Transtheoretical Model-based Postpartum Sexual Health Education Program Improves Women's Sexual Behaviors and Sexual Health

Introduction. Postpartum sexual health education was once routinely administered to postpartum women, but few interventions were specifically described or clearly based on theory, and few sexual interventions affected women's sexual behaviors. Aim. To evaluate the effectiveness of a refined theory-based interactive postpartum sexual health education program (IPSHEP) in enhancing postpartum women's sexual behavior and health. Methods. For this prospective, randomized controlled trial, 250 participants were randomized to three groups. Experimental group A received our refined theory-based IPSHEP. Experimental group B received only an interactive, self-help pamphlet. The control group received routine education (a 10- to 15-minute educational talk and a sexual health pamphlet without an interactive design). Data were collected at baseline, 3 days, 2 months, and 3 months postpartum. Main Outcome Measure. Postpartum women's sexual self-efficacy (SSE), diversity of sexual activity (DSA), return to sexual activity, and sexual satisfaction (SS). Results. Women who received our theory-based postpartum sexual health education program had significantly greater SSE (P<0.05) and greater DSA (P<0.05), and tended to resume their sexual life earlier than women in the routine teaching and interactive pamphlet-only groups (P<0.05). However, the SS levels of postpartum women who received our program did not differ significantly from those of women who received routine teaching or the interactive pamphlet only. Conclusions. Our findings suggest that a theory-based postpartum sexual health education program improved women's sexual health and sexual behavior and that the transtheoretical model can be translated into practice, supporting its use to enhance the sexual health of postpartum women. Despite the lack of a significant effect on SS, women who received our theory-based postpartum sexual health education program tended to maintain their prepregnancy level of SS in early postpartum.