**1. Introduction**

According to the World Health Organization (WHO) [1] sexual health is a complex biological and sociological concept that requires a positive and responsible approach to sexuality and sexual relationships. It cannot be merely defined as the absence of sexual dysfunction. Sexual health can be greatly altered during pregnancy, birth and the postpartum period.

This chapter discusses selected important issues in sexual health during pregnancy, birth and the postpartum period. Pregnancy is a period where many physical and psychological changes occur. Such changes influence couples' lives in many ways, and their sexual life changes. Healthy sexuality during pregnancy appears to be a key stage in the evolution of a couple towards becoming parents. Sexual activity is reported to decrease throughout pregnancy, and the prevalence of reduced sexual interest and enjoyment in this period is over 60% [2]. Decreased sexual activity may be attributable to nausea, fear of miscarriage, fear of harming the foetus, lack of interest, discomfort, physical awkwardness, and fear of membrane rupture, fear of infection or fatigue or others [3].

Sexual activity is known to have an effect on the spontaneous onset of labour. This effect is thought to be due to the presence of prostaglandin E in human semen, which matures the cervix and initiates uterine contractions; the female orgasm with the liberation of oxytocin, which is responsible for uterine contractions; and breast stimulation, which initiates the oxytocin release reflex [3]. Although the effect of sexual activity in reducing the risk of prolonged pregnancies has been well documented, less is known concerning its potential consequences on the prognosis of labour [3]. Many pregnant women (and some physicians) believe that sexual intercourse at term will have an impact on the onset of labour. However, recent studies show that sexual intercourse at term is not associated with ripening of the cervix and does not hasten labour [4].

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Postpartumsexualfunctionisinfluencedbythemanysignificantchangesinanatomy,hormonal milieu, family structure, and partner relationships that accompany childbirth [5], yet wom‐ en's experiences of postpartum sexuality have rarely been explored beyond physical dimen‐ sions and focus mostly on issues related to pregnancy, vaginal trauma and breastfeeding [6].

Despite the lack of large well designed studies on the discussed topic, the evidence available so far shows that pregnancy, childbirth and the postpartum period determine a relevant, even if reversible, negative effect on sexuality. Sexual health during pregnancy, birth and the postpartum period is increasingly being recognized as an important component of women's lives and an important area of maternity service provision, and therefore deserves our greater attention.
