The Enigma of Rapid Repeat Pregnancy: A Qualitative Study of Teen Mothers

Study ObjectiveRapid repeat pregnancy accounts for 18% of teen pregnancies and leads to adverse health, economic, and developmental outcomes for teen mothers and their children. Few interventions have been successful in reducing rapid repeat pregnancy. In this qualitative study we examined adolescent mothers' perceptions of their decision-making and behaviors that helped prevent or promote a rapid repeat pregnancy.Design, Setting, Participants, Interventions, and Main Outcome MeasuresSemistructured interviews were conducted with 31 adolescent mothers, aged 16-21 years; 15 of these subjects experienced a repeat pregnancy within a year of their first child's birth and 16 had not. Two researchers used a grounded, inductive technique to identify emergent themes; interviews were subsequently coded accordingly. Counts were tabulated of the number of times themes were endorsed among those with or without a repeat pregnancy.ResultsFour overarching themes emerged from the interviews: intentionality regarding pregnancy planning, patients' degree of independence in making contraceptive choices, sense of control over life experience, and barriers to follow-through on contraceptive planning. Teens who had not experienced a rapid repeat pregnancy more often endorsed themes of intentionality in preventing or promoting a pregnancy, independence in decision-making, and feelings of control over their experience. Ambivalence and lack of decision-making about seeking another pregnancy were frequently endorsed by mothers who had experienced a second pregnancy.ConclusionDecision-making regarding seeking or preventing a rapid repeat pregnancy is complex for teen mothers; techniques to help support decision-making or to delay pregnancy until decision-repeat making is complete might be important in reducing rapid pregnancy.     

Examining Links between Sexual Risk Behaviors and Dating Violence Involvement as a Function of Sexual Orientation

Study ObjectiveTo examine the association between dating violence perpetration and victimization and sexually risky behaviors among sexual minority and heterosexual adolescent girls.DesignAdolescent girls reported on sexual orientation, sexual behaviors, and risk-taking, and their use of, and experience with, dating violence in the past year. Data were analyzed using multinomial regression adjusted for race, poverty, living in a single parent household, and gender of current partner to examine (1) whether sexual minority status was associated with sexual risk behaviors after sociodemographic correlates of sexual risk were controlled; and (2) whether dating violence context accounted for elevated risk.SettingUrban, population-based sample of girls interviewed in the home.Participants1,647 adolescent girls (38% European American, 57% African American, and 5% other) aged 17 years. Over one-third of the sample lived in poverty.InterventionsNone.Main Outcome MeasureSexual risk-taking.ResultsSexual minority status differentiated girls engaging in high sexual risk-taking from those reporting none, after controlling for sociodemographic and relationship characteristics. Dating violence perpetration and victimization made unique additional contributions to this model and did not account for the elevated risk conferred by sexual minority status.ConclusionsSexual minority girls (SMGs) were more likely than heterosexual girls to report high sexual risk-taking and teen dating violence victimization. As with heterosexual girls, sexual risk-taking among SMGs was compounded by dating violence, which was not explained by partner gender. Adolescent girls' risky sexual behavior may be reduced by interventions for teen dating violence regardless of sexual minority status.     

Optimizing Preconception Health among Young Women: What Are We Missing?

Study ObjectiveTo evaluate whether receipt of specific preconception counseling topics differs between teen, young adult, and older mothers.Design, Setting, Participants, Interventions, and Main Outcome MeasuresA survey of 291 primarily low-income, minority mothers with young children at pediatric practices in Baltimore, Maryland was conducted. Multivariable logistic regression models generated relative odds of preconception counseling receipt comparing teens (ages 14-19 years) and young adults (ages 20-24 years) to adult women (age ≥25 years) controlling for demographic characteristics, parity, and pregnancy intention.ResultsTeen mothers were less than half as likely to be counseled about taking folic acid, 4 times more likely to be counseled about vaccines, and twice as likely to be counseled about mental health before pregnancy compared with adult mothers.ConclusionAdolescent preventive care might promote some aspects of preconception health, but topics related specifically to pregnancy outcomes might be missed. Because of the high rate of unplanned teen pregnancy in the United States, additional strategies to promote preconception health in this population are warranted.     

