The prevailing narrative about sexual declines during the transition to parenthood is largely based on studies assessing the average couple, but there is increasing evidence of variability in the sexual well-being of new parents. We sought to establish distinct subgroups of couples based on sexual function and sexual distress trajectories and examine biopsychosocial risk and protective factors of these trajectories. A prospective cohort of 257 first-time parent couples reported on sexual function and sexual distress from 20-week pregnancy (baseline) to 6 months postpartum across four time-points. Biopsychosocial factors were assessed at baseline and 3 months postpartum. Dyadic latent class growth analysis identified two distinct sexual function classes (high, 85%; discrepant, 15%) and three sexual distress classes (low, 77%; moderate, 12%; discrepant, 11%). We identified biomedical (vaginal delivery, perineal tear, breastfeeding) and psychosocial (fatigue, stress, anxiety, depression, attitudes toward sex during pregnancy, relationship quality, perceived partner support) factors that can be assessed at critical time-points (i.e., 20-week pregnancy and 3 months postpartum) to identify high-risk couples. Current results indicate that the course of change in sexual well-being for new parents is heterogeneous, with most new parents retaining high function and low distress and only a minority showing trajectories in which mothers, but not fathers, experience clinically significant and persistent levels of low sexual function and high sexual distress. These results may facilitate more nuanced approaches to the assessment and intervention of new parents’ sexual well-being.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
De-identified data and syntax for the analyses are available on the Open Science Framework at https://osf.io/wabfk/?view_only=b80534a86fa043f9b7c45695db316d6c
Alligood-Percoco, N. R., Kjerulff, K. H., & Repke, J. T. (2016). Risk factors for dyspareunia after first childbirth. Obstetrics and Gynecology, 128(3), 512–518. https://doi.org/10.1097/AOG.0000000000001590
Asselmann, E., Hoyer, J., Wittchen, H.-U., & Martini, J. (2016). Sexual problems during pregnancy and after delivery among women with and without anxiety and depressive disorders prior to pregnancy: A prospective-longitudinal study. Journal of Sexual Medicine, 13(1), 95–104. https://doi.org/10.1016/j.jsxm.2015.12.005
Atlantis, E., & Sullivan, T. (2012). Bidirectional association between depression and sexual dysfunction: A systematic review and meta-analysis. Journal of Sexual Medicine, 9(6), 1497–1507. https://doi.org/10.1111/j.1743-6109.2012.02709.x
Bakk, Z., Tekle, F. B., & Vermunt, J. K. (2013). Estimating the association between latent class membership and external variables using bias-adjusted three-step approaches. Sociological Methodology, 43(1), 272–311. https://doi.org/10.1177/0081175012470644
Barlow, D. H. (1986). Causes of sexual dysfunction: The role of anxiety and cognitive interference. Journal of Consulting and Clinical Psychology, 54(2), 140–148. https://doi.org/10.1037//0022-006x.54.2.140
Barnett, R., & Shen, Y.-C. (1997). Gender, high- and low-schedule-control housework tasks, and psychological distress: A study of dual-earner couples. Journal of Family Issues, 18(4), 403–428. https://doi.org/10.1177/019251397018004003
Basson, R. (2000). The female sexual response: A different model. Journal of Sex & Marital Therapy, 26(1), 51–65. https://doi.org/10.1080/009262300278641
Beveridge, J. K., Vannier, S. A., & Rosen, N. O. (2018). Fear-based reasons for not engaging in sexual activity during pregnancy: Associations with sexual and relationship well-being. Journal of Psychosomatic Obstetrics and Gynaecology, 39(2), 138–145. https://doi.org/10.1080/0167482X.2017.1312334
Bolck, A., Croon, M., & Hagenaars, J. (2004). Estimating latent structure models with categorical variables: One-step versus three-step estimators. Political Analysis, 12(1), 3–27. https://doi.org/10.1093/pan/mph001
Busby, D. M., Christensen, C., Crane, D. R., & Larson, J. H. (1995). A revision of the Dyadic Adjustment Scale for use with distressed and nondistressed couples. Journal of Marital and Family Therapy, 21(3), 289–308.
