child health, has. For this reason, this study intends to combine qualitative interviews and quantitative research methods, depth interview of pregnancy women of sexual experience, the cognition of sexual life, sexual function and the status of the sexual behavior and its influencing factors, so as to further improve prenatal care instruction work to provide scientific basis.Objectives1 To explore the pregnant women’s experiences of sexual cognition, attitude and behavior changes, as well as the individual adaptation process.2 To analyze and understand the status of the female sexual activity and sexual function during pregnancy.3 To discover and discuss the influence factors of sexual function and sexual behavior among pregnant women.MethodsPart I Qualitative researchQualitative research in depth interview method were conducted to study the experiences of female sexual experiences during pregnancy, about pregnancy women’s sexual cognition, attitude and behavior changes, as well as individual adaptation process. These will be helpful to provide a reference for further analysis of the female sexual activity and function status during pregnancy.1 Research object23 primipara were selected for interviews by purposeful sampling method, in October 2013 to January 2014 from a regular prenatal obstetrics and gynecology clinic of a hospital in Guangzhou.1.1 Inclusion criteria(1) Natural conception;(2) Primipara;(3) Single pregnancy;(4) Normal or low risk of pregnancy, no pregnancy complications and no fetus and the placenta, amniotic fluid, umbilical cord abnormalities;(5) Pregnancy 9 weeks to 38 weeks(include);(6) Age 18 years old to 35 years old (include);(7) Spouses in good health;(8) Without cognitive impairment, and a good language expression ability;(9) Voluntary and informed consent to participate in this study.1.2 Exclusion criteria(1) Not natural conception, such as in vitro fertilization and embryo transplantation conception reproductive technology;(2)Have birth experiences;(3) Twin pregnancy;(4)High-risk pregnancy, pregnancy complications and complications, or abnormal fetus and the placenta, amniotic fluid, umbilical cord;(5) Pregnancy< 9 weeks or> 38 weeks;(6) Age<18 years old or>35 years old;(7) The death of a spouse or a spouse affect sexual health problems;(8) Cognitive impairment;(9) Bad language expression ability;(10) Failed to cooperate.2 Research methodsUsing qualitative research method, firstly, we choosed an quiet and disturbed separate office for interview venue, then used the unified instructions and had face-to-face interviews with primipara by semi-structured and in-depth interviews. Interview content includes the necessity of pregnancy sexual activity and sexual knowledge sources, sexual activity changes during pregnancy, and pleasant or unpleasant experience and feelings, etc. Observation, notes were combined with the external expression in tone and expression to collect data. Artistic conception analysis method and generic analysis methods were used to analyze real experience in the process of sexual activity, summarizes the refining theme.Part Ⅱ Quantitative researchAccording to the cross-sectional study method, the Female Sexual Function Scale(FSFI) and self-designed questionnaire were used to survey the personal basic information, sexual attitudes, sexual demand, frequency of sexual activity, FSFI scores and sexual information sources, the concern about sex during pregnancy, and so on. Then statistical analysis of the influencing factors of were benefit to the sexual health education during pregnancy, which provided the reference for the future.1 Research objectUsing the convenience sampling method, from April to July in 2014,642 pregnant women who acceptted regular prenatal from four hospital maternity clinic in Guangzhou and Foshan city were the research objects.1.1 Inclusion criteria(1) Age≥18 years old;(2) Single pregnancy;(3) Normal or low risk of pregnancy, no pregnancy complications and no fetus and the placenta, amniotic fluid, umbilical cord abnormalities;(4) Without cognitive impairment, and be able to complete the questionnaire;(5) Voluntary and informed consent to participate in this study.1.2 Exclusion criteria(1) Age< 18 years old;(2) Twin pregnancy;(3)High-risk pregnancy, pregnancy complications and complications, or abnormal fetus and the placenta, amniotic fluid, umbilical cord;(4) Cognitive impairment and no ability to complete the questionnaire;(5) Failed to cooperate.2 Research methodsThis study used a pregnancy women sexual behaviour questionnaire, including general information, pregnancy sex cognitive questionnaire, Chinese version of Female Sexual Function Index scale(FSFI), sexual activity during pregnancy status questionnaire. Each questionnaire Cronbach’s alpha coefficients were greater than 0.7, the contents were approved by experts, with good validity.3 Research contents(1) Basic social demographic characteristics:primipara, gestational weeks, pregnancy, marital status, age, culture level of pregnant women and the spouse, family monthly income, work situation, living with parents, etc.(2) Cognitive status:10 personality description of common cognitive problems.