Impact of delivery mode on sexual functions in the first year after childbirth: A comparative study of vaginal and cesarean sections
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Abstract
Background:
There are studies showing that women's sexual functions are affected for a while after giving birth. However, there are relatively few studies showing which component of sexual function is affected by the mode of delivery.
Methods:
This study was conducted with 228 participants who met the study criteria, 51 of whom had a VD, and 177 had a C/S delivery. The participants in the postpartum period between 3-12 months answered the Turkish version of the Female Sexual Function Index (FSFI) questionnaire. Total FSFI and subscale scores of the groups were compared.
Results:
In both groups (VD/CS), weekly sexual intercourse frequency values after delivery were found to be statistically significantly lower than before delivery. When the group giving birth with VD was compared with the C/S group, both the total FSFI score and the whole domain scores were lower.
Conclusion:
Regardless of the mode of delivery, all participating women in the postpartum period had deficiencies in total FSFI scores and all subscale scores, indicating sexual dysfunction. This inadequacy in sexual dysfunction was more pronounced in women who gave birth normally than those who gave birth by cesarean section. Considering the importance of having a healthy sexual life for a quality life standard, appropriate sexual therapy and support should be provided to women in the postpartum period.
Article Details
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References
Female Sexual Dysfunction: ACOG Practice Bulletin Clinical Management Guidelines for Obstetrician-Gynecologists, Number 213. Obstet Gynecol 2019;134:e1-e18.
Basson R, Berman J, Burnett A, Derogatis L, Ferguson D, Fourcroy J, et al. Report of the international consensus development conference on female sexual dysfunction: definitions and classifications. J Urol 2000;163:888-93.
Ninivaggio C, Rogers RG, Leeman L, Migliaccio L, Teaf D, Qualls C. Sexual function changes during pregnancy. Int Urogynecol J 2017;28:923-9.
Pauls RN, Occhino JA, Dryfhout VL. Effects of pregnancy on female sexual function and body image: a prospective study. J Sex Med 2008;5:1915-22.
Glazener CM. Sexual function after childbirth: women's experiences, persistent morbidity and lack of professional recognition. Br J Obstet Gynaecol 1997;104:330-5.
Rosen NO, Pukall C. Comparing the Prevalence, Risk Factors, and Repercussions of Postpartum Genito-Pelvic Pain and Dyspareunia. Sex Med Rev 2016;4:126-35.
Barrett G, Pendry E, Peacock J, Victor C, Thakar R, Manyonda I. Women's sexual health after childbirth. Bjog 2000;107:186-95.
Griffiths A, Watermeyer S, Sidhu K, Amso NN, Nix B. Female genital tract morbidity and sexual function following vaginal delivery or lower segment caesarean section. J Obstet Gynaecol 2006;26:645-9.
Hartmann K, Viswanathan M, Palmieri R, Gartlehner G, Thorp J, Jr., Lohr KN. Outcomes of routine episiotomy: a systematic review. JAMA 2005;293:2141-8.
Klein K, Worda C, Leipold H, Gruber C, Husslein P, Wenzl R. Does the mode of delivery influence sexual function after childbirth? J Womens Health (Larchmt) 2009;18:1227-31.
De Souza A, Dwyer PL, Charity M, Thomas E, Ferreira CH, Schierlitz L. The effects of mode delivery on postpartum sexual function: a prospective study. BJOG 2015;122:1410-8.
Fan D, Li S, Wang W, Tian G, Liu L, Wu S, et al. Sexual dysfunction and mode of delivery in Chinese primiparous women: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2017;17:408.
Meston CM, Freihart BK, Handy AB, Kilimnik CD, Rosen RC. Scoring and Interpretation of the FSFI: What can be Learned From 20 Years of use? J Sex Med 2020;17:17-25.
Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000;26:191-208.
Aygin D. The Turkish adaptation of the female function index. Turkiye Klinikleri J Med Sci 2005;25:393-9.
de Sousa NQ, Borges AC, Sarabando R, Bivar L, Viana J, Cerqueira M, et al. The Role of Operative Vaginal Delivery in Postpartum Sexual Dysfunction: MOODS - A Prospective Study. J Sex Med 2021;18:1075-82.
Cattani L, De Maeyer L, Verbakel JY, Bosteels J, Deprest J. Predictors for sexual dysfunction in the first year postpartum: A systematic review and meta-analysis. BJOG 2022;129:1017-28.
Gutzeit O, Levy G, Lowenstein L. Postpartum Female Sexual Function: Risk Factors for Postpartum Sexual Dysfunction. Sex Med 2020;8:8-13.
Hosseini L, Iran-Pour E, Safarinejad MR. Sexual function of primiparous women after elective cesarean section and normal vaginal delivery. Urol J 2012;9:498-504.