Choosing motherhood: The complexities of pregnancy decision-making among young black women ‘looked after’ by the State

Objectivethis paper addresses the experiences of a group of young black teenage mothers looked after by the State, most of whom were also either migrants or asylum seekers. The paper explores the experience of discovery of pregnancy, attempts to seek professional help and the eventual decision to continue with the pregnancy.Designan interpretative study with in-depth interviews.Settingsinterviews were carried out in the participants' homes and focussed on their experiences of pregnancy decision-making.Participants15 young women (aged 16–19), from black minority ethnic groups, with a history of care (past or present), currently pregnant or mothers of a child no older than two years of age.Findingsall the pregnancies were unexpected: eight of the informants conceived as a result of rape and seven while in a relationship. All the young women chose motherhood over abortion despite their complex social and pregnancy background.Conclusionsthe importance of social positioning of migrants in terms of the cluster of negative aspects and environmental disadvantage generally experienced by most immigrants in the host country is raised in this paper. Care practices of pregnant women with complex social factors were little observant of woman-centred care approaches.     

The desire for a child among a sample of heterosexual Australian couples

Objective: To understand the desire for children among heterosexual couples planning for a first child. Background: In Australia, almost two-thirds of all pregnancies are planned, and over 40% of all children born each year are to first-time mothers. Methods: Semi-structured interviews were undertaken as part of a longitudinal study on planned first-time parenthood among Australian heterosexual couples. Ten couples who were planning for a pregnancy were interviewed, men and women separately. Results: An inductive thematic analysis identified four modes of decision-making: (1) female partner-directed, (2) male partner-directed, (3) joint-directed due to circumstance, and (4) joint-directed, and three themes related to the desire to have a child: (1) having children is a natural progression, (2) there is an innate drive to want to have children, and (3) a desire to see oneself reflected in another human being. Conclusions: The paper concludes by exploring the implications of the findings for service provision. Specifically, intending parents may be better supported by services that provide gender-specific information during the planning stage, including about infertility.     

A Qualitative Study of Factors That Influence Contraceptive Choice among Adolescent School-Based Health Center Patients

Study ObjectiveLong-acting reversible contraceptive (LARC) methods can prevent teen pregnancy yet remain underutilized by adolescents in the United States. Pediatric providers are well positioned to discuss LARCs with adolescents, but little is known about how counseling should occur in pediatric primary care settings. We explored adolescent womens' attitudes and experiences with LARCs to inform the development of adolescent-centered LARC counseling strategies.DesignQualitative analysis of one-on-one interviews.SettingParticipants were recruited from 2 urban school-based, primary care centers.ParticipantsThirty adolescent women aged 14-18 years, diverse in race/ethnicity, and sexual experience.InterventionsInterviews were audio-recorded, transcribed, and coded using inductive and deductive coding.Main Outcome MeasureMajor themes were identified to integrate LARC-specific adolescent preferences into existing counseling approaches.ResultsParticipants (mean age, 16.2 years; range, 14-18 years) represented a diverse range of racial and/or ethnic identities. Half (15/30) were sexually active and 17% (5/30) reported current or past LARC use. Five themes emerged regarding key factors that influence LARC choice, including: (1) strong preferences about device-specific characteristics; (2) previous exposure to information about LARCs from peers, family members, or health counseling sessions; (3) knowledge gaps about LARC methods that affect informed decision-making; (4) personal circumstances or experiences that motivate a desire for effective and/or long-acting contraception; and (5) environmental constraints and supports that might influence adolescent access to LARCs.ConclusionWe identified 5 factors that influence LARC choice among adolescent women and propose a framework for incorporating these factors into contraceptive counseling services in pediatric primary care settings.     

Anxiety and Depression Among Sexual Minority Women and Men in Sweden: Is the Risk Equally Spread Within the Sexual Minority Population?

