1
|
Rezaei N, Behboodi Moghadam Z, Tahmasebi A, Taheri S, Namazi M. Women`s sexual function during the postpartum period: A systematic review on measurement tools. Medicine (Baltimore) 2024; 103:e38975. [PMID: 39058853 PMCID: PMC11272350 DOI: 10.1097/md.0000000000038975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 06/27/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Sexual health is a critical component of overall well-being, yet discussions around sexual function, especially in the context of postpartum recovery, are often taboo or sidelined. The aim was to review measurement tools assessing women's sexual function/health during the postpartum period. METHODS We did a systematic search according to preferred reporting items for systematic reviews and meta-analyses 2020 guidelines in different databases, including PubMed, Web of Science, Scopus, Embase, ProQuest and Open Access Thesis and Dissertations, and Google scholar search engine until June 2023. Also, the reference list of the related reviews has been screened. Eligible studies included observational studies or clinical trials that evaluated women`s sexual function during the postpartum period using existing tools. Data extraction covered study characteristics, measurement tools, and their validity and reliability. RESULTS From 3064 retrieved records, after removing duplicates and excluding ineligible studies, and reviewing the reference list of the related reviews, 41 studies were included in this review. Tools measuring sexual function were developed from 1996 to 2017. Sexual activity questionnaire, female sexual function index (FSFI), sexual function questionnaire, short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire, sexual health outcomes in women questionnaire, shorter version of FSFI, and sexual function questionnaire's medical impact scale and Carol scale. CONCLUSION Sexual activity questionnaire, FSFI, sexual function questionnaire, short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire, sexual health outcomes in women questionnaire, shorter version of FSFI, sexual function questionnaire's medical impact scale, and Carol scale are valid and reliable measuring tools to assess sexual function or sexual health during postpartum period, which can be used in primary studies according to the study aim and objectives.
Collapse
Affiliation(s)
- Nazanin Rezaei
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Department of Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Zahra Behboodi Moghadam
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Atbin Tahmasebi
- School of Medicine, Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Safoura Taheri
- Department of Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Masoumeh Namazi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Fanshawe AM, De Jonge A, Ginter N, Takács L, Dahlen HG, Swertz MA, Peters LL. The Impact of Mode of Birth, and Episiotomy, on Postpartum Sexual Function in the Medium- and Longer-Term: An Integrative Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5252. [PMID: 37047868 PMCID: PMC10094321 DOI: 10.3390/ijerph20075252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/05/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
(1) Background: Sexual function can be affected up to and beyond 18 months postpartum, with some studies suggesting that spontaneous vaginal birth results in less sexual dysfunction. This review examined the impact of mode of birth on sexual function in the medium- (≥6 months and <12 months postpartum) and longer-term (≥12 months postpartum). (2) Methods: Literature published after January 2000 were identified in PubMed, Embase and CINAHL. Studies that compared at least two modes of birth and used valid sexual function measures were included. Systematic reviews, unpublished articles, protocols and articles not written in English were excluded. Quality was assessed using the Newcastle Ottawa Scale. (3) Results: In the medium-term, assisted vaginal birth and vaginal birth with episiotomy were associated with worse sexual function, compared to caesarean section. In the longer-term, assisted vaginal birth was associated with worse sexual function, compared with spontaneous vaginal birth and caesarean section; and planned caesarean section was associated with worse sexual function in several domains, compared to spontaneous vaginal birth. (4) Conclusions: Sexual function, in the medium- and longer-term, can be affected by mode of birth. Women should be encouraged to seek support should their sexual function be affected after birth.
Collapse
Affiliation(s)
- Anne-Marie Fanshawe
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
- Department of Genetics, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands
| | - Ank De Jonge
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
- School of Nursing and Midwifery, Western Sydney University, Blacktown, NSW 2148, Australia
| | - Nicole Ginter
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Lea Takács
- Department of Psychology, Faculty of Arts, Charles University, 128 08 Prague, Czech Republic
| | - Hannah G. Dahlen
- School of Nursing and Midwifery, Western Sydney University, Blacktown, NSW 2148, Australia
| | - Morris A. Swertz
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Lilian L. Peters
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
- School of Nursing and Midwifery, Western Sydney University, Blacktown, NSW 2148, Australia
| |
Collapse
|
3
|
Alimi R, Marvi N, Azmoude E, Heidarian Miri H, Zamani M. Sexual function after childbirth: a meta-analysis based on mode of delivery. Women Health 2023; 63:83-96. [PMID: 36576252 DOI: 10.1080/03630242.2022.2158412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Although many women report sexual dysfunction in the postpartum period, controversial research has been reported the relationship between delivery mode and sexual function. This meta-analysis aimed to investigate the sexual function after childbirth and identify the difference of sexual function based on the female sexual function index (FSFI) questionnaire in women with elective cesarean section, vaginal delivery with episiotomy and vaginal delivery without episiotomy. Studies were found by searching in Medline, PubMed, Web of Science, Scopus and considering the references of the related papers from their start dates until September 2021. All observational studies in English that reported the mean and SD of score of sexual function and its domains based on the mode of delivery were included in this meta-analysis. Random effect model was used to combine the results of included studies on female sexual function and its subdomains. Finally, 17 articles with a total population of 3410 were included in the meta-analysis. Total mean (95 percent CI) of sexual function was 24.27 (22.82, 25.72) with substantial heterogeneity among studies (χ2 = 7487.63, P < .001; I2 = 99.45). In subgroup analyses, the mean score of sexual function was significantly differed in terms of time elapsed since delivery (P = .04) and studied country (P < .001). But, the mode of delivery has no significant effect on postpartum sexual function and subdomains. The result indicated that elective cesarean section, vaginal delivery with episiotomy, vaginal delivery without episiotomy are not associated with the female sexual function.