Cappell, J., Bouchard, K. N., Chamberlain, S. M., Byers-Heinlein, A., Chivers, M. L., & Pukall, C. F. (2020). Is mode of delivery associated with sexual response? A pilot study of genital and subjective sexual arousal in primiparous women with vaginal or cesarean section births. Journal of Sexual Medicine, 17(2), 257–272. https://doi.org/10.1016/j.jsxm.2019.11.264
Chew, P. Y., Choy, C. L., Sidi, H. B., Abdullah, N., Che Roos, N. A., Salleh Sahimi, H. M., Abdul Samad, F. D., & Ravindran, A. (2021). The association between female sexual dysfunction and sexual dysfunction in the male partner: A systematic review and meta-analysis. Journal of Sexual Medicine, 18(1), 99–112. https://doi.org/10.1016/j.jsxm.2020.10.001
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385. https://doi.org/10.2307/2136404
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786. https://doi.org/10.1192/bjp.150.6.782
Cranston-Cuebas, M. A., & Barlow, D. H. (1990). Cognitive and affective contributions to sexual functioning. Annual Review of Sex Research, 1, 119–161.
Dawson, S. J., Leonhardt, N. D., Impett, E. A., & Rosen, N. O. (2021). Associations between postpartum depressive symptoms and couples’ sexual function and sexual distress trajectories across the transition to parenthood. Annals of Behavioral Medicine, 55(9), 879–891. https://doi.org/10.1093/abm/kaaa117
Dawson, S. J., Strickland, N. J., & Rosen, N. O. (2022). Longitudinal associations between depressive symptoms and postpartum sexual concerns among first-time parent couples. Journal of Sex Research, 59, 150–159. https://doi.org/10.1080/00224499.2020.1836114
Dawson, S. J., Vaillancourt-Morel, M.-P., Pierce, M., & Rosen, N. O. (2020). Biopsychosocial predictors of trajectories of postpartum sexual function in first-time mothers. Health Psychology, 39(8), 700–710. https://doi.org/10.1037/hea0000861
Derogatis, L., Clayton, A., Lewis-D’agostino, D., Wunderlich, G., & Fu, Y. (2008). Validation of the Female Sexual Distress Scale-Revised for assessing distress in women with hypoactive sexual desire disorder. Journal of Sexual Medicine, 5(2), 357–364. https://doi.org/10.1111/j.1743-6109.2007.00672.x
Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8(3), 430–457. https://doi.org/10.1207/S15328007SEM0803_5
Erickson, R. J. (2005). Why emotion work matters: Sex, gender, and the division of household labor. Journal of Marriage and Family, 67(2), 337–351. https://doi.org/10.1111/j.0022-2445.2005.00120.x
Ferguson, S. L., Moore, G. E. W., & Hull, D. M. (2019). Finding latent groups in observed data: A primer on latent profile analysis in Mplus for applied researchers. International Journal of Behavioral Development, 44(5), 458–468. https://doi.org/10.1177/0165025419881721
Fitzpatrick, E. T., Kolbuszewska, M. T., & Dawson, S. J. (2021). Perinatal sexual dysfunction: The importance of the interpersonal context. Current Sexual Health Reports, 13(3), 66–67. https://doi.org/10.1007/s11930-021-00314-7
Grimm, K. J., Ram, N., & Estabrook, R. (2016). Growth modeling: Structural equation and multilevel modeling approaches. Guilford Press.
Foran, H. M., & Kliem, S. (2015). Longitudinal analysis of dyads using latent variable models: Current practices and constraints. In M. Stemmler, A. von Eye, & W. Wiedermann (Eds.), Dependent data in social sciences research (pp. 203–229). Springer International.
Forbes, M. K., Baillie, A. J., & Schniering, C. A. (2014). Critical flaws in the Female Sexual Function Index and the International Index of Erectile Function. Journal of Sex Research, 51(5), 485–491. https://doi.org/10.1080/00224499.2013.876607
Giuliano, F., Rampin, O., & Allard, J. (2002). Neurophysiology and pharmacology of female genital sexual response. Journal of Sex & Marital Therapy, 28(Suppl 1), 101–121. https://doi.org/10.1080/00926230252851230
INE. (2011). Censos 2011. [2011 Portuguese National Census].
