Practices and perceptions on sexual activity before and during pregnancy among woman attending antenatal clinic in Dar es salaam - Tanzania.

Abstract

Background: Pregnancy represents a significant period in the life of any woman and influences practices and experiences towards sexual activities. Changes occur in sexuality during pregnancy which may be physical or emotional. It is the responsibility of health care providers to address sexuality concerns, validate women's feelings, and provide suggestions of modifications in sexual practices to meet women's needs for sexual expression within the range of activities that are safe and acceptable. Inappropriate perceptions such as dilatation of birth canal to ease labour and delivery, dirty patch on the baby, abortion and preterm labour abound pregnancy sexuality in different societies leading to changes in the pattern of sexual behaviour during pregnancy. No study has been found to prove sexual intercourse in pregnancy as the cause of any undesired consequence or such perceived advantages. Objective: The broad objective of the study was to determine the practices and perceptions on Sexual activity before and during Pregnancy among Women attending Antenatal Clinic in Dar es salaam Materials and Methods: A descriptive cross-sectional study was carried out among 318 women attending antenatal clinic to determine their practices and perceptions on pregnanyc sexuality.Respondents were selected by systematic random selection from attendance register. Information on their demographic characteristics, practices and experience and perceptions was collected through interviewer administered structured and semi-structured questionnaires. The data so obtained were then entered and analyzed using SPSS program.

Results: Generally, pregnancy sexuality practices and experiences were significantly different from pre-pregancy state as they were all negatively skewed in terms of rate of sexual activity, arousal, satisfaction, desire, orgasm, frequency and initiation of intercourse. More than 45% of respondents were in favour of sexual intercourse during pregnancy while about 34% were against it and the rest did not have an opinion. The perceived benefits of sexual intercourse in pregnancy included dilatation of birth canal (68.8%), initiation of labour (23%) and aiding growth and development (21.5%). Dirty patch on the baby’s body (80.6%), abortion (49%) and preterm labour (13.0%)were the most frequently mentioned perceived adverse effects among respondents who were against it. More than 51% of them did not have sexuality discussion and 62.3% thought it was appropriate to discuss sexuality at the clinic and 70.0% prefered healthcare workers to initiate such discussion. Conclusion and Recommendations: The findings of this study shows that practices and experiences on sexual activity changed significantlycompared to pre-pregnancy state. The belief that the baby will be born with dirty patches on the body was a unique finding of this study which was not mentioned as a reason to avoid sexual intercourse in pregnancy by the respondents in other studies. Inappropriate reasons such as dilatation of birth canal, bleeding, premature labour and growth of the baby were consistent with other studies. There is evidence of lack of knowledge about sexual intercourse during pregnancy among the respondents. It is our opinion that issues of pregnancy sexuality be deliberately included in the routine health education at the antenatal clinic by the healthcare workers.