IntroductionSexual minority individuals have a higher risk of anxiety and depression compared with heterosexuals. However, whether the higher risk is spread equally across the sexual minority population is not clear.AimTo investigate the association between sexual orientation and self-reported current anxiety and a history of diagnosis of depression, paying particular attention to possible subgroup differences in risks within the sexual minority population, stratified by sex and to examine participants' history of medical care for anxiety disorders and depression.MethodsWe conducted a population-based study of 874 lesbians and gays, 841 bisexuals, and 67,980 heterosexuals recruited in 2010 in Stockholm County. Data were obtained from self-administered surveys that were linked to nationwide registers.Main Outcome MeasuresBy using logistic regression, we compared risks of current anxiety, histories of diagnosed depression, and register-based medical care for anxiety and/or depression in lesbian and gay, bisexual, and heterosexual individuals.ResultsBisexual women and gay men were more likely to report anxiety compared with their heterosexual peers. Bisexual individuals and gay men also were more likely to report a past diagnosis of depression. All sexual minority groups had an increased risk of having used medical care for anxiety and depression compared with heterosexuals, with bisexual women having the highest risk.ConclusionBisexual women appear to be a particularly vulnerable sexual minority group. Advocating for non-discrimination and protections for lesbian, gay, and bisexual people is a logical extension of the effort to lower the prevalence of mental illness.Björkenstam C, Björkenstam E, Andersson G, et al. Anxiety and Depression Among Sexual Minority Women and Men in Sweden: Is the Risk Equally Spread Within the Sexual Minority Population? J Sex Med 2017;14:396–403.     

Emergency Contraception Services for Adolescents: a National Survey of Children's Hospital Emergency Department Directors

Study ObjectiveTo assess emergency contraception (EC) counseling and prescribing practices of children's hospital emergency department (ED) directors and the use of EC protocols in these settings.DesignCross-sectional study of children's hospital ED directors responding to a 15-minute 44-item semi-structured survey during telephone interviews.Participants50 of 96 eligible directors of children's hospital EDs in the United States.Main Outcome MeasuresEC protocols, EC counseling processes, EC prescribing practices.ResultsMost (80%) ED directors reported always offering EC as part of sexual assault care; 66% were more likely to provide onsite EC in these situations. Only 52% identified the progestin-only regimen as the EC dispensed in their ED, and most (96%) limited provision to fewer than 120 hours after sex. Although 58% of ED directors reported ever prescribing ongoing contraception when providing EC, none had prescribed EC for future use. Written ED protocols for providing EC were more common for sexual assault care (76%) than for non-sexual assault care (14%). Directors who worked at hospitals with a sexual assault program were less likely to discuss all the recommended topics for EC counseling.ConclusionsThe recommended standard of care for providing EC to adolescents in children's hospital EDs is not being met. Although risk of pregnancy following sexual assault and consensual unprotected sex is identical, discrepant practices emerged from this survey of pediatric ED directors. Increased education and policy initiatives within children's hospital EDs are needed to standardize EC services for adolescents in this setting.     

Changes in sexual desire and activity during pregnancy among women in Shahroud,Iran

ObjectiveTo evaluate women's perception of sexual activity during pregnancy in Shahroud, Iran.MethodsData were gathered during 4 semi-structured group interviews with 33 pregnant women attending 2 obstetric outpatient clinics of a teaching hospital in Shahroud. The interviewers taped the interviews, coded and categorized their content, and performed a qualitative content analysis.ResultsMost women reported a decrease in sexual desire and frequency of intercourse during pregnancy (69.7% and 81.8%, respectively). Sexual desire, however, increased for 18.2% of the women. Some felt that accepting intercourse prevented spousal infidelity, but 65.2% worried that it might cause injury to the fetus. Only 24.2% received information on the advisability of sexual activity during pregnancy from their physicians or midwives, and the other 75.8% sensed that they should discuss the topic with a professional but were not comfortable starting the conversation.ConclusionAlong with excessive anxiety, insufficient information is the major reason why sexual intercourse is often considered dangerous, and sometimes avoided, during pregnancy in Iran. Healthcare professionals, especially midwives, should educate and counsel women, and reassure them that intercourse is safe in women with healthy pregnancies.     

