Sexual Aspects of Fertility Disturbances

This chapter concentrates on fertility and subfertility and their various sexual implications. On the one hand, there are sexual dysfunctions that impair conceiving. On the other hand, the message to be infertile or subfertile is usually a severe blow to a person’s or a couple’s identity, quickly impacting sexual desire and sexual pleasure. In middle- and high-income countries, most couples will continue towards medically assisted forms of reproduction. Those phases of examinations and treatments tend to have extensive short-term and long-term sexual consequences. This chapter will elaborate on those elements inherent to medically assisted forms of reproduction that negatively influence sexuality, such as loss of privacy, demolished intimacy, painful vaginal examinations, and hormonal disturbances. The chapter will also indicate ways to diminish negative impacts on sexual satisfaction and pleasure. Maintaining sexual satisfaction and pleasure during such treatments will keep couples less stressed, positively influencing their conception chances. Besides, less stress will keep the woman more relaxed when undergoing pregnancy checks and during childbirth. In the long term, the amount of stress experienced during ART treatment will influence the couple’s sexual life in the subsequent phases of pregnancy and young parenthood. The information in this chapter is relevant for the midwives and HCPs involved in such fertility treatment processes and for other HPCs to better understand the long-term effects of fertility treatment on the couple’s sexuality. This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.</p

Sexual Aspects of Getting Pregnant (Conception and Preconception)

Whereas the start of trying to become pregnant tends to be pleasurable for many couples, that pleasure easily can get lost when it takes longer than the couple had expected. One of the explanations for that is a higher age when starting this process, combined with the idea of the malleability of life that gradually developed in many high-income countries. ‘Still not being pregnant’ can be a real blow to a couple’s identity, one of the reasons behind decreased sexual desire and ‘conception inefficiency’. Usually, that has nothing to do with infertility but with poor logistics in the area between sexual pleasure, couple pleasure, couple expectations and ‘good conception sex’. This chapter will explain the road to such conception inefficiency and offer relevant elements of ‘good conception sex’ and information for the HCP towards preventing the couple from getting into this downward inefficiency. From the principle of ‘chain care’, the focus of good care should also be on the future. After all, most couples plan a pregnancy more or less to reach happy parenthood and happy couplehood. So this chapter includes sexuality in pre-conception care, a completely new approach with ideas on preventing sexual disturbances in the conception phase but also already in the last stage of pregnancy and post-partum. This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.</p

Sexual Aspects of Labour and Birth

Childbirth can be experienced in many different ways. The physiological delivery is, for some women, painful and devastating. For other women, however, it can be an overwhelming sensual or nearly erotic experience that closely can resemble an orgasm. After all, delivery, orgasm and breastfeeding are similar processes, all strongly associated with oxytocin. That makes oxytocin one of the potential factors when couples look for a way to influence labour proactively. The chapter will pay attention to various aspects of physical—sexual stimuli that could affect the start of labour and its continuation. It will also describe several ways of dealing with pain and how the culture and the medical culture influence those processes. The first delivery is not only a physical process but also a significant life event, influencing the bonding between the partners towards parenthood. This chapter also looks into the partner’s role and how to navigate through this process optimally. This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.</p

Sexual Aspects of Getting Pregnant (Conception and Preconception)

Whereas the start of trying to become pregnant tends to be pleasurable for many couples, that pleasure easily can get lost when it takes longer than the couple had expected. One of the explanations for that is a higher age when starting this process, combined with the idea of the malleability of life that gradually developed in many high-income countries. ‘Still not being pregnant’ can be a real blow to a couple’s identity, one of the reasons behind decreased sexual desire and ‘conception inefficiency’. Usually, that has nothing to do with infertility but with poor logistics in the area between sexual pleasure, couple pleasure, couple expectations and ‘good conception sex’. This chapter will explain the road to such conception inefficiency and offer relevant elements of ‘good conception sex’ and information for the HCP towards preventing the couple from getting into this downward inefficiency. From the principle of ‘chain care’, the focus of good care should also be on the future. After all, most couples plan a pregnancy more or less to reach happy parenthood and happy couplehood. So this chapter includes sexuality in pre-conception care, a completely new approach with ideas on preventing sexual disturbances in the conception phase but also already in the last stage of pregnancy and post-partum. This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.</p

Sexual Aspects of High-Risk and Complicated Pregnancy

In a healthy pregnancy, the best response to sexual insecurity is reassurance and telling the couple that they can continue to be sexually active. When the situation gets complicated, things can be different. This chapter elaborates on the sexual risks in conditions such as premature birth, shortened cervix, placental dysfunction, and multiple gestation. It will delineate the relationship between various sexual activities and their potential influence on the uterus and the pregnancy. The chapter will also address how to communicate when specific sexual acts should be discouraged (or forbidden) and simultaneously give room for other sexual acts, in other words: the sexual do’s and don’ts. Midwives and HCPs must be aware of the cultural taboos between the woman and the couple regarding sexuality and pregnancy. It is a common finding in research that patients have many questions about sex but do not ask them. The consequence is that the professional must anticipate when providing information, as it were, by ‘answering the not-asked questions’. This chapter provides the background information needed to do just that in high-risk and complicated pregnancies. This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.</p

Midwifery and Sexuality

This first open-access book on midwifery and sexuality integrates sexual health into the care for the pregnant and postpartum couple. It addresses sexuality and intimacy from an education and prevention perspective instead of just focusing on treating problems, aiming to foster the development of sexual well-being and happy couplehood. Sexuality and intimacy are essential elements in the bonding of the couple and the parents-to-be. That process can be seriously hampered by sexual problems due to mutual misunderstanding, fear and sexual troubles (especially when the natural processes of conceiving, pregnancy and delivery are disturbed). In this phase of life, disruption of intimacy, sexuality and sexual relationship is a significant risk factor for developing couple and family problems. The need for such a book stems from the very limited attention given to this health area in the daily practice of most midwives and related healthcare professionals. In building a close relationship with the couple through frequent, intense, longstanding contact, the midwife acquires a perfect position to address sexuality and intimacy. With 36 authors from 14 countries, the book comprises five modules: 1. Sexuality; 2. Sexual aspects of the various phases of reproduction when things develop without complications; 3. Sexual aspects when those same phases deviate from physiology; 4. Special topics on sexuality relevant to daily midwifery practice; 5. Teaching, learning, skills and competencies with regard to sexuality. This new practical textbook guides healthcare professionals such as midwives, obstetricians, gynaecologists, nurses, general practitioners, pelvic floor therapists, etc., by offering both basic knowledge and skills on sexual health and wellbeing, combined with modern sexological knowledge, like the entirely new topic of sexual aspects of preconception care.</p

Various Sexual Consequences of Interventions in Midwifery Practice

Many different elements influence sexuality and intimacy. Whereas some elements are entirely outside obstetric care, others are directly related to what happens in contact with the midwife. This chapter deals with the consequences (the ‘sexual side effects’) of what the midwife is doing or not doing. It focuses more on behaviour and attitude than on the ‘medical or technical’ aspects. The chapter will discuss possible sexual implications of the midwife’s daily work, incorporating the sexuality theme with attention to body integrity, boundaries, and respect. The chapter will provide part of the information in the form of questions for exercises related to the professional attitude in daily midwife practice. It will also include some aspects of personal involvement in the care of the woman and the couple. A midwife is also a person with sexual feelings, most probably with a sexual life and maybe a sexual relationship. Many HCPs tend not to consider those realities related to their work. However, they can significantly impact when the positive and negative aspects of their clients’ intimacy and sexuality intensely or repeatedly confront the midwife. This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.</p