About this trial
Becoming parents exerts powerful and long-lasting effects on couples' well-being and quality of life. The transition to parenthood (TtP; pregnancy to 12-months postpartum) poses significant challenges as couples balance the task of caring for a newborn while maintaining their romantic relationship. One crucial way that couples sustain their connection is through their sexuality. Most new parents experience significant disruptions to their sexual well-being (i.e., sexual satisfaction, desire, distress), with sexual concerns such as reduced sexual frequency and lack of time and energy for sex being nearly ubiquitous. Simultaneously, most new parents lack easily accessible, reliable information on the common sexual changes associated with the TtP and there is a lack of evidence-based research aimed at helping couples navigate changes to their sexual well-being across this life transition. The investigators have identified risk (e.g., stress) and protective (e.g., intimacy) factors for couples' sexual well-being across the TtP that can be targeted in a prevention program, though no such programs exist.
The goal of this two-centre randomized controlled trial is to evaluate the efficacy of STORK (Supporting the Transition to Parenthood through Online Sex and Relationship Knowledge), a novel couple-based online program to support new parents' sexual well-being. This program comprises psychoeducation about common sexual changes as well as skills that couples can develop together to manage these changes and constitutes the first evidence-based program for new parent couples' sexual well-being. The investigators expect that, compared to a waitlist control group, couples who complete STORK will have better sexual, relational, and psychological adjustment across the transition to parenthood (from 13 to 27-weeks gestation to 12-months postpartum). Given that up to 78% of new parents report receiving little-to-no information about what to expect regarding changes to their postpartum sexual relationship, this study addresses the need for accessible, couple-based supports for this commonly challenging transition. By strengthening couples' sexual relationships, the results of this research have the potential to promote the quality of new parents' relationships, strengthening the overall well-being of their families during this critical life stage.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
married or cohabitating romantic relationship of at least 12 months
one member of the couple must be currently pregnant (13-27 weeks gestation) with their first baby together (If the couple has a history of miscarriage or stillbirth, previously gave a baby up for adoption, or have other children who do not live with them, they are still eligible to participate.)
low-risk pregnancy
live in Canada, the United States, Australia, New Zealand, the Republic of Ireland, or the United Kingdom
Disqualifiers
severe relational distress or conflict as determined by baseline measures
one or both partners of a couple do not complete the baseline survey - this includes cases where one or both partners do not pass at least 3/5 attention checks in the baseline survey
instructed to avoid sexual activity from a healthcare professional
Trial design
Parallel
Treatments tested in this trial
STORK Program
Other interventionThe STORK program includes a brief orientation module (Module 0, intended to be completed in the same sitting as Module 1) followed by six full-length modules: five weekly modules in pregnancy (Modules 1 to 5) and one module at 3-months postpartum (Module 6). Couples are assigned a trained facilitator (undergraduate research assistant, graduate student, or postdoc) to answer questions or resolve any technical issues.
Treatment groups
Trial outcomes
Primary outcomes
Sexual Satisfaction
The Global Measure of Sexual Satisfaction Scale consists of five items assessing a subjective evaluation of the sexual relationship: good vs. bad, pleasant vs. unpleasant, positive vs. negative, satisfying vs. unsatisfying, and valuable vs. worthless (Lawrance \& Byers, 1995). Ratings are summed where possible scores range from 5 to 35, with higher scores indicating greater sexual satisfaction. This measure has demonstrated excellent psychometrics in previous studies (e.g., Paquette et al., 2025).
Sexual Distress
Sexual distress will be assessed with the 3-item Sexual Distress Scale-3 (Derogatis, 2008; Lin et al., 2024). Using a 5-point Likert scale, participants rate how frequently (e.g., 0 = never, to 4 = always) they experience a sexuality related problem. Ratings are summed such that possible scores range from 0 to 12, with higher scores indicating greater sexual distress. This measure has demonstrated good psychometrics in differentiated individuals who did and did not experience sexual problems (Lin et al., 2024).
Sexual Desire
Sexual desire will be measured using 7-items of partner-focused sexual desire from the Sexual Desire Inventory (Moyano et al., 2017). Participants rate their interest in sexual activity using a Likert-type response scale from 0 (e.g., not at all) to 7 or 8 (e.g., a lot). Ratings are summed (range = 0 to 54) such that higher scores indicate greater sexual desire for one's partner. This measure has demonstrated good psychometrics (Moyano et al., 2017).
Secondary outcomes
Depressive Symptoms
The Edinburgh Postnatal Depression Scale (EPDS; Cox, 1987) is a widely used 10-item measure designed to screen for perinatal depression in pregnancy and in parents with infants. The EPDS asks individuals to answer how they have been feeling in the previous 7 days using a response scale from 0 (e.g., Not at all) to 3 (e.g., As much as I ever did), with questions involving common indicators of depression. A total sum score is computed (range = 0 to 30) where higher scores indicate more depressive symptoms. This measure has good psychometric properties (e.g., Kernot et al., 2014) and high sensitivity for detecting postnatal depression (e.g., Eberhard-Gran et al., 2001).
Anxiety Symptoms
Anxiety symptoms will be measured using the 7-item GAD-7 (Spitzer et al., 2006), which assesses symptoms of generalized anxiety. Participants rate the frequency of experiencing anxiety symptoms on a Likert scale from 0 (Not at all) to 3 (Nearly every day). A total sum score is computed (range = 0 to 21) with higher scores indicating greater anxiety symptoms. This measure has good psychometric properties (Spitzer et al., 2006).
Relationship Satisfaction
Relationship satisfaction will be measured with the 4-item version of the Couples Satisfaction Index (CSI) developed by Funk and Rogge (Funk, 2007). Participants rate their general relationship satisfaction, including how happy they are with their relationship, how frequently they disagree with their partner, and how they feel their relationship compares to others, using a 6- or 7-point Likert scale from 0 (e.g., Not at all true) to 5 or 6 (e.g., completely true). A total sum score is computed (range = 0 to 21) where higher scores indicate greater relationship satisfaction. The 4-item version has good psychometric properties and a cut-off for high relationship distress (Funk \& Rogge, 2007).
Relationship Conflict
Relationship conflict will be measured using 2 items assessing conflict in the relationship from the Revised Dyadic Adjustment Scale (Busby, 1995). These items ask participants to report how often they argue with their partner or how often they get on each others' nerves. To measure sexual conflict, the same two items were adapted to ask specifically about sex. Participants respond using a Likert scale from 0 ("All the time) to 5 ("Never"). A total sum score is computed for each of relationship and sexual conflict (range = 0 to 10) where higher scores indicate less conflict.
Sponsors and contacts
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Dalhousie University
Lead sponsor
University of British Columbia
Collaborator