“If Everyone Else Is Having This Talk With Their Doctor,Why Am I Not Having This Talk With Mine?”: The Experiences of Sexuality and Sexual Health Education of Young Women With Spina Bifida

IntroductionWomen with spina bifida are sexually active, but most never discuss this topic with providers.AimTo determine what women with spina bifida understand about their sexual health, how they learned about it, what questions they have, and their experiences with their sexuality.MethodsFor this qualitative study, women with spina bifida ages 16 and older without marked developmental delay were individually interviewed. 25 women with spina bifida participated (mean age 27.1 years, range 16–52). Interviews were independently coded for themes by 3 reviewers, using Grounded Theory, with disagreements resolved by consensus.Main Outcome MeasuresWe identified overlapping themes regarding the women’s perception and experience of their sexuality and sexual health education.Results17 of the 25 (68%) participants had been or were currently sexually active. 5 themes emerged regarding their understanding of their sexuality and their sexual experiences: (i) being perceived as asexual, (ii) sources for sex education, (iii) need for spina bifida–specific sex education, (iv) impact of spina bifida–specific features on sexual encounters, and (v) perceived relationship between low sexual self-confidence and risk for sexual assault.Clinical ImplicationsWomen with spina bifida are sexual beings, but they are perceived as asexual by providers, which prevents them from getting adequate sexual health education and leaves them with misconceptions and unanswered questions, as well as vulnerable to sexual abuse.Strength & LimitationsThe strengths of this study include the diversity of women interviewed, including their age, severity of disability, and experiences with their sexuality, as well as the ability to reach thematic saturation. The limitation of this study is that most women received treatment at a single Midwestern tertiary referral center in the United States.ConclusionIncluding sexual health discussions in the usual care of women with spina bifida is critical to enhancing their sexual confidence and experience and preventing sexual abuse.Streur CS, Schafer CL, Garcia VP, et al. “If Everyone Else Is Having This Talk With Their Doctor, Why Am I Not Having This Talk With Mine?”: The Experiences of Sexuality and Sexual Health Education of Young Women With Spina Bifida. J Sex Med 2019;16:853–859.     

Declines in Pregnancies among U.S. Adolescents from 2007 to 2017: Behavioral Contributors to the Trend

Study ObjectivesAdolescent pregnancies and births in the United States have undergone dramatic declines in recent decades. We aimed to estimate the contribution of changes in 3 proximal behaviors to these declines among 14- to 18-year-olds for 2007-2017: 1) delays in age at first sexual intercourse, 2) declines in number of sexual partners, and 3) changes in contraceptive use, particularly uptake of long-acting reversible contraception (LARC).DesignWe adapted an existing iterative dynamic population model and parameterized it using 6 waves of the Centers for Disease Control and Prevention's Youth Risk Behavior Survey. We compared pregnancies from observed behavioral trends with counterfactual scenarios that assumed constant behaviors over the decade. We calculated outcomes by cause, year, and age.ResultsWe found that changes in these behaviors could explain pregnancy reductions of 496,200, 78,500, and 40,700 over the decade, respectively, with total medical and societal cost savings of $9.71 billion, $1.54 billion, and $796 million. LARC adoption, particularly among 18-year-olds, could explain much of the improvement from contraception use. The 3 factors together did not fully explain observed birth declines; adding a 50% decline in sex acts per partner did.ConclusionsDelays in first sexual intercourse contributed the most to declining births over this decade, although all behaviors considered had major effects. Differences from earlier models could result from differences in years and ages covered. Evidence-based teen pregnancy prevention programs, including comprehensive sex education, youth-friendly reproductive health services, and parental and community support, can continue to address these drivers and reduce teen pregnancy.     

