During the transition to parenthood, new parents face numerous challenges, including sexual difficulties like reduced sexual desire, lubrication issues, and genitopelvic pain. Genitopelvic pain affects 8-10% of women generally but up to 45% of mothers six months postpartum. Factors such as pain before or during pregnancy, perineal trauma during childbirth, and breastfeeding can increase this pain.

Addressing these issues is crucial for mothers who may be dealing with body changes, lack of sleep, and intimacy difficulties. Unfortunately, perfectionism and body image concerns may worsen or prolong pain. Perfectionistic mothers might avoid sex due to fear of pain, unintentionally creating a cycle of increased anxiety and pain. What’s more, negative body image can lead to dissatisfaction and avoidance of sexual activities, further exacerbating pain.

Relationship intimacy, including open communication and empathy, can help manage pain but may also lead to avoidance if partners are overly solicitous. Taking all of this into account, a new study aimed to examine how perfectionism, body image concerns, and perceived intimacy affect genitopelvic pain in new mothers. Understanding these factors can help health professionals identify at-risk mothers early, potentially preventing chronic pain and related sexual difficulties.

A total of 211 new mothers in mixed-gender (204) and same-gender (7) relationships participated in this study. They were recruited from hospitals, birth centers, maternity fairs, and social media. Participants were mostly Canadian, with diverse educational backgrounds and income levels. The average age was around 28 years for mothers and 30 years for partners, with relationships lasting about 4.8 years on average. Most mothers had vaginal deliveries, and many experienced perineal injuries. At four months postpartum, 92% had resumed sexual intercourse.

Participants completed questionnaires during pregnancy and at 4, 8, and 12 months postpartum. They reported on factors like genitopelvic pain, perfectionism, body image concerns, and intimacy. Data analysis using multilevel modeling examined how these factors influenced genitopelvic pain over time, considering variables like prenatal pain and childbirth-related factors. This approach helped the researchers understand the impact of psychological and relational factors on postpartum pain among new mothers.

For this study, the authors looked at two types of perfectionism: adaptive and maladaptive. Adaptive perfectionism involves setting high standards and goals in a healthy way, aiming for excellence without excessive self-criticism. Maladaptive perfectionism is when these standards become unrealistic or unattainable, leading to stress, anxiety, and negative emotions when they aren’t met.

Interestingly, data from the 211 new mothers showed that both adaptive and maladaptive perfectionism, along with body image concerns, were linked to higher postpartum genitopelvic pain over the first year after childbirth, beyond initial pain levels during pregnancy. However, perceived intimacy between partners did not significantly affect mothers’ pain levels. Multilevel modeling indicated stable pain levels from 4 to 12 months postpartum.

These findings highlight how psychological factors like perfectionism and body image concerns can influence women’s experiences of postpartum pain. Mothers who strive for perfection in their recovery may feel more anxiety and perceive pain as a failure, impacting their ability to cope.

Similarly, concerns about body image were associated with increased pain, possibly due to distractions during sexual activity. Surprisingly, perceived intimacy between partners did not significantly affect pain levels, suggesting that supportive partners may inadvertently contribute to pain avoidance strategies. While the study provides valuable insights, limitations include a small sample of same-sex couples and a lack of pre-pregnancy pain data. Future research should explore these factors more comprehensively to aid in early detection and management of postpartum pain.

References:

Dubé, S., Beaulieu, N., Bergeron, S., Lafontaine, M.-F., Péloquin, K., Brault-Labbé, A., Gosselin, P., & Brassard, A. (2024). Do perfectionism, body image concerns, and intimacy predict genitopelvic pain in the postpartum? A prospective study of new mothers. The Journal of Sexual Medicine, 21(6), 566-572. https://doi.org/10.1093/jsxmed/qdae039