Collapse
Affiliation(s)
- Rasoul Alimi
- Department of Epidemiology and Biostatistics, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Nahid Marvi
- Reproductive Health, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Azmoude
- Department of Midwifery, School of Nursing and Midwifery, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Hamid Heidarian Miri
- Social Determinants of Health Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Zamani
- Department of Midwifery, School of Nursing and Midwifery, Neyshabur University of Medical Sciences, Neyshabur, Iran
| |
Collapse
|
4
|
Ghades S, Kaabia O, Fatnassi M. Impact de la voie d’accouchement sur la sexualité des primipares. SEXOLOGIES 2022. [DOI: 10.1016/j.sexol.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
5
|
Martin FZ, Madley‐Dowd P, Ahlqvist VH, Jónsson‐Bachmann E, Fraser A, Forbes H. Mode of delivery and maternal sexual wellbeing: A longitudinal study. BJOG 2022; 129:2010-2018. [PMID: 35856885 PMCID: PMC9804306 DOI: 10.1111/1471-0528.17262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 07/02/2022] [Accepted: 07/18/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To investigate the association between mode of delivery and subsequent maternal sexual wellbeing. DESIGN Prospective birth cohort study. SETTING Avon (in Bristol area), UK. POPULATION Participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). METHODS Mode of delivery was abstracted from obstetric records and sexual wellbeing measures were collected via a self-report questionnaire. Missing data were imputed using multiple imputation, and ordinal logistic regression models for ordered categorical outcomes were adjusted for the covariates maternal age at delivery, pre-pregnancy body mass index, diabetes during pregnancy, socio-economic position, parity, depression and anxiety. MAIN OUTCOME MEASURES Sexual enjoyment and frequency at four time points postpartum (between 33 months and 18 years) and two types of sex-related pain (pain in the vagina during sex and elsewhere after sex) at 11 years postpartum. RESULTS We found no association between mode of delivery and sexual enjoyment (e.g. adjusted odds ratio [OR] 1.11, 95% confidence interval [95% CI] 0.97-1.27 at 33 months) or sexual frequency (OR 0.99, 95% CI 0.88-1.12 at 33 months). Caesarean section was associated with an increased odds of pain in the vagina during sex at 11 years postpartum as compared with vaginal delivery in the adjusted model (OR 1.74, 95% CI 1.46-2.08). CONCLUSIONS These findings provide no evidence supporting associations between caesarean section and sexual enjoyment or frequency. However, mode of delivery was shown to be associated with dyspareunia, which may not be limited to abdominal scarring.
Collapse
Affiliation(s)
- Florence Z. Martin
- MRC Integrative Epidemiology UnitPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Paul Madley‐Dowd
- Centre for Academic Mental HealthPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | | | | | - Abigail Fraser
- MRC Integrative Epidemiology UnitPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Harriet Forbes
- Centre for Academic Mental HealthPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| |
Collapse
|
6
|
The Effect of Type of Delivery on Female Postpartum Sexual Functioning: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10071212. [PMID: 35885738 PMCID: PMC9322469 DOI: 10.3390/healthcare10071212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/18/2022] [Accepted: 06/26/2022] [Indexed: 11/22/2022] Open
Abstract
Female sexual function could be considered as multifactorial. Specific physiological structures and hormonal fluctuations postpartum, along with the psychological adjustment of women, could result in altered sexual function. The primary aim of this review was to systematically appraise the existing data on the effect of mode of delivery on female sexual function. This review was designed based on the PRISMA statement guidelines. An extensive literature search was performed in the Pubmed, Scopus, and PsycInfo databases, using prespecified inclusion/exclusion criteria, between the 20 September and 10 October 2021. Studies’ quality assessment was conducted using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the National Heart, Lung, and Blood Institute. The initial search involved 1592 studies. The last step of the screening procedure yielded 16 studies, including 41,441 subjects with a mean age of 29.9 years. Studies included groups with spontaneous and assisted vaginal and C-section delivery modes. No statistically significant difference between groups was found. The type of delivery appears to be irrelevant regarding this relationship. Moderating factors seemed to indirectly influence this relationship. Health professionals should educate expectant mothers and be aware of the possibility that delivery method could affect sexual function.
Collapse
|
7
|
Delgado-Pérez E, Rodríguez-Costa I, Vergara-Pérez F, Blanco-Morales M, Torres-Lacomba M. Recovering Sexuality after Childbirth. What Strategies Do Women Adopt? A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020950. [PMID: 35055771 PMCID: PMC8775547 DOI: 10.3390/ijerph19020950] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 01/15/2023]
Abstract
This study aimed to determine the strategies used by women to adapt to the changes that affect the first sexual relations after childbirth. A qualitative study with a phenomenological approach used three data collection techniques (in-depth interviews, discussion groups, and online forums). Thirty-six women in the first six months postpartum participated in the study, from physiotherapy centers with maternal child specialties in several locations in Spain. Women with different types of delivery, presence or absence of perineal trauma during delivery, previous deliveries, and different types of breastfeeding were included. Among the strategies, closeness support and understanding were the ones that women used to adjust to the new situation, in order to improve the couple's relationship, intimacy, and cope with the significant changes that appear in the first six months postpartum. Changes and adaptations in sexual practices become a tool for coping with a new sexuality, especially if it is affected by the presence of pain or discomfort associated with physical changes. Personal time facilitates emotional management and improvement of emotional changes related to the demands of motherhood. Accepting the changes that motherhood brings is critical to dealing with the new situation. Strategies used by postpartum women focus on acceptance, self-care, partner, couple time, personal time, and adapting encounters. The findings of this study are of interest to health professionals as they provide insight into how women cope with the changes that appear in the first six months postpartum. In this way, the findings will be able to transmit to couples the alternatives they can adopt before the resumption of sexual relations to improve satisfaction both as a couple and in terms of sexuality after childbirth.