Understanding Differences in Problematic Pornography Use: Considerations for Gender and Sexual Orientation

BackgroundWhile preliminary research suggests non-heterosexual men and women view more pornography than their heterosexual counterparts, few studies have examined how problematic use differs across sexual and gender identity groups.AimWe sought to test measurement invariance across popular measures of problematic pornography use (PPU) and examine mean PPU differences across heterosexual men, non-heterosexual men, heterosexual women, and non-heterosexual women.MethodsWe used 3 large archival datasets to examine psychometrics/group differences on the Brief Pornography Screen (BPS; N = 1,439), Problematic Pornography Use Scale (PPUS; N = 5,859), and Cyber Pornography Use Inventory-4 (CPUI-4; N = 893).OutcomesMost PPU scales/subscales demonstrated acceptable fit, and non-heterosexual men and women tended to report more PPU than heterosexual men and women (though exceptions were evident).ResultsConfirmatory factor analyses revealed good fit across each group and instrument, with exception to sexual minority women on the CPUI-4. Each instrument demonstrated at least metric invariance between groups, with exception to one item between heterosexual and sexual minority men on the CPUI-4. Mean differences suggested that sexual minority men and women tend to report more PPU than heterosexual men and women, though several exceptions were evident depending on the PPU dimension. Men tended to report more PPU than women, though exceptions were also evident. Effect sizes ranged from large-to-non-significant depending on PPU dimension.Clinical ImplicationsResearchers and clinicians should consider sexual orientation, gender, and PPU dimension when addressing PPU concerns.Strengths & LimitationsA primary strength of this study is the use of multiple large samples, meaning our results are likely highly generalizable. However, this study is limited in that it only examined sexual orientation groups broadly and did not account for non-cisgender identities.ConclusionsThe BPS, PPUS, and CPUI-4 are all appropriate tools to measure PPU depending on researcher and clinician needs.Borgogna NC, Griffin KR, Grubbs JB, and Kraus SW. Understanding Differences in Problematic Pornography Use: Considerations for Gender and Sexual Orientation. J Sex Med 2022;19:1290–1302.     

Prevalence of Chronic Pelvic Pain by Sexual Orientation in a Large Cohort of Young Women in the United States

BackgroundSexual minority (lesbian, bisexual, mostly heterosexual) young women face many sexual and reproductive health disparities, but there is scant information on their experiences of chronic pelvic pain, including an absence of information on prevalence, treatment, and outcomes.AimThe purpose of this study was to describe the characteristics of chronic pelvic pain experiences of young women by sexual orientation identity and gender of sexual partners.MethodsThe analytical sample consisted of a nationwide sample of 6,150 U.S. young women (mean age = 23 years) from the Growing Up Today Study who completed cross-sectional questionnaires from 1996 to 2007.OutcomesAge-adjusted regression analyses were used to examine groups categorized by sexual orientation identity (completely heterosexual [ref.], mostly heterosexual, bisexual, lesbian) and gender of sexual partner (only men [ref.], no partners, both men, and women). We examined differences in lifetime and past-year chronic pelvic pain symptoms, diagnosis, treatment, and quality of life outcomes. Sensitivity analyses also examined the role of pelvic/gynecologic exam history and hormonal contraceptive use as potential effect modifiers.ResultsAround half of all women reported ever experiencing chronic pelvic pain, among whom nearly 90% had past-year chronic pelvic pain. Compared to completely heterosexual women, there was greater risk of lifetime chronic pelvic pain among mostly heterosexual (risk ratio [RR] = 1.30, 95% confidence interval [CI]: 1.22–1.38), bisexual (RR = 1.30, 95% CI: 1.10–1.52), and lesbian (RR = 1.23, 95% CI: 1.00–1.52) young women. Additionally, compared to young women with only past male sexual partners, young women who had both men and women as past sexual partners were more likely to report chronic pelvic pain interfered with their social activities (b = 0.63, 95% CI: 0.25–1.02), work/school (b = 0.55, 95% CI: 0.17–0.93), and sex (b = 0.53, 95% CI: 0.05–1.00).Clinical ImplicationsHealthcare providers, medical education, and field-wide standards of care should be attentive to the way sexual orientation-based healthcare disparities can manifest into differential prognosis and quality of life outcomes for women with chronic pelvic pain (particularly bisexual women).Strengths & LimitationsOur study is the first to examine a variety of chronic pelvic pain outcomes in a nationwide U.S. sample across different outcomes (ie, past-year and lifetime). Though limited by sample homogeneity in terms of age, race, ethnicity, and gender, findings from this article provide foundational insights about chronic pelvic pain experiences of sexual minority young women.ConclusionOur key finding is that sexual minority women were commonly affected by chronic pelvic pain, and bisexual women face pain-related quality of life disparities.Tabaac AR, Chwa C, Sutter ME, et al. Prevalence of Chronic Pelvic Pain by Sexual Orientation in a Large Cohort of Young Women in the United States. J Sex Med 2022;19:1012–1023.     

