SEXUAL DESIRE AND PREGNANCY WOMEN

Nurmahya Isnaini* Nurhidayati Hanifah* Nurmaryani Wahyuni* Nurul Laily Ramadani* *Student of Nursing Science Program in Diponegoro University, Semarang Sexuality is still considered taboo to be discussed, especially in Indonesia. Whereas, the needs of sexuality is one of the fourteen basic human needs that must be met. Sexuality is an expression of love of two people or feeling of affection, respect, caring, and mutually agreeable to each other, not just confined to coitus (Ika & Saryono, 2010). The cuoples assume that sexuality is a personal thing to talk to others, though to the health server, so the couple have little information about sexuality need. One of that information is about sexual needs during pregnancy (Raheleh, 2011). During pregnancy there was a change in the pattern of sexuality in married couples. It is influenced by several factor, both wives and husbands factors. There are many change in pregnant women, both psychologically and physically. Physically changes such as changes in body shape, breast become painful when touched, nausea, vomiting, back pain, and increased vaginal secretion (Fabamwo & Akinola, 2011). Psychologically change are fear, anxiety, mood changes, and decrease sexual desire. Psychological changes experienced by pregnant women are also affected partner. Husband to be no desire for sexual intercourse. Not only that, the wifes body shape changes also give affect (Raheleh, 2011). According to the journal research by Fabamwo Adetokunbo and Akinola Oluwarotini Ireti, 2011, about sexuality and sexual experience among women with uncomplicated pregnancies in Ikeja, Lagos, one of the issues about sexual activity in pregnancy has to do with the husbands desire was decrease for sexual intercourse mainly attributed to the enlarging abdomen and inconvenient positioning. The pregnant woman herself in most cases develops repulsion to sex as the pregnancy progresses. Beside that, the fear of harming the foetus or precipitating a premature labour abounds. It is believed that hormonal and physiological changes influence womens well-being, mood and sexual behaviour. In pregnancy sexual behaviour is increasingly modified as pregnancy progresses due to biological, psychological

and social factors. Pregnancy represents a life crisis to the pregnant woman and her husband. Complex psychosocial and physiological demands may produce insecurities, anxieties and somatic complaints. Based on the results of qualitative research conducted by Raheleh Babazadeh, Khadijeh Mirzaii, and Zahra Masomi about changes in sexual desire and sexual activity during pregnancy in the northeast of Iran between May and July 2011 in thirty three pregnant womens stated that twenty three womens reported decreased sexual desire, six womens have increased, while three other womens avoid sex altogether. Intensity decrease sexual desire was reported by twenty one womens and a decreased frequency of orgasm was reported by twenty three women. A decrease in the frequency and quality of sexual activity caused by physiologic and mental changes can lead to sexual dysfunction. In turn, as reported in similar studies, sexual dysfunction can cause serious partnership problems and lead to infidelity on the part of the husband; it can also lead to divorce (Raheleh et. all, 2011). Based on the study above, interested groups to further discuss about the sexuality needs during pregnancy. Influence of sexual activity on pregnancy When sexual stimulation, blood flow vagina and vulva will increase but blood flow to uterus still uncertain. If the contraction muscle when doing intercourse like when exercising, so the blood flow to the uterus will be decreased. The emphasis inferior vena cava caused by uterus when lying down position will cause hypotension especially in the third trimester. Sexual stimulation and orgasmus will cause uterine contraction, rhythmic contraction of pelvic muscles and increased vaginal pressure. In this time, the fetus movement will reduced and deceleration will be occur, but this isonly temporary and not harmful. When the penetration, perineum and vagina will get pressure from penis. This local stimuli can lead secretion of oxytocin that called ferguson reflex that can cause uterus will contraction. During ejaculation, semen can cause uterine contractions because there are cement contains prostaglandins (Samuel, 2000). Changes in sexual patterns during pregnancy

Apart from these there are also studies conducted by the research journal Fabamwo and Akinola (2011) with the title of Sexuality and Sexual Experience among Women with Uncomplicated Pregnancies in Ikeja, Lagos were performed on 196 pregnant women in September to October 2009, shows that a hundred and sixty two couples still do coitus with different frequencies among five couples have sex every day, twenty one couples perform three times a week, twice a week twenty nine couples, fourty six couples once a week, twenty seven couples perform four days, twenty - eight couples perform once a month, three couples once in two months, and three other couples only have sex at any time. The reason for decrease of sexual desire During pregnancy, most of the pregnant women experience discomfort even feel pain when having sex with their husbands. Though such feel the wife still have sex with her husband for mencegegah the disharmony in the family. There are several things that can result in decreased sexual desire in pregnant women, including the fear of harming the fetus, changes in body image, and dyspareunia. Decrease in sexual desire can affect sexual satisfaction. A Decrease in the frequency and quality of sexual activity and mental caused by physiologic changes can lead to sexual dysfunction. In turn, as reported in similar studies, sexual dysfunction problems can cause serious partnership and lead to infidelity on the part of the husband; it can also lead to divorce (Raheleh et. all, 2011). Based on the results of qualitative research conducted by Raheleh Babazadeh, Khadijeh Mirzaii, and Zahra Masomi about changes in sexual desire and sexual activity during pregnancy in the northeast of Iran between May and July 2011, the reasons which lead to decreased sexual desire raised by twenty three pregnant women between the can fetal harm, embarrassed by her body shape, pain during coitus, fear of abortion or premature labor, her husband did not like the smell. Based on research journal by Jian (2010), entitled sexual position and sexual satisfaction of pregnant women, stated that the decrease in sexual drive in pregnant women can be affected by several factors such as physical discomfort, fear of hurting the baby, lack of knowledge, loss of interest to perform sex, coitus awkwardness. Besides, an increase in abdominal circumference, body size, and changes of emotions can also affect the sexual desire of pregnant women. The coverage of sexual need during pregnancy

The difficulty in finding a comfortable position can contribute to the lack of sexual desire or pleasure during sex with a partner, and occurs pain due to deep penetration. To overcome these problems, the couple should change positions during sex. The position is recommended for pregnant women are superior to women, side by side, rear entry and weight supported. Changing sex positions during pregnancy is to increase sexual satisfaction in couples and for the safety of the fetus (Jian et. all, 2010). Conclusion Sexuality is one of basic needs of human, like food and sleep, and if the desire exists it should not be suppressed though during pregnancy. There are some advantages if the couple get sexual stimulation and especially orgasm, the hormone oxytocin is released, which has a positive effect upon uterine contraction, and semen has the added benefit of containing prostaglandins that helps to soften the cervix. But, sex during pregnancy may not be safe for women with a history of repeated miscarriages, preterm labor, bleeding, or an incompetent cervix (a condition in which the cervix effaces and dilates without contractions in the second or early third trimester, when the babys weight puts increasing pressure on it). Different women will display different proclivities during their pregnancy: for some, sex is a total turn off; for others, sexual desire is really only strong during certain periods of the pregnancy; whereas for yet still others, they find their sexual appetite increased. The challenges intercourse during pregnancy is to find a comfortable position, but with the gentleness of her partner, the help of some pillows and a willingness to experiment the couple can easily find a pleasurable solution.
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