Collapse
Affiliation(s)
- Esther Delgado-Pérez
- Physiotherapy Department, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (E.D.-P.); (M.B.-M.)
| | - Isabel Rodríguez-Costa
- Humanization in the Intervention of Physiotherapy for the Integral Attention to the People (HIPATIA) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28801 Madrid, Spain
- Correspondence:
| | - Fernando Vergara-Pérez
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28801 Madrid, Spain; (F.V.-P.); (M.T.-L.)
| | - María Blanco-Morales
- Physiotherapy Department, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (E.D.-P.); (M.B.-M.)
| | - María Torres-Lacomba
- Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28801 Madrid, Spain; (F.V.-P.); (M.T.-L.)
| |
Collapse
|
8
|
Fan X, Zhou F, Li Y, Xia W, Che Y. Factors associated with postpartum resumption of sexual intercourse among women in China: A retrospective multicenter study. J Obstet Gynaecol Res 2021; 48:230-238. [PMID: 34788897 DOI: 10.1111/jog.15088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 09/16/2021] [Accepted: 10/22/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To examine the prevalence and factors associated with early resumption of sexual intercourse among postnatal women in China. METHOD We conducted a retrospective multicenter study of 15 834 postpartum women from 60 hospitals in 15 different locations across China. Data were obtained from questionnaires administered to the participants. All dates were analyzed using a one-way ANOVA and two-level Cox multiple linear regression models. RESULTS More than half of the participating women (55.9%) resumed sexual intercourse by 3 months postpartum. The independent variables associated with the postpartum resumption of sexual intercourse included sociodemographic characteristics (age, geographic location, educational attainment) and medical histories, including the previous abortion (incorporate with spontaneous and voluntary abortion) frequency, menstrual recovery, exclusive breastfeeding, and number of living children (p < 0.05). CONCLUSION More than half of the women in this study resumed sexual intercourse within 3 months postpartum. Women with a lower educational attainment and from the western regions of China were more likely to resume sexual intercourse earlier. Increasing age, delayed recovery of menses, and exclusive breastfeeding were associated with a delayed resumption of sexual intercourse. Women who had greater experience with abortion or the number of living children resumed sexual intercourse earlier than their counterparts.
Collapse
Affiliation(s)
- Xiaorong Fan
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Zhou
- Reproductive Medicine Department, Hubei Maternal and Child Health Hospital, Wuhan, China
| | - Yuyan Li
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - Wei Xia
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Che
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China.,NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | | |
Collapse
|
9
|
Knutson AJ, Boyd SS, Long JB, Kjerulff KH. Early Resumption of Sexual Intercourse after First Childbirth and Unintended Pregnancy within Six Months. Womens Health Issues 2021; 32:51-56. [PMID: 34602327 DOI: 10.1016/j.whi.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE We aimed to evaluate factors associated with early resumption of sexual intercourse after first childbirth and assess whether early intercourse is associated with unprotected intercourse, subsequent pregnancy, and unintended pregnancy over 6 months. METHODS This secondary analysis used data from the First Baby Study, a prospective study of women aged 18-35 years with singleton pregnancies who delivered at 76 hospitals in Pennsylvania. At 1 and 6 months postpartum, women were asked about intercourse and the use of birth control since childbirth. We compared women who resumed intercourse in the first month after childbirth (early resumption) with those who resumed intercourse later, via multivariable logistic regression models. RESULTS In our cohort, 261 of 2,643 women (9.9%) reported first intercourse within the first postpartum month (7-31 days). Women who resumed intercourse early were less educated, younger, and less likely to breastfeed, have had a perineal laceration, or have had an episiotomy than those who resumed intercourse later. In addition, they were more likely to have unprotected intercourse in at least one of the first 6 months after first childbirth (adjusted odds ratio [aOR], 2.33; 95% confidence interval [CI], 1.76-3.09); to be pregnant by 6 months postpartum (aOR, 3.03; 95% CI, 1.48-6.20); and to report that pregnancy as unintended (aOR, 3.32; 95% CI, 1.50-7.36). CONCLUSIONS Nearly 10% of women resumed intercourse in the first month after childbirth. Because early resumption of intercourse was associated with a greater likelihood of unprotected intercourse and unintended pregnancy within 6 months of first childbirth, clinicians should focus efforts on comprehensive family planning and contraception counseling beginning in the prenatal period.
Collapse
Affiliation(s)
- Alex J Knutson
- Department of Obstetrics and Gynecology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Sarah S Boyd
- Department of Obstetrics and Gynecology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Jaime B Long
- Department of Obstetrics and Gynecology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Kristen H Kjerulff
- Department of Obstetrics and Gynecology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania; Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, Pennsylvania.