The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany

BackgroundPreliminary research shows a substantial impact of the COVID-19 pandemic on women's sexual health, whereby empirical work on sexual well-being of minoritized sexual identities is still rare.AimThe objective of this study was to explore sexual health in heterosexual, lesbian and bisexual cis women during the first wave of COVID-19 pandemic in Germany.MethodsAn anonymous nationwide online survey was conducted among cis women during the first nationwide lockdown in Germany from April 20th to July 20th, 2020. The questionnaire was distributed via e-mail, online chats and social-media platforms.OutcomesDemographic variables and self-report measures from the Sexual Behavior Questionnaire (SBQ-G) "before the pandemic" and "since the pandemic" were collected.ResultsA total of 1,368 cis women participants were included: heterosexual women (n = 844), lesbian women (n = 293), bisexual women (n = 231). Results indicate overall decrease in frequency of sexual contacts and masturbation during the COVID-19 pandemic. Regarding differences before and during the pandemic lesbian women showed significant changes in sexual arousal whereas heterosexual women showed significant changes in all dimensions except capability to enjoy sexual intercourse. The data of bisexual women showed significant changes in almost all dimensions except for frequency of sexual intercourse and sexual arousal. Results of the multiple regression analysis revealed that being younger than 36 years-old, and being in a relationship as well as being heterosexual (compared with being lesbian) is positively associated with general satisfaction with sexual life during the pandemic.Clinical ImplicationsThe findings suggest that during a pandemic sexual and mental health care for (cis) women should be provided and address the specific needs of sexual minority groups.Strengths & LimitationsThis is the first study to describe sexual behavior in heterosexual, lesbian and bisexual women during the COVID-19 pandemic in Germany. Limitations, however, include the fact that the data described were obtained at only one time point so there is a possibility of recall bias, and that the results cannot be generalized because of the underrepresentation of women over age 46.ConclusionThis study examined the impact of the COVID-19 pandemic and resulting social constraints on the sexual health of particular groups of lesbian and bisexual women, which may improve preparedness for future public health and policy crises.Batz F, Lermer E, Hatzler L, et al. The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany. J Sex Med 2022;19:907–922.     

Substance use and mental health disparities among sexual minority girls: results from the Pittsburgh girls study

PurposeTo examine substance use and mental health disparities between sexual minority girls and heterosexual girls.MethodsData from the Pittsburgh Girls Study were analyzed. All girls were 17 years old. Girls were included if they were not missing self-reported sexual orientation and mental health data (N = 527). Thirty-one girls (6%) endorsed same-sex romantic orientation/identity or current same-sex attraction. Bivariate analyses were conducted to test group differences in the prevalence of substance use and suicidal behavior, and group differences in depression, anxiety, borderline personality disorder (BPD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms.ResultsCompared with heterosexual girls, sexual minority girls reported higher past-year rates of cigarette, alcohol, and heavy alcohol use, higher rates of suicidal ideation and self-harm, and higher average depression, anxiety, BPD, ODD, and CD symptoms.ConclusionsSexual minority girls are an underrepresented group in the health disparities literature, and compared with heterosexual girls, they are at higher risk for mental health problems, most likely because of minority stress experiences such as discrimination and victimization. The disparities found in this report highlight the importance of discussing sexual orientation as part of a comprehensive preventive care visit.     