Jawed-Wessel, S., Herbenick, D., Schick, V., Fortenberry, J. D., Cattelona, G., & Reece, M. (2016). Development and validation of the Maternal and Partner Sex During Pregnancy Scales. Journal of Sex & Marital Therapy, 42(8), 681–701. https://doi.org/10.1080/0092623X.2015.1113587
Joel, S., Eastwick, P. W., Allison, C. J., Arriaga, X. B., Baker, Z. G., Bar-Kalifa, E., Bergeron, S., Birnbaum, G. E., Brock, R. L., Brumbaugh, C. C., Carmichael, C. L., Chen, S., Clarke, J., Cobb, R. J., Coolsen, M. K., Davis, J., de Jong, D. C., Debrot, A., DeHaas, E. C., & Wolf, S. (2020). Machine learning uncovers the most robust self-report predictors of relationship quality across 43 longitudinal couples studies. PNAS, 117(32), 19061–19071. https://doi.org/10.1073/pnas.1917036117
Jones, B. L., & Nagin, D. S. (2007). Advances in group-based trajectory modeling and an SAS procedure for estimating them. Sociological Methods & Research, 35, 542–571. https://doi.org/10.1177/0049124106292364
Jung, T., & Wickrama, K. A. S. (2008). An introduction to latent class growth analysis and growth mixture modeling. Social and Personality Psychology Compass, 2(1), 302–317. https://doi.org/10.1111/j.1751-9004.2007.00054.x
LaMarre, A. K., Paterson, L. Q., & Gorzalka, B. B. (2003). Breastfeeding and postpartum maternal sexual functioning: A review. Canadian Journal of Human Sexuality, 12(3–4), 151–168.
Lorenz, T. K., Ramsdell, E. L., & Brock, R. L. (2020). A close and supportive interparental bond during pregnancy predicts greater decline in sexual activity from pregnancy to postpartum: Applying an evolutionary perspective. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.02974
McBride, H. L., & Kwee, J. L. (2017). Sex after baby: Women’s sexual function in the postpartum period. Current Sexual Health Reports, 9(3), 142–149. https://doi.org/10.1007/s11930-017-0116-3
Meston, C. M., Freihart, B. K., Handy, A. B., Kilimnik, C. D., & Rosen, R. C. (2020). Scoring and Interpretation of the FSFI: What can be learned from 20 years of use? Journal of Sexual Medicine, 17(1), 17–25. https://doi.org/10.1016/j.jsxm.2019.10.007
Meyer-Bahlburg, H. F. L., & Dolezal, C. (2007). The Female Sexual Function Index: A methodological critique and suggestions for improvement. Journal of Sex & Marital Therapy, 33(3), 217–224. https://doi.org/10.1080/00926230701267852
Mitchell, K. R., Lewis, R., O’Sullivan, L. F., & Fortenberry, J. D. (2021). What is sexual wellbeing and why does it matter for public health? The Lancet Public Health, 6(8), e608–e613. https://doi.org/10.1016/S2468-2667(21)00099-2
Muthén, L. K., & Muthén, B. O. (1998–2017). Mplus user’s guide (Eighth ed.). Muthén & Muthén.
Norton, G. R., & Jehu, D. (1984). The role of anxiety in sexual dysfunctions: A review. Archives of Sexual Behavior, 13(2), 165–183. https://doi.org/10.1007/BF01542150
Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Structural Equation Modeling: A Multidisciplinary Journal, 14(4), 535–569. https://doi.org/10.1080/10705510701575396
Robertson, L. G., Anderson, T. L., Hall, M. E. L., & Kim, C. L. (2019). Mothers and mental labor: A phenomenological focus group study of family-related thinking work. Psychology of Women Quarterly, 43(2), 184–200. https://doi.org/10.1177/0361684319825581
Rosen, N. O., Dawson, S. J., Binik, Y., Pierce, M., Brooks, M., Pukall, C. F., Chorney, J., Snelgrove-Clarke, E., & George, R. (2021a). Trajectories of dyspareunia from pregnancy to 24 months postpartum. Obstetrics & Gynecology, 139(3), 391–399.
Rosen, N. O., Dawson, S. J., Leonhardt, N. D., Vannier, S. A., & Impett, E. A. (2021b). Trajectories of sexual well-being among couples in the transition to parenthood. Journal of Family Psychology, 35, 523–533. https://doi.org/10.1037/fam0000689
Rosen, R., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., Ferguson, D., & D’Agostino, R. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex and Marital Therapy, 26(2), 191–205. https://doi.org/10.1080/009262300278597
Rosen, R., Riley, A., Wagner, G., Osterloh, I. H., Kirkpatrick, J., & Mishra, A. (2021a). The International Index of Erectile Function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 49(6), 822–830. https://doi.org/10.1016/S0090-4295(97)00238-0
Rowland, M., Foxcroft, L., Hopman, W. M., & Patel, R. (2005). Breastfeeding and sexuality immediately post partum. Canadian Family Physician Medecin de Famille Canadien, 51(10), 1366–1367.