(3) Sexual status:pregnant women in sexual desire, arousal, vaginal lubrication, orgasm, sexual satisfaction, pain the six aspects of the FSFI score, as well as the different stages of pregnancy female sexual situations.(4) Sex behavior status:the changes of sexual desire, frequency of sexual intercourse, sexual satisfaction, and change the way of sexual intercourse posture, basic information and knowledge sources, such as concern about sex.4 Statistical methodsThe data was inputted by Epidata3.1 and analyzed by SPSS 13.0 statistical software.(1) Measurement data (such as age, gestational weeks, marriage) was analyzed in statistical description (X±S).(2) Social demographic characteristics such as the way of pregnancy, marital status, educational level, etc.), the cognition of sex, sex condition (such as sex, frequency of sexual intercourse, the change of the way), the source of the information, major concerns were described by frequency, percentage.(3) chi-square test was used to compare the differences in sexual desire, sexual intercourse frequency change in the first, second, third trimester of pregnancy.(4) As the dependent variable amount of female sexual score is continuity count data, the t test and variance analysis were used to compare the sexual differences in scores between the two groups,such as primipara and multipara, live with their parents or not. Variance analysis was used to compare different pregnant women and spouse age groups, different stages of pregnancy, different ways of pregnancy, not gay cognitive level, different degree, different occupation, family income levels between groups of the differences in sexual function score, preliminary analysis of the related factors influencing the female sexual score during pregnancy. Select inspection level as the alpha was 0.05, P<0.05 for the difference was statistically significant.(5) Pregnancy female sexual score as the dependent variable, select the the occurrence factors as independent variables, multiple stepwise linear regression analysis was used to explore the related factors that affect pregnancy female sexual. Select inspection level as the alpha was 0.05, P<0.05 for the difference was statistically significant.Results1. Four themes were outlined from 13 subthemes:(1) Differences of sexual activity cognition; (2) Declines of sexual function; (3) Changes of sexual mentality. (4) Measures for changing sexual lifestyle. Primiparas received different sexual information during pregnancy, so the degree of necessity or exclusion for sex was different. And they experienced a decline of sexual function because of sexual hypo-activity, vaginal dryness and satisfaction reduction. Besides, the emotional state varied from jovial and happy to scared, nervous, disgusted and angry. Finally, some measures are adapted to the sexual activity changing during pregnancy, like lowering expectation, limiting frequency and using different positions instead.2. During pregnancy,56.6% of women had the demand for sex,61.4% of women consider the fetus and din’t want to make love for sexual intercourse during pregnancy,the concerns mainly for abortion (61.7%), vaginal bleeding (49.8%), premature birth (45.0%), infection (42.2%), premature rupture of membranes (25.1%).3.48.3% of the pregnant women didn’t know how to have sex; the ways of acceptting sexual information were mainly browsing the web (53.6%), reading newspapers and books (43.6%), doctors recommend (22.3%), friends (17.0%), the elders told (10.6%), 80.8% of women were willing to accept professional help and advice.4. In 642 pregnant women,71.5% of pregnant women’s sexual desire was reduced, 89.4% sexual intercourse frequency decreased,41.9% of pregnant women sexual satisfaction levels dropped.5. Pregnant female sexual score was 18.13±6.08, much lower than the critical value of 26.55.6. Multi-factor analysis showed, the influence factors of female sexual score during pregnancy were the change of sexual behavior, the pregnancy weeks, concerns vaginal bleeding, and pregnant women’s age(P< 0.05).The statistics are:sexual behavior change (B=-2.889, Beta=-0.343, t= 9.449, P= 0.000), the pregnancy stages (B=-1.359, Beta=-0.149, t= 4.097, P= 0.000), concern about vaginal bleeding (B=-1.250, Beta=-1.250, t= 2.840, P= 0.005), pregnant women age (B=-0.701, Beta=-0.701, t= 2.127, P= 0.034).Conclusions1. Women still have sexual needs during pregnancy, which are easy to be suppressed with traditional culture influence.2. Pregnancy women desire is really caring, understanding, attention, fetal safety is the biggest concern for their sex life.3. Pregnancy women didn’t had scientific sexual perception guidance, for the lack of medical personnel professional health education.4. Pregnant Women’s libido and sexual satisfaction decreased, the frequency of sexual intercourse reduced.5. Domestic female sexual function during pregnancy was at low levels, which prompted medical personnel should be active in disseminating the knowledge of safe sexual activity during pregnancy, including the advantages and disadvantages of the relationship between pregnancy and sexual life and the corresponding problems of the processing, more system comprehensively to ensure the safety of maternal and infant.