Nikolaidou E, Antoniou E, Sarella A, Iliadou M, Orovou E, Dagla M. The Effect of Type of Delivery on Female Postpartum Sexual Functioning: A Systematic Review. Healthcare (Basel) 2022;10.
Johnson CE. Sexual health during pregnancy and the postpartum. J Sex Med 2011;8:1267-84; quiz 85-6.
Lorenz TK, Ramsdell EL, Brock RL. Communication changes the effects of sexual pain on sexual frequency in the pregnancy to postpartum transition. J Psychosom Obstet Gynaecol 2022;43:91-8.
Stjernholm YV, Petersson K, Eneroth E. Changed indications for cesarean sections. Acta Obstet Gynecol Scand 2010;89:49-53.
Laganà AS, Burgio MA, Ciancimino L, Sicilia A, Pizzo A, Magno C, et al. Evaluation of recovery and quality of sexual activity in women during postpartum in relation to the different mode of delivery: a retrospective analysis. Minerva Ginecol 2015;67:315-20.
Signorello LB, Harlow BL, Chekos AK, Repke JT. Postpartum sexual functioning and its relationship to perineal trauma: a retrospective cohort study of primiparous women. Am J Obstet Gynecol 2001;184:881-8; discussion 8-90.
Jiang H, Qian X, Carroli G, Garner P. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database Syst Rev 2017;2:CD000081.
Chang SR, Chen KH, Lin HH, Chao YM, Lai YH. Comparison of the effects of episiotomy and no episiotomy on pain, urinary incontinence, and sexual function 3 months postpartum: a prospective follow-up study. Int J Nurs Stud 2011;48:409-18.
Connolly A, Thorp J, Pahel L. Effects of pregnancy and childbirth on postpartum sexual function: a longitudinal prospective study. Int Urogynecol J Pelvic Floor Dysfunct 2005;16:263-7.
Hannah ME, Whyte H, Hannah WJ, Hewson S, Amankwah K, Cheng M, et al. Maternal outcomes at 2 years after planned cesarean section versus planned vaginal birth for breech presentation at term: the international randomized Term Breech Trial. Am J Obstet Gynecol 2004;191:917-27.
Nappi RE, Cucinella L, Martella S, Rossi M, Tiranini L, Martini E. Female sexual dysfunction (FSD): Prevalence and impact on quality of life (QoL). Maturitas 2016;94:87-91.
Bachmann G. Female sexuality and sexual dysfunction: are we stuck on the learning curve? J Sex Med 2006;3:639-45.
Rowland M, Foxcroft L, Hopman WM, Patel R. Breastfeeding and sexuality immediately post partum. Can Fam Physician 2005;51:1366-7.
Saleh DM, Hosam F, Mohamed TM. Effect of mode of delivery on female sexual function: A cross-sectional study. J Obstet Gynaecol Res 2019;45:1143-7.
Levin RJ. Sex and the human female reproductive tract--what really happens during and after coitus. Int J Impot Res 1998;10 Suppl 1:S14-21.
Kolotkin RL, Binks M, Crosby RD, Ostbye T, Gress RE, Adams TD. Obesity and sexual quality of life. Obesity (Silver Spring) 2006;14:472-9.
Ribeiro MC, Nakamura MU, Torloni MR, Scanavino Mde T, Mancini PE, Forte BM, et al. Maternal overweight and sexual function in pregnancy. Acta Obstet Gynecol Scand 2016;95:45-51.
Daud S, Zahid AZM, Mohamad M, Abdullah B, Mohamad NAN. Prevalence of sexual dysfunction in pregnancy. Arch Gynecol Obstet 2019;300:1279-85.
Aydin M, Cayonu N, Kadihasanoglu M, Irkilata L, Atilla MK, Kendirci M. Comparison of Sexual Functions in Pregnant and Non-Pregnant Women. Urol J 2015;12:2339-44.
Kadioglu P, Yetkin DO, Sanli O, Yalin AS, Onem K, Kadioglu A. Obesity might not be a risk factor for female sexual dysfunction. BJU Int 2010;106:1357-61.
Erbil N. The Relationships Between Sexual Function, Body Image, and Body Mass Index Among Women. Sexuality and Disability 2013;31:63-70.
Esposito K, Ciotola M, Giugliano F, Bisogni C, Schisano B, Autorino R, et al. Association of body weight with sexual function in women. Int J Impot Res 2007;19:353-7.
Szollosi K, Komka K, Szabo L. Risk factors for sexual dysfunction during the first year postpartum: A prospective study. Int J Gynaecol Obstet 2022;157:303-12.
O'Malley D, Higgins A, Begley C, Daly D, Smith V. Prevalence of and risk factors associated with sexual health issues in primiparous women at 6 and 12 months postpartum; a longitudinal prospective cohort study (the MAMMI study). BMC Pregnancy Childbirth 2018;18:196.