Postpartum sexuality: an interview with Dr Sari van Anders, University of Michigan, Ann Arbor

Sari van Anders ARTICLE IMAGE

Why has research on postpartum sexuality traditionally focused on birth mothers?

Research on postpartum seems to have focused on birth mothers for good reason: women (and, of course, some transmen) are the ones who carry a pregnancy and give birth, and the postpartum is conceptualized as “following birth”.

But there seem to be other reasons as well, including that caregiving has been seen as a natural property of women and a woman’s job, such that men and fathers were given only a minor part to play in care of newborns. Moreover, the focus on birth as a biological and physical event focused the postpartum on women; in our work, we try to conceptualize the postpartum (and childbirth) as, in addition, a social and relational event. In this way, fathers and co-parents are certainly important and involved.

How did you come to study the sexuality of partners of postpartum women?

Because our research team positioned postpartum sexuality as a relational and social phenomenon, it made sense to examine partners. If researchers assume that all postpartum sexuality experiences relate to the biological events of childbirth, like hormonal changes, then it would be difficult to include co-parents (though there is research showing that co-parents do undergo hormonal changes with childbirth).

We felt that it was more scientifically accurate to start out with fewer presumptions of specific influences or causal trajectories, and that invoking only hormones limited the scope without justification. By hypothesizing that social and relational factors might be important to understanding postpartum sexuality, we came to the logical conclusion that partners merited attention too.

As a behavioural neuroendocrinologist, I am typically interested in hormonal phenomena – postpartum sexuality is thought to be a hormonal phenomenon, but I was sceptical at how whether this was the case.

What did your research involve?

We studied female and male partners of women who had given birth, using a retrospective design. In this way, we asked participants to think back on their sexual experiences during the postpartum and respond to an online questionnaire. Our lab is very interested in sexual behaviour and sexual desire; we were interested in how both might be experienced in the postpartum. The two are often conflated, but our experience – and the results from this study – support their separation into distinct constructs.

Researchers have largely been focused on infrequent or ‘delayed’ penis-vagina intercourse; we were interested in a larger set of sexual behaviors, including solitary ones and non-penetrative ones. We also did not approach the postpartum as a time of sexual deficit, per se, and studied both high and low sexual desire.

Did your research find shifts in sexuality in the partners of postpartum women? How did the changes documented by partners compare to those of the birth mothers?

Our research was not longitudinal, so we weren’t looking at shifts per se. However, we found very interesting patterns of sexual behaviour in partners. For example, we found that partners reported engaging in masturbation the earliest, then receptive oral sex, followed by penis-vagina intercourse and performative oral sex.

We also found that, by about 12 weeks, all partners reported reengaging in intercourse and masturbation, most reported reengaging in receptive oral sex, and a majority reported reengaging in performative oral sex. This was very similar to what birth mothers had reported.

We also found that partners reported that their highest sexual desire was influenced by relational factors like birth mothers’ sexual interest and feelings of intimacy, as well as new baby factors like amount of time. These factors were also very similar to what birth mothers reported.

One difference was that partners reported “amount of sexual feelings” was a strong influence on high desire, which birth mothers did not rank highly. But both partners and birth mothers ranked new baby factors as the strongest influences on low sexual desire; things like fatigue, stress, baby’s sleeping habits. These are probably not surprising to the average new mother, father, or co-mother! But factors related to the new baby had been almost absent in prior research, and our study is one of the first to show that these factors are so important, and more important than physiological or biological influences.

How much variance did you find?

People are very variable, and the same is true for postpartum sexuality. For example, very few people indicated that the birth mother’s breastfeeding affected their own sexual desire (in contrast to common assumptions among the public and researchers), but a very small number of people did. And, though the vast majority of partners had reengaged in sexual behaviour in the first few months, a number of others did not.

Were you surprised by your results and how do you think they can be explained?

We were surprised at how strong the effect of new baby factors were as an influence on low desire given how rarely they had been studied in previous research, but not so surprised to see them matter!

We were also somewhat surprised at how important social and relational factors were in terms of influencing desire; obviously, we expected this to some extent, otherwise we would not have included these measures. But these factors all so completely overshadowed birth-related experiences, which was surprising given that those factors (e.g., birth trauma) are largely what has been attended to. So, in some ways we were surprised at the disconnect between what past studies had attended to, and what a broader scope of measures revealed.

Finally, we were surprised by how closely our present results from partners mapped onto our previous results from birth mothers. Of course, we expected some convergence, but the close match was exciting because it really supported the meaningfulness of our findings.

How many people were involved in your study? Is further research needed to confirm your results?

We had 114 participants, but only a small number of the partners were women. We’d like to do a more in-depth study of partners who are women. Our study was retrospective, and we would really like to examine postpartum sexuality as it happens to help us understand it even more.

What impact do you think your research will have?

We hope that this research will help health practitioners think about sexuality in the postpartum as a social and relational phenomenon. And, because our results show that people are engaging in sexual behaviour much earlier than what is currently “officially” recommended, we see implications for sexual health practices and prevention of pregnancy and/or sexually transmitted infections.

We also hope that, by bringing partners into the picture, we expand cultural understandings of the postpartum to include partners (when they are present).

Finally, the postpartum is not just a biomedical event; there’s a new baby! Changes in relationship parameters! We hope our research helps to link all these factors and expand our somewhat narrow current conceptualizations.

What further work needs to be done to increase our understanding of postpartum sexuality?

There is so much to be done; postpartum sexuality is not a widely studied phenomenon. Studying couples would be helpful. Studying the role that postpartum sexuality and/or its deferment plays in relationship functioning would be very valuable. Understanding cultural proscriptions and traditions around postpartum sexuality, and how they impact sexual desire and behaviour would also be very useful. And, studying early postpartum sexuality would be useful for sexual health efforts. Social support is also really important during this time, so studying how access to support and the financial or familial underpinnings of this might help demonstrate how desired sexuality is or is not fairly distributed.

Where can readers find more information?

Talking to a health professional is always a good idea. Many pregnancy websites also have some useful information.

About Dr Sari van Anders

Sari van Anders BIG IMAGESari van Anders is Assistant Professor of Psychology and Women’s Studies at the University of Michigan, and affiliate faculty in the Neuroscience, Reproductive Sciences, and Science, Technology, and Society Programs.

Trained in behavioral neuroendocrinology, Dr. van Anders has published over 50 papers on hormones and intimacy in social context, attending to sexuality, nurturance, and partnering/pair bonding alongside sexual diversity.

Dr. van Anders was awarded the 2013 Association for Psychological Science Janet Taylor Spence Award for Transformative Early Career Contributions, and has organized several feminist sexuality research events.

In addition, Dr. van Anders has spoken at the National Institutes of Health (Health, Behavioral, and Social Sciences), Canadian Institute of Health Research (Institute for Gender and Health), Society for Behavioral Neuroendocrinology, the Society for Personality and Social Psychology, International Academy of Sex Research, Society for Sex Therapy and Research, International Society for the Study of Women’s Sexual Health, and the Society for the Scientific Study of Sexuality.

April Cashin-Garbutt

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April Cashin-Garbutt

April graduated with a first-class honours degree in Natural Sciences from Pembroke College, University of Cambridge. During her time as Editor-in-Chief, News-Medical (2012-2017), she kickstarted the content production process and helped to grow the website readership to over 60 million visitors per year. Through interviewing global thought leaders in medicine and life sciences, including Nobel laureates, April developed a passion for neuroscience and now works at the Sainsbury Wellcome Centre for Neural Circuits and Behaviour, located within UCL.

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