Cent Eur J Nurs Midw 2026, 17(2):2456-2465 | DOI: 10.15452/cejnm.2026.17.0014

The factors that affect the quality of women’s sexual function during the first year after childbirth in Greece: a cross-sectional study

Eleni Charitopoulou1, Dimitrios Papatheodorou1, Evangelia Nitsa1, Dimitrios Papoutsis2, Angeliki Antonakou1
1 Midwifery Department, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
2 Midwifery Department, School of Health Sciences, University of Western Macedonia, Kozani, Greece

Aim: Postpartum sexual dysfunction is common yet understudied, and the factors that contribute to it remain unclear. This study aimed to identify the determinants of sexual function among women in Greece during the first twelve months after childbirth.

Design: A cross-sectional study.

Methods: A cross-sectional online survey was conducted among 441 Greek-speaking women. The participants completed a structured questionnaire on sexual function, as well as associated demographic, physical, and psychosocial factors.

Results: Higher maternal age, shorter sleep duration, limited family support, exclusive breastfeeding, and flatus incontinence were negatively associated with sexual function. In contrast, greater frequency of sexual intercourse before and during pregnancy, as well as a longer time elapsed since childbirth, were positively associated with sexual function. No significant associations were found with perineal trauma, mode of delivery, parity, high body mass index, or smoking.

Conclusion: Prenatal parenting programs should incorporate counseling on maintaining sexual activity during and after pregnancy, provide information on breastfeeding, promote pelvic floor exercises, and emphasize the importance of family support. These factors were identified as key to improving maternal sexual health postpartum.

Keywords: maternal well-being, postnatal intimacy, postpartum period, reproductive education, sexual health

Received: May 26, 2025; Revised: March 17, 2026; Accepted: May 25, 2026; Published: June 5, 2026  Show citation

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Charitopoulou E, Papatheodorou D, Nitsa E, Papoutsis D, Antonakou A. The factors that affect the quality of women’s sexual function during the first year after childbirth in Greece: a cross-sectional study. Central European Journal of Nursing and Midwifery. 2026;17(2):2456-2465. doi: 10.15452/cejnm.2026.17.0014.
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    References