| |
Collapse
|
10
|
Secondary Dyspareunia After Childbirth: A Pilot Study for Comparison Between Group of Women With Episiotomy and Women Without Perineal Trauma. INTERNATIONAL JOURNAL OF CHILDBIRTH 2021. [DOI: 10.1891/ijcbirth-d-20-00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PROBLEMDyspareunia research following childbirth usually includes women who received an episiotomy during childbirth. Few studies have examined dyspareunia after childbirth in women who had no episiotomy or perineal trauma.PURPOSEThe purpose of this study was to compare the incidence of dyspareunia in women with perineal trauma related to childbirth to women without perineal trauma related to childbirth. The second aim was to assess risk factors for dyspareunia after childbirth.METHODSA quantitative cross-sectional study was designed and data were collected from a questionnaire that were sent via the internet (online). The study was performed in Slovenia. The study design included purposive and snowball sampling. Participants were assured anonymity.Analysis of data was conducted using SPSS 20.0. Factor analysis determined the validity and Cronbach's coefficient alpha determined the reliability of the questionnaire. The adequacy of a correlation matrix for factorization was assessed with the Kaiser–Meyer–Olkin (KMO) test and the Bartlett's test. To determine statistically significant differences, the chi-square (χ2) test was used. Kullback–Leibler divergence was used to measure how one probability distribution was different from the other probability distribution when the χ2 test was not satisfactory.FINDINGSThere were 387 respondents to the online questionnaire and 22% of the women who received an episiotomy prior to childbirth reported dyspareunia after childbirth; 13.69% reporteddyspareunia when they had no perineal trauma associated with childbirth. Dyspareunia persisted up to 18 months in 11% of participants who had an episiotomy and in 8% of women who experienced no perineal trauma.DISCUSSIONAfter an atraumatic childbirth, women can also experience dyspareunia. Pregnant women may benefit when their provider knows the risk factors for dyspareunia and limits episiotomy to those situations when there is a clear indication. Additional research may elucidate risk factors for dyspareunia following an atraumatic delivery.
Collapse
|
11
|
Szöllősi K, Komka K, Szabó L. Risk factors for sexual dysfunction during the first year postpartum: A prospective study. Int J Gynaecol Obstet 2021; 157:303-312. [PMID: 34418077 DOI: 10.1002/ijgo.13892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/01/2021] [Accepted: 08/20/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the connection of postpartum sexual dysfunction with mode of delivery, amenorrhea, depressive symptoms, and relationship satisfaction. METHODS For a prospective longitudinal study, we invited 729 Hungarian obstetrics patients to complete questionnaires at 3 months (T1), 6 months (T2), and 12 months (T3) postpartum. We sent them the Female Sexual Function Index (FSFI), the Edinburgh Postnatal Depression Scale (EDPS), the Relationship Assessment Scale (RAS), and a self-constructed questionnaire for body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) and other data. Of the 389 who responded at T1, we selected 293 who met our criteria for age, obstetrical history, relationship history, completeness of response, and sexual activity. At T2 and T3, we selected 214 and 95. We analyzed their data by multivariate logit regression. RESULTS The rates of sexual dysfunction were 44.70% (T1), 40.18% (T2), and 23.15% (T3). Mode of delivery was not a risk factor. Amenorrhea was a risk factor at T1 (P = 0.012) and T2 (P = 0.001). Obesity was a protective factor at T1 (P = 0.021). The higher the EPDS score (T1: P < 0.001; T2: P = 0.035; T3: P = 0.043), and the lower the RAS score (T1: P = 0.016; T2: P = 0.010; T3: P = 0.032), the greater was the risk of dysfunction. CONCLUSION Level of relationship satisfaction, severity of depressive symptoms, amenorrhea, and BMI are connected with sexual dysfunction within a year postpartum.
Collapse
Affiliation(s)
- Katalin Szöllősi
- School of PhD Studies, Semmelweis University, Budapest, Hungary.,Department of Family Care Methodology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Kinga Komka
- Department of Chemical and Environmental Process Engineering, Faculty of Chemical Technology and Biotechnology, Budapest University of Technology and Economics, Budapest, Hungary
| | - László Szabó
- Department of Family Care Methodology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary.,Heim Pál Children's Hospital, Budapest, Hungary
| |
Collapse
|
12
|
de Sousa NQ, Borges AC, Sarabando R, Bivar L, Viana J, Cerqueira M, Miranda A, Reis I, Nogueira-Silva C. The Role of Operative Vaginal Delivery in Postpartum Sexual Dysfunction: MOODS - A Prospective Study. J Sex Med 2021; 18:1075-1082. [PMID: 37057472 DOI: 10.1016/j.jsxm.2021.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 03/22/2021] [Accepted: 04/02/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Childbirth brings many changes to women's life and sexual health. The influence of operative vaginal delivery on sexual function has produced inconsistent results. AIM To evaluate the effects of mode of vaginal delivery (spontaneous or operative) in postpartum sexual function. METHODS Descriptive prospective study (MOODS- Maternal-neonatal Outcomes in Operative Vaginal Delivery) including 304 women who had a singleton term vaginal delivery (operative or spontaneous in a relation 2:1). Women were invited to answer a questionnaire at 3, 6 months and 1 year postpartum. OUTCOMES MEASUREMENT A validated questionnaire was applied, the Female Sexual Function Index (FSFI) Score, to evaluate effects of operative delivery on sexual health. Sexual dysfunction was defined by FSFI score <26.55. RESULTS 211 women answered at least one questionnaire. Overall rate of sexual dysfunction was 62%, 43% and 48% at 3, 6 and 12 months respectively. At 3 months, total FSFI score was significantly lower in operative vaginal delivery group (mean±SD, 21.3±8.6 vs 24.9±7.9, P = 0.015). Arousal (P = 0.028), orgasm (P = 0.029), satisfaction (P = 0.015) and pain (P = 0.007) FSFI domains were also significantly inferior. At this time, 44% women in spontaneous delivery group and 70% in operative delivery group had sexual dysfunction (P = 0.0002). At 6 months, there were no differences in FSFI scores according the type of delivery. At 12 months, total FSFI score was similar in both groups, but pain domain was significantly lower in operative delivery (P = 0.004). Considering type of instrument (Thierry's Spatulas or Kiwi Vacuum), no differences were found regarding episiotomy, perineal trauma, obstetric anal sphincter injury or postpartum complications. FSFI scores did not differ between the two instruments at any time point. A logistic regression showed that, when controlled for perineal trauma, mode of delivery was independently associated with sexual dysfunction at 3 months (P = 0.02). CLINICAL IMPLICATIONS Clinicians should assess women's sexual health during pregnancy and postpartum period in order to enhance their wellbeing. STRENGTHS/LIMITATIONS Strengths include its prospective design, standardized questionnaire and the new perspectives about a different obstetrical instrument (Thierry's spatulas). Limitations include the absence of pre-pregnancy sexual function data and considerable drop-out rate. CONCLUSION Sexual dysfunction affects a great proportion of newly mothers and in postpartum period mode of delivery and perineal trauma seem to play an important role. Although there was a progressive reduction over time, prevalence of sexual dysfunction at 6 months and 1 year postpartum was still considerable. The type of obstetrical instrument does not seem to influence short or long-term sexual function. de Sousa NQ, Borges AC, Sarabando R, et al. The Role of Operative Vaginal Delivery in Postpartum Sexual Dysfunction: MOODS - A Prospective Study. J Sex Med 2021;18:1075-1082.