“It's Worked Well for Me”: Young Women's Reasons for Choosing Lower-Efficacy Contraceptive Methods

Study ObjectiveTo understand the diverse reasons why some young women choose contraceptive methods that are less effective at preventing pregnancy, including condoms, withdrawal, and emergency contraception pills, even when more effective contraceptive methods are made available to them.DesignIn-depth interviews with young women at family planning clinics in July-November 2016. Interview data were thematically coded and analyzed using an iterative approach.SettingTwo youth-serving family planning clinics serving predominantly Latinx and African American communities in the San Francisco Bay Area, California.ParticipantsTwenty-two young women ages 15-25 years who recently accessed emergency contraception to prevent pregnancy.InterventionsNone.Main Outcome MeasuresYoung women's experiences using different methods of contraception, with specific attention to methods that are less effective at preventing pregnancy.ResultsYoung women reported having previously used a range of higher- and lower-efficacy contraceptive methods. In interviews, they described affirmative values that drive their decision to use lower-efficacy methods, including: a preference for flexibility and spontaneity over continual contraceptive use, an emphasis on protecting one's body, and satisfaction with the method's effectiveness at preventing pregnancy. Some young women described using a combination of lower-efficacy methods to reduce their pregnancy risk.ConclusionYoung women make contraceptive decisions on the basis of preferences and values that include, but are not limited to, effectiveness at preventing pregnancy. These reasons are salient in their lives and need to be recognized as valid by sexual health care providers to ensure that young women receive ongoing high-quality care.     

Pregnancy and Sexual Relationships Study Involving wOmen and meN (PASSION Study)

IntroductionSexual satisfaction is believed to decrease during pregnancy; however, the effect of pregnancy on the sexual relationship in a couple is not well studied.AimTo assess for sexual dysfunction in heterosexual couples during pregnancy.MethodsWe performed a cross-sectional study of heterosexual pregnant women in the third trimester and their cohabitating partners.Main Outcome MeasuresSexual satisfaction in heterosexual couples during pregnancy was assessed with a self-reported questionnaire, the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) questionnaire.ResultsA total of 53 couples met eligibility criteria, and nearly all of those approached participated (52 of 53 couples). All couples were enrolled at or after 35 weeks’ gestation. The mean age was 29.0 ± 6.4 and 31.3 ± 6.9 years for women and men, respectively. 60% of couples were married, and the remainder were cohabitating and in a committed relationship. When analyzing the results of the GRISS questionnaire for both partners, a significant difference was seen in mean avoidance of sex between women and men (3.31 vs 2.63; P = .047) and non-sensuality (3.54 vs 2.75; P = .040). Women reported more of a decrease in communication about sex when compared with their partners (3.79 vs 3.23; P = .047). Vaginismus was more problematic during pregnancy than before (mean = 4.17), and frequency of intercourse was decreased (mean = 4.93) based on calculated GRISS scores.Clinical ImplicationsPregnant couples reported decreased frequency of intercourse and more pain with intercourse in women. Women were more likely to avoid intercourse and reported more problems with communication regarding sexual needs.Strength & LimitationsThis study is the first to assess both partners in pregnancy. Due to the nature of the study, we were unable to assess other factors affecting the relationship that may result in sexual dysfunction, there was no control group, and the results are limited to heterosexual couples.ConclusionOverall sexual satisfaction and function were not problematic for these couples during pregnancy based on the GRISS scale.Dwarica DS, Garbe Collins G, Fitzgerald C, et al. Pregnancy and Sexual Relationships Study Involving WOmen and MeN (PASSION Study). J Sex Med 2019;16:975–980.