Operative vaginal delivery might be linked to poorer sexual function for women after childbirth, according to new research published in The Journal of Sexual Medicine.
Many women experience sexual issues after childbirth. Both hormonal and physical changes can lead to low desire, poor lubrication, diminished orgasms, and painful intercourse. Past research has examined how the method of childbirth, such as vaginal or caesarian section, affects postpartum sexuality. However, results have been mixed.
For this study, a team of Italian researchers considered the effects of spontaneous vaginal delivery, operative vaginal delivery, and caesarian section on women’s sexual function. Operative vaginal delivery generally involved the use of a vacuum extractor, as was the custom in Italy.
The scientists worked with 269 women who had given birth for the first time. The participants’ mean age was 34 years. One hundred thirty-two women had undergone spontaneous vaginal delivery, 45 had had operative vaginal delivery, and 92 had given birth via caesarian section.
Within three days after childbirth, the women completed the Female Sexual Function Index (FSFI), a questionnaire designed to assess six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. At this time, the focus was on sexual function during the final trimester of pregnancy. Six months later, the women again filled out the FSFI, taking postpartum experiences into account.
Data on postpartum depression, breastfeeding, and resumption of sexual activity were also collected at the six month point.
The researchers found that after six months, about 41% of the women could be diagnosed with sexual dysfunction based on FSFI scores. About 18% had postpartum depression and 40% were breastfeeding. The time period for resuming sexual activity was similar across the groups, with a mean range of 2.2 to 2.5 months.
The women who had undergone operative vaginal delivery tended to have poorer arousal, lubrication, orgasm, and overall sexual functioning scores than the caesarean group. They also had lower scores on the orgasm domain when compared to the spontaneous vaginal delivery group.
Breastfeeding also affected postpartum sexual function, with breastfeeding women reporting more pain, poorer lubrication, and a longer time period before resuming sexual activity.
The authors acknowledged that among women who had undergone vaginal deliveries, about 85% had had episiotomies, a rate “which is one of the largest reported in the literature.” However, it was unclear to what degree episiotomies affected sexual function for the study participants.
They added that considering other variables, such as women’s feelings about childbirth, cross-cultural factors, and relationships with partners, would be helpful in future research.
Resources
The Journal of Sexual Medicine
Barbara, Giussy, MD, et al.
“Impact of Mode of Delivery on Female Postpartum Sexual Functioning: Spontaneous Vaginal Delivery and Operative Vaginal Delivery vs Cesarean Section”
(Full-text. March 2016)
http://www.jsm.jsexmed.org/article/S1743-6095(16)00081-3/fulltext