Collapse
Affiliation(s)
| | | | - Rita Sarabando
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
| | - Leonor Bivar
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
| | - Johanna Viana
- School of Medicine, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Margarida Cerqueira
- School of Medicine, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Alexandra Miranda
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal; School of Medicine, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Isabel Reis
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
| | - Cristina Nogueira-Silva
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal; School of Medicine, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| |
Collapse
|
13
|
Zgliczynska M, Zasztowt-Sternicka M, Kosinska-Kaczynska K, Szymusik I, Pazdzior D, Durmaj A, Szlachta M, Bartnik P, Wielgos M. Impact of childbirth on women's sexuality in the first year after the delivery. J Obstet Gynaecol Res 2020; 47:882-892. [PMID: 33372310 DOI: 10.1111/jog.14583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/16/2020] [Accepted: 11/15/2020] [Indexed: 12/14/2022]
Abstract
AIM The aim was to compare the quality of sexual life before pregnancy and after delivery and to find out whether and how selected factors affect women's sexuality during this period. METHODS The study group consisted of 433 women who completed the survey containing basic demographic questions and two Female Sexual Function Index (FSFI) questionnaires: a retrospective one, regarding time before pregnancy and the current period. The inclusion criteria: time between 10 weeks and 1 year after delivery, vaginal intercourses before pregnancy and the resumption of vaginal intercourses after delivery. RESULTS We observed the negative impact of labor on the total FSFI score, regardless of the time that had passed since birth and the delivery mode. The decrease by at least 10% of the initial FSFI score was noticed in 44.3% of the participants. FSD (Female Sexual Dysfunction) occurred statistically more commonly after delivery than before pregnancy (45.3% vs 17.1%; P < 0.001). The following factors had an impact on the risk of post-partum FSD: pre-pregnancy FSD (adjusted odds ratio [aOR] = 4.17 [95% confidence interval [CI] 2.38-7.31]) and nulliparity (aOR = 1.67 [95% CI 1.09-2.53]). CONCLUSION Childbirth has an undeniable impact on women's sexuality. The prevention and treatment of sexual dysfunctions is very important, especially in this crucial period of life.
Collapse
Affiliation(s)
- Magdalena Zgliczynska
- Second Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Warsaw, Poland
| | - Monika Zasztowt-Sternicka
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | | | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Dominika Pazdzior
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Aneta Durmaj
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Szlachta
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Bartnik
- Second Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
14
|
Effects of mode of delivery on sexual functions of parturients in Nigeria: a prospective cohort study. Int Urogynecol J 2020; 32:1925-1933. [PMID: 33037450 DOI: 10.1007/s00192-020-04541-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/14/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Female sexual function disorders (FSFDs) have received less attention than male sexual function disorders, despite being more prevalent. Furthermore, most available literature is on the effect of vaginal delivery (VD) on sexual function, and studies on the effect of caesarean section (CS) are generally lacking. This study determined the comparative effect of CS and VD on FSFDs. METHODS A prospective cohort of postnatal mothers at two hospitals in Nigeria was studied. In the intervention group women delivered via CS whereas women in the control group had a VD. Both groups were followed up to 3 months to determine the time to first coitus and other FSFs using a validated questionnaire. RESULTS At 6 weeks postpartum, mean time (days) to first coitus was shorter in the CS than in the VD group (29.2 ± 4.3 vs 32.1 ± 4.9; t = 2.38; p = 0.02). However, no difference was observed at 3 months (37.3 ± 8.7 vs 40.9 ± 9.9; t = 1.83; p = 0.07). Also, there were no differences in mean Female Sexual Function Index (FSFI) total scores at 6 weeks and 3 months (p > 0.05). Mean FSFI domain scores at 6 weeks for orgasm, satisfaction, and pain were significantly higher in the CS group (p < 0.05). However, there were no differences in any of the domain scores at 3 months (p > 0.05). CONCLUSION Mode of delivery does not affect time to resumption of coitus after childbirth, and FSF disorders by 3 months postpartum. Caesarean section should therefore not be recommended to women merely for early resumption of coital activity or preservation/maintenance of sexual function after childbirth.
