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Objective: To evaluate which factors determine sexual activity and satisfaction with the sexual relationship 1 year after the first delivery. Design: Prospective longitudinal cohort study.

Setting: Ten midwifery practices. Population: Three hundred and seventy-seven nulliparous women were included. Methods: The Maudsley Marital Questionnaire is a standardised and validated questionnaire with 15 items relating to marital and sexual adjustment, with a nine-point scale appended to each question.

Scores on the sexual scale MMQ-S range from 0 to Higher scores are indicative of greater dissatisfaction. Sexual intercourse was dichotomised into having sexual intercourse or not having sexual intercourse. Several obstetric and maternal factors were analysed. Main outcome measurements: Sexual intercourse at 1 year postpartum and dissatisfaction with the sexual relationship as assessed by the MMQ-S scale.

Results: In multiple logistic regression analysis, the main predictive factor for no sexual intercourse 1 year postpartum was no sexual intercourse at 12 weeks of gestation beta Dissatisfaction with the sexual relationship 1 year after childbirth, assessed with the MMQ-S scale, is associated with not being sexually active at 12 weeks of gestation beta- 0.