Santos-Iglesias, P., Mohamed, B., Danko, A., & Walker, L. M. (2018). Psychometric validation of the Female Sexual Distress Scale in male samples. Archives of Sexual Behavior, 47(6), 1733–1743. https://doi.org/10.1007/s10508-018-1146-2
Shapiro, A. F., Gottman, J. M., & Carrère, S. (2000). The baby and the marriage: Identifying factors that buffer against decline in marital satisfaction after the first baby arrives. Journal of Family Psychology, 14(1), 59–70. https://doi.org/10.1037/0893-322.214.171.124
Tavares, I. M., Barros, T., Rosen, N. O., Heiman, J., & Nobre, P. J. (2022). Is expectant couples’ similarity in attitudes to sex during pregnancy linked to their sexual well-being? A dyadic study with response surface analysis. Journal of Sex Research, 59, 160–172. https://doi.org/10.1080/00224499.2021.1946672
Tavares, I. M., Heiman, J. R., Rosen, N. O., & Nobre, P. J. (2021). Validation of the maternal and partner sex during pregnancy scales (MSP/PSP) in Portugal: Assessing dyadic interdependence and associations with sexual behaviors. Journal of Sexual Medicine, 18(4), 789–799. https://doi.org/10.1016/j.jsxm.2021.01.184
Tavares, I. M., Moura, C. V., & Nobre, P. J. (2020). The role of cognitive processing factors in sexual function and dysfunction in women and men: A systematic review. Sexual Medicine Reviews, 8(3), 403–430. https://doi.org/10.1016/j.sxmr.2020.03.002
Tavares, I. M., Schlagintweit, H. E., Nobre, P. J., & Rosen, N. O. (2019). Sexual well-being and perceived stress in couples transitioning to parenthood: A dyadic analysis. International Journal of Clinical and Health Psychology, 19, 198–208. https://doi.org/10.1016/j.ijchp.2019.07.004
van Anders, S. M., Herbenick, D., Brotto, L. A., Harris, E. A., & Chadwick, S. B. (2022). The heteronormativity theory of low sexual desire in women partnered with men. Archives of Sexual Behavior, 51, 391–415. https://doi.org/10.1007/s10508-021-02100-x
van de Schoot, R., Sijbrandij, M., Winter, S. D., Depaoli, S., & Vermunt, J. K. (2017). The GRoLTS-checklist: Guidelines for reporting on latent trajectory studies. Structural Equation Modeling, 24(3), 451–467. https://doi.org/10.1080/10705511.2016.1247646
Vermunt, J. K. (2010). Latent class modeling with covariates: Two improved three-step approaches. Political Analysis, 18(4), 450–469.
Wiegel, M., Meston, C., & Rosen, R. (2005). The Female Sexual Function Index (FSFI): Cross-validation and development of clinical cutoff scores. Journal of Sex & Marital Therapy, 31(1), 1–20. https://doi.org/10.1080/00926230590475206
World Health Organization. (2010). Developing sexual health programmes: A framework for action. Author.
Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52(1), 30–41. https://doi.org/10.1207/s15327752jpa5201_2
The authors would like to thank Centro Materno Infantil do Norte for their collaboration in recruiting participants for this study and to the couples who participated in this research.
This research was funded by the Portuguese Foundation for Science and Technology (FCT) and the COMPETE 2020 program (CPUP UIDB/00050/2020, POCI-01-0145-FEDER-0072). The first author was supported by a grant from FCT (SFRH/BD/131808/2017).
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Conflict of interest
The authors report no conflicts of interest.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Tavares, I.M., Rosen, N.O., Heiman, J.R. et al. Biopsychosocial Predictors of Couples’ Trajectories of Sexual Function and Sexual Distress Across the Transition to Parenthood. Arch Sex Behav (2022). https://doi.org/10.1007/s10508-022-02480-8
- Sexual well-being
- Sexual function
- Sexual distress