Collapse
|
15
|
A Comparison of the Sexual Well-Being of New Parents With Community Couples. J Sex Med 2020; 17:2156-2167. [PMID: 32943374 DOI: 10.1016/j.jsxm.2020.08.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/07/2020] [Accepted: 08/13/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Changes in sexual well-being are common for new mothers and their partners after the birth of a baby. However, most research has sampled mothers not couples, assessed only one aspect of sexual well-being, and has not included a control sample of couples. AIM This study aimed to compare the sexual well-being (ie, sexual frequency, sexual satisfaction, sexual desire, sexual distress) of first-time mothers and their partners in the transition to parenthood (first 12-month postpartum) to community couples who are not actively in this transition. We also compared the sexual well-being within couples (eg, mothers to their partners). METHODS Couples in the transition to parenthood (n = 99) completed measures of sexual satisfaction, sexual desire, sexual distress, and sexual frequency at 3, 6, and 12 months postpartum, and community couples (n = 104) completed the measures at a single time point. OUTCOMES Measures included the following: (i) Global Measure of Sexual Satisfaction Scale; (ii) Female Sexual Function Index and International Index of Erectile Function sexual desire subscale; (iii) Female Sexual Distress Scale-Revised; and (iv) checklist of sexual behaviors. RESULTS Compared with community controls, new parents reported lower sexual satisfaction, lower sexual desire, and higher sexual distress at all time-points; however, these group differences became less pronounced by 12 months postpartum. By 6 months postpartum, there was no difference in sexual frequency between postpartum couples and the control group. Mothers experienced persistently lower sexual desire relative to their partners throughout the 12 months postpartum. Between 39% and 59% of mothers reported clinically low sexual desire, and 47-57% reported significant sexual distress at all time points. There were no significant differences reported in sexual satisfaction, sexual desire, or sexual distress between women and their partners in the community sample. CLINICAL IMPLICATIONS Clinicians should be aware that sexual well-being may be compromised in new parents, and some of these challenges are still present for new parents at 12 months postpartum. Findings can be used to educate new parents regarding their expectations about postpartum sexual well-being. STRENGTHS & LIMITATIONS The strengths of the present study are the dyadic approach, assessing multiple aspects of sexual well-being in new parents over time, and the comparison with a community sample. An important limitation is that the control sample was not followed up over time. CONCLUSION Education regarding postpartum sexual well-being should be incorporated in routine perinatal and postnatal healthcare practices to support new parents in developing realistic expectations about changes during the transition to parenthood, potentially preventing undue distress. Schwenck GC, Dawson SJ, Muise A, et al. A Comparison of the Sexual Well-Being of New Parents With Community Couples. J Sex Med 2020;17:2156-2167.
Collapse
|
16
|
Spaich S, Link G, Alvarez SO, Weiss C, Sütterlin M, Tuschy B, Berlit S. Influence of Peripartum Expectations, Mode of Delivery, and Perineal Injury on Women's Postpartum Sexuality. J Sex Med 2020; 17:1312-1325. [PMID: 32532706 DOI: 10.1016/j.jsxm.2020.04.383] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 03/31/2020] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Sexual health has been identified as an important factor for postpartum quality of life. Although pregnancy-related changes in anatomy and metabolism return to their prepregnancy state, female sexual function may not be at the level it was before birth because of physical and psychological changes. AIM The goal of our study was to explore the influence of the mode of delivery, perineal injury, and peripartum expectations on postpartum sexual function. METHODS Between 2013 and 2018, 522 women were enrolled in this prospective investigation. At time of recruitment during the peripartum hospitalization, patients completed a standardized questionnaire addressing expectations concerning postpartum sexuality with focus on expected influence of the mode of delivery. Sexual function was evaluated using the Female Sexual Function Index (FSFI) and Sexual Activity Questionnaire (SAQ) at time of recruitment to evaluate baseline sexual function (4 weeks before pregnancy). Follow-up assessments were conducted at 3, 6, and 12 months postpartum. OUTCOMES Peripartum expectations, influence of the mode of delivery, and perineal injury were analyzed for their impact on women's sexual function within 12 months postpartum by repetitive FSFI and SAQ assessments. RESULTS A total of 522 women with 263 spontaneous vaginal deliveries, 41 operative vaginal deliveries, and 218 cesarean sections were analyzed. Although the data demonstrate a significant postpartum decline in sexual function at 3 and 6 months postpartum, sexual functioning converges to baseline prepregnancy values 12 months postpartum. This observation was independent of the mode of delivery and perineal injuries with no significant between-group differences at any of the analyzed time points. Apart from breastfeeding, for which negative anticipations resulted in impaired sexuality, women's expectations (pertaining to quantity and quality of female orgasm, partner's sexuality, fear of altered sexuality, frequency of intercourse, the mode of delivery) do not influence female sexual function at 12 months postpartum. CLINICAL IMPLICATIONS Deciphering the potential influence of patient expectations as well as pregnancy- and childbirth-related aspects on female postpartum sexuality will help in the effort to improve women's postpartum sexual health. STRENGTHS & LIMITATIONS As a strength of this study, postpartum sexuality was independently assessed with 2 different scoring systems (FSFI and SAQ). Limitations include that our follow-up is incomplete and amounts to about 2-thirds of patients who were initially recruited. CONCLUSION The mode of delivery and perineal trauma do not influence women's postpartum sexual function. With the exception of breastfeeding, peripartum expectations do not result in altered sexual functioning at 12 months postpartum. Spaich S, Link G, Alvarez SO, et al. Influence of Peripartum Expectations, Mode of Delivery, and Perineal Injury on Women's Postpartum Sexuality. J Sex Med 2020;17:1312-1325.