    1. Aydin Besen, M., & Rathfisch, G. (2020). The effect of suture techniques used in repair of episiotomy and perineal tear on perineal pain and dyspareunia. Health Care for Women International, 41(1), 22-37. https://doi.org/10.1080/07399332.2019.1663194 Go to original source... Go to PubMed...
    2. Banaei, M., Alidost, F., Ghasemi, E., & Dashti, S. (2020). A comparison of sexual function in primiparous and multiparous women. Journal of Obstetrics and Gynaecology, 40(3), 411-418. https://doi.org/10.1080/01443615.2019.1640191 Go to original source... Go to PubMed...
    3. Banaei, M., Moridi1, A., & Dashti, A. (2018). Sexual dysfunction and its associated factors after delivery: longitudinal study in Iranian women. Materia Socio Medica, 30(3), 198-203. https://doi.org/10.5455/msm.2018.30.198-203 Go to original source... Go to PubMed...
    4. Body, C., & Christie, J. A. (2016). Gastrointestinal diseases in pregnancy: nausea, vomiting, hyperemesis gravidarum, gastroesophageal reflux disease, constipation, and diarrhea. Gastroenterology Clinics of North America, 45(2), 267-283. https://doi.org/10.1016/j.gtc.2016.02.005 Go to original source... Go to PubMed...
    5. Cho, J. W., & Duffy, J. F. (2019). Sleep, sleep disorders, and sexual dysfunction. The World Journal of Men's Health, 37(3), 261-275. https://doi.org/10.5534/wjmh.180045 Go to original source...
    6. Fan, D., Li, S., Wang, W., Tian, G., Liu, L., Wu, S., Guo, X., & Liu, Z. (2017). Sexual dysfunction and mode of delivery in Chinese primiparous women: a systematic review and meta-analysis. BMC Pregnancy and Childbirth, 17, 408. https://doi.org/10.1186/s12884-017-1583-2 Go to original source... Go to PubMed...
    7. Fuentealba-Torres, M., Cartagena-Ramos, D., Fronteira, I., Lara, L. A., Arroyo, L. H., Arcoverde, M. A. M., Yamamura, M., Nascimento, L. C., & Arcêncio, R. A. (2019). What are the prevalence and factors associated with sexual dysfunction in breastfeeding women? A Brazilian cross-sectional analytical study. BMJ Open, 9(4), e025833. https://doi.org/10.1136/bmjopen-2018-025833 Go to original source... Go to PubMed...
    8. Galbally, M., Watson, S. J., Permezel, M., & Lewis, A. J. (2019). Depression across pregnancy and the postpartum, antidepressant use and the association with female sexual function. Psychological Medicine, 49(9), 1490-1499. https://doi.org/10.1017/S0033291718002040 Go to original source... Go to PubMed...
    9. Ghorat, F., Jafarzadeh Esfehani, R., Sharifzadeh, M., Tabarraei, Y., & Aghahosseini, S. S. (2017). Long term effect of vaginal delivery and cesarean section on female sexual function in primipara mothers. Electronic Physician, 9(3), 3991-3996. http://dx.doi.org/10.19082/3991 Go to original source...
    10. Gutzeit, O., Levy, G., & Lowenstein, L. (2020). Postpartum female sexual function: risk factors for postpartum sexual dysfunction. Sexual Medicine, 8(1), 8-13. https://doi.org/10.1016/j.esxm.2019.10.005 Go to original source...
    11. Hadizadeh-Talasaz, Z., Sadeghi, R., & Khadivzadeh, T. (2019). Effect of pelvic floor muscle training on postpartum sexual function and quality of life: a systematic review and meta-analysis of clinical trials. Taiwanese Journal of Obstetrics and Gynecology, 58(6), 737-747. https://doi.org/10.1016/j.tjog.2019.09.003 Go to original source...
    12. Hellenic Statistical Authority. (2022). Physical activity statistics: year 2022. Hellenic Statistical Authority.
    13. Hellenic Statistical Authority. (2023). Survey on the use of information and communication technologies in households and by individuals: 2023. https://www.statistics.gr/documents/20181/f6542bff-1b44-2feb-a362-6d17818ec4a3
    14. Hjorth, S., Kirkegaard, H., Olsen, J., Thornton, J. G., & Nohr, E. A. (2019). Mode of birth and long-term sexual health: a follow-up study of mothers in the Danish National Birth Cohort. BMJ Open, 9(11), e029517. https://doi.org/10.1136/bmjopen-2019-029517 Go to original source... Go to PubMed...
    15. Kahramanoglu, I., Baktiroglu, M., Hamzaoglu, K., Kahramanoglu, O., Verit, F. F., & Yucel, O. (2017). The impact of mode of delivery on the sexual function of primiparous women: a prospective study. Archives of Gynecology and Obstetrics, 295(4), 907-916. https://doi.org/10.1007/s00404-017-4299-7 Go to original source... Go to PubMed...
    16. Kettle, C., Dowswell, T., & Ismail, K. M. (2012). Continuous and interrupted suturing techniques for repair of episiotomy or second-degree tears. Cochrane Database of Systematic Reviews, 2012(11). https://doi.org/10.1002/14651858.CD000947.pub3 Go to original source... Go to PubMed...
    17. Lagaert, L., Weyers, S., Van Kerrebroeck, H., & Elaut, E. (2017). Postpartum dyspareunia and sexual functioning: a prospective cohort study. The European Journal of Contraception & Reproductive Health Care, 22(3), 200-206. https://doi.org/10.1080/13625187.2017.1315938 Go to original source...
    18. Martínez-Galiano, J. M., Arredondo-López, B., Hidalgo-Ruiz, M., Narvaez-Traverso, A., Lopez-Morón, I., & Delgado-Rodriguez, M. (2020). Suture type used for perineal injury repair and sexual function: a randomised controlled trial. Scientific Reports, 10(1), 10553. https://doi.org/10.1038/s41598-020-67659-2 Go to original source...
    19. McDonald, E., Woolhouse, H., & Brown, S. J. (2017). Sexual pleasure and emotional satisfaction in the first 18 months after childbirth. Midwifery, 55, 60-66. https://doi.org/10.1016/j.midw.2017.09.002 Go to original source... Go to PubMed...
    20. O'Malley, D., Higgins, A., Begley, C., Daly, D., & Smith, V. (2018). Prevalence of and risk factors associated with sexual health issues in primiparous women at 6 and 12 months postpartum; a longitudinal prospective cohort study (the MAMMI study). BMC Pregnancy and Childbirth, 18(1), 196. https://doi.org/10.1186/s12884-018-1838-6 Go to original source... Go to PubMed...
    21. Quoc Huy, N. V., Phuc An, L. S., Phuong, L. S., & Tam, L. M. (2019). Pelvic floor and sexual dysfunction after vaginal birth with episiotomy in Vietnamese women. Sexual Medicine, 7(4), 514-521. https://doi.org/10.1016/j.esxm.2019.09.002 Go to original source... Go to PubMed...
    22. Ramar, C. N., Vadakekut, E. S., & Grimes, W. R. (2024, August 11). Perineal lacerations. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK559068/
    23. 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 & Marital Therapy, 26(2), 191-208. https://doi.org/10.1080/009262300278597 Go to original source...
    24. Rosen, N. O., & Pukall, C. (2016). Comparing the prevalence, risk factors, and repercussions of postpartum genito-pelvic pain and dyspareunia. Sexual Medicine Reviews, 4(2), 126-135. https://doi.org/10.1016/j.sxmr.2015.12.003 Go to original source... Go to PubMed...
    25. Seehuus, M., & Pigeon, W. (2018). The sleep and sex survey: relationships between sexual function and sleep. Journal of Psychosomatic Research, 112, 59-65. https://doi.org/10.1016/j.jpsychores.2018.07.005 Go to original source... Go to PubMed...
    26. Smith, J. P., & Forrester, R. I. (2021). Association between breastfeeding and new mothers' sleep: a unique Australian time use study. International Breastfeeding Journal, 16(1), 7. https://doi.org/10.1186/s13006-020-00347-z Go to original source... Go to PubMed...
    27. Sobhgol, S. S., Priddis, H., Smith, C. A., & Dahlen, H. G. (2019). The effect of pelvic floor muscle exercise on female sexual function during pregnancy and postpartum: a systematic review. Sexual Medicine Reviews, 7(1), 13-28. https://doi.org/10.1016/j.sxmr.2018.08.002 Go to original source... Go to PubMed...
    28. Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach's alpha. International Journal of Medical Education, 2, 53-55. https://doi.org/10.5116/ijme.4dfb.8dfd Go to original source... Go to PubMed...
    29. 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 Go to original source... Go to PubMed...
    30. Zachariou, A., Filiponi, M., & Kirana, P. S. (2017). Translation and validation of the Greek version of the Female Sexual Function Index questionnaire. International Journal of Impotence Research, 29(4), 171-174. https://doi.org/10.1038/ijir.2017.18 Go to original source...

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