Collapse
Affiliation(s)
- Saskia Spaich
- Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany.
| | - Georgina Link
- Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefanie Ortiz Alvarez
- Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Christel Weiss
- Department of Medical Statistics and Biomathematics, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Marc Sütterlin
- Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Benjamin Tuschy
- Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Sebastian Berlit
- Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| |
Collapse
|
17
|
Evcili F, Demirel G, Bekar M, Guler H. Effectiveness of postpartum sexual health education programme structured according to Levine's conservation model: An interventional study. Int J Nurs Pract 2020; 26:e12855. [PMID: 32510741 DOI: 10.1111/ijn.12855] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 03/18/2020] [Accepted: 05/01/2020] [Indexed: 01/29/2023]
Abstract
AIM This study aimed to determine the effects of a postpartum sexual health education programme structured according to Levine's conservation model on postpartum women. METHODS The interventional study was completed with 67 postpartum women. The intervention group was given the postpartum sexual health education programme structured according to Levine's conservation model. The control group received routine discharge training. The data were collected using a personal information form, The Index of Female Sexual Function, Arizona Sexual Experience Scale and Golombok-Rust Inventory of Sexual Satisfaction. RESULTS It has been determined that the decrease in sexual arousal and desire is the first among postpartum sexual problems experienced by women. This study demonstrated that sexual function, sexual satisfaction and sexual response were higher in nonbreastfeeding women, women who had sexual intercourse one to three times a week and women who could talk to health care professionals on sexual matters. After the programme, the intervention group had more adequate sexual function, and they developed a strong, easy and satisfactory sexual response than the control group (p < 0.05). CONCLUSION This programme was effective in increasing the sexual functions and satisfaction of the postpartum women. Models provide guidance to nurses for provision of care in a systematic manner.
Collapse
Affiliation(s)
- Funda Evcili
- Vocational School of Health Care Services, Cumhuriyet University, Sivas, Turkey
| | - Gulbahtiyar Demirel
- Faculty of Health Sciences, Midwifery Department, Cumhuriyet University, Sivas, Turkey
| | - Mine Bekar
- Faculty of Health Sciences, Midwifery Department, Cumhuriyet University, Sivas, Turkey
| | - Handan Guler
- Faculty of Health Sciences, Midwifery Department, Cumhuriyet University, Sivas, Turkey
| |
Collapse
|
18
|
García-Mejido JA, Idoia-Valero I, Aguilar-Gálvez IM, Borrero González C, Fernández-Palacín A, Sainz JA. Association between sexual dysfunction and avulsion of the levator ani muscle after instrumental vaginal delivery. Acta Obstet Gynecol Scand 2020; 99:1246-1252. [PMID: 32198764 DOI: 10.1111/aogs.13852] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The effects of levator ani muscle (LAM) avulsion after instrumental delivery on the sexual function of patients are currently unknown. Therefore, the objective of our study was to use a validated questionnaire, namely, the Female Sexual Function Index (FSFI), to compare the sexual function in patients with and without LAM avulsion after instrumental vaginal delivery. MATERIAL AND METHODS This was a prospective observational study of 112 primiparous women after instrumental (vacuum or forceps) vaginal delivery. The obstetric and general characteristics of the population were studied. At 6 months postpartum, the contraceptive method used and the occurrence of LAM avulsion (using four-dimensional transperineal ultrasound) were determined, and the FSFI was administered. RESULTS A total of 100 patients (62 without avulsion and 38 with avulsion) completed the study. Thirty-eight (38%) were diagnosed with avulsion (42.1% after Kielland forceps delivery, 57.9% after Malmström vacuum delivery; P = .837). Women with LAM avulsion had significantly lower scores for desire (2.9 ± 1.2 vs 3.4 ± 1.1; P = .049), arousal (2.8 ± 1.7 vs 3.6 ± 1.4; P = .014), lubrication (2.3 ± 1.4 vs 3.0 ± 1.2; P = .011), orgasm (2.6 ± 1.6 vs 3.3 ± 1.2; P = .006) and satisfaction (3.1 ± 1.8 vs 3.9 ± 1.5; P = .051) than did women without LAM avulsion. The overall FSFI score was lower in patients with avulsion (16.7 ± 8.9 vs 20.7 ± 6.9, P = .033). These results were obtained after controlling for confounders (delivery mode, induced labor, birthweight, perineal tears, avulsion degree, contraceptive method and group assignment for the parent study) in the multivariate analysis (F = 4.974, P = .001). CONCLUSIONS Patients with LAM avulsion present a higher degree of sexual dysfunction compared wiith patients without avulsion at 6 months after instrumental vaginal delivery.
Collapse
Affiliation(s)
- José A García-Mejido
- Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain.,Department of Obstetrics and Gynecology, University of Seville, Seville, Spain
| | - Irene Idoia-Valero
- Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain
| | | | - Carlota Borrero González
- Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain.,Department of Obstetrics and Gynecology, University of Seville, Seville, Spain
| | - Ana Fernández-Palacín
- Biostatistics Unit, Department of Preventive Medicine and Public Health, University of Seville, Seville, Spain
| | - José A Sainz
- Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain.,Department of Obstetrics and Gynecology, University of Seville, Seville, Spain
| |
Collapse
|
19
|
Sussmann LGPR, Faisal-Cury A, Pearson R. Depressão como mediadora da relação entre violência por parceiro íntimo e dificuldades sexuais após o parto: uma análise estrutural. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200048. [DOI: 10.1590/1980-549720200048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/26/2019] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Introdução: Não foram encontrados estudos que avaliam associação entre violência por parceiro íntimo (VPI) anterior ao parto e dificuldades na esfera da sexualidade no período pós-parto. O presente estudo avalia se existe essa associação. Método: Estudo transversal com 700 mulheres que realizaram o pré-natal em Unidade Básica de Saúde (UBS), em São Paulo, entre 2006 e 2007. As dificuldades sexuais (DS) foram avaliadas por meio de questionário elaborado pelos autores e a VPI foi investigada por questionário estruturado elaborado pela Organização Mundial da Saúde (OMS). Já a depressão pós-parto (DPP) foi avaliada por meio do Self-Reporting Questionnaire (SRQ-20) e foi considerada variável mediadora. Para calcular os coeficientes de associação das vias diretas e indiretas foi utilizada a análise estrutural (path analysis). Resultados: As prevalências de DS, a VPI e a DPP foram, respectivamente, 30, 42,8 e 27,8%. A violência ocorrida antes do parto não mostrou associação direta - ED = 0,072 (-0,06 - 0,20; p = 0,060) - nem indireta - EI: 0,045 (-0,06 - 0,20; p = 0,123) - em relação ao desfecho estudado. Conclusão: Futuras investigações sobre a relação entre as três variáveis estudadas são recomendadas. Estudos longitudinais que incluam outros mediadores podem trazer melhor entendimento da cadeia causal e elucidação das variáveis que influenciam as questões da sexualidade no pós-parto.
Collapse
|
20
|
Benton M, Salter A, Tape N, Wilkinson C, Turnbull D. Women's psychosocial outcomes following an emergency caesarean section: A systematic literature review. BMC Pregnancy Childbirth 2019; 19:535. [PMID: 31888530 PMCID: PMC6937939 DOI: 10.1186/s12884-019-2687-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 12/17/2019] [Indexed: 11/10/2022] Open
Abstract
Background Given the sudden and unexpected nature of an emergency caesarean section (EmCS) coupled with an increased risk of psychological distress, it is particularly important to understand the psychosocial outcomes for women. The aim of this systematic literature review was to identify, collate and examine the evidence surrounding women’s psychosocial outcomes of EmCS worldwide. Methods The electronic databases of EMBASE, PubMed, Scopus, and PsycINFO were searched between November 2017 and March 2018. To ensure articles were reflective of original and recently published research, the search criteria included peer-reviewed research articles published within the last 20 years (1998 to 2018). All study designs were included if they incorporated an examination of women’s psychosocial outcomes after EmCS. Due to inherent heterogeneity of study data, extraction and synthesis of both qualitative and quantitative data pertaining to key psychosocial outcomes were organised into coherent themes and analysis was attempted. Results In total 17,189 articles were identified. Of these, 208 full text articles were assessed for eligibility. One hundred forty-nine articles were further excluded, resulting in the inclusion of 66 articles in the current systematic literature review. While meta-analyses were not possible due to the nature of the heterogeneity, key psychosocial outcomes identified that were negatively impacted by EmCS included post-traumatic stress, health-related quality of life, experiences, infant-feeding, satisfaction, and self-esteem. Post-traumatic stress was one of the most commonly examined psychosocial outcomes, with a strong consensus that EmCS contributes to both symptoms and diagnosis. Conclusions EmCS was found to negatively impact several psychosocial outcomes for women in particular post-traumatic stress. While investment in technologies and clinical practice to minimise the number of EmCSs is crucial, further investigations are needed to develop effective strategies to prepare and support women who experience this type of birth.
Collapse
Affiliation(s)
- Madeleine Benton
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia.
| | - Amy Salter
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Nicole Tape
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Chris Wilkinson
- Maternal Fetal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Deborah Turnbull
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
21
|
Lolowang NL, Afiyanti Y, Ungsianik T. Kegel's exercise to improve sexual self-efficacy in primiparous women. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
22
|
Abstract
OBJECTIVES This is a cross sectional study conducted in order to determine sexual dysfunction in healthy women and risk factors. PATIENTS AND METHODS The population of the study consisted of 282 women. The whole of the population, without sample selection, was included in the study. For data, questionnaire and Female Sexual Function Index-FSFI, whose Turkish validity and reliability study was conducted, were used. Student t and chi-square significant tests and logistic regression analysis were used to carry out statistical analysis. RESULTS It was found that 35.8% of 282 women who participated in the study were in the age range of 30-39 years, 54.6% had high school educational level or above, and 59.6% worked. Prevalence was determined as 53.2% FSFI score < 26 according to Female Sexual Function Index FSFI; 23% of the women had complaints about urinary incontinence UI. According to logistic regression results, it is determined that CFB risk is increased in patients with age and urination problem. It was determined that there was no significant correlation between income, number of children, prceived economic status, dyspareunia, having problem with the partner, experiencing premenstrual syndrome, and SD. CONCLUSION In this study, approximately half of healthy women had SD and development of SD was affected based on some descriptive characteristics. As sexual life was considered as a factor increasing life quality, it was thought that it is fairly important to discuss the questioning of problems related to sexual life for systematic evaluation of patients, as well.
Collapse
Affiliation(s)
- Meral Kılıç
- Ataturk University Faculty of Health Sciences, Erzurum, Turkey
| |
Collapse
|
23
|
Serrano Drozdowskyj E, Gimeno Castro E, Trigo López E, Bárcenas Taland I, Chiclana Actis C. Factors Influencing Couples' Sexuality in the Puerperium: A Systematic Review. Sex Med Rev 2019; 8:38-47. [PMID: 31447412 DOI: 10.1016/j.sxmr.2019.07.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The puerperium is a period of adaptation in which various transformations take place in the lives of women and men on their way to becoming mothers and fathers. These changes can also have repercussions on their sexual relations. How the couple deals with this transition is crucial to the well-being of the couple and affects how parents relate to the baby. AIM This study aimed to explore the factors that influence sexuality in both women and men during postpartum. METHODS We conducted a bibliographic review of 236 articles found on the PubMed database and published from 2008 to January 2019. MAIN OUTCOME MEASURE The main outcome measure was the impact of various physical, psychological, and sociocultural factors on couples' sexual functioning during postpartum. RESULTS The main problems that couples face after childbirth can be classified as (i) psychological changes, such as loss of a sense of self, transitioning to parenthood, taking on the new roles of mother and father, and feelings of abandonment among men; (ii) body changes in women that affect their self-image and perineal trauma; (iii) hormonal changes in women and men that can lead to reduced sexual desire in both and vaginal dryness or dyspareunia in women; (iv) changes in the marital relationship, including changes in each other's roles, taking time for intimacy, and initiating sexual intercourse; (v) sociocultural influences, such as social support, culturally expected roles, and beliefs regarding when to resume sex; and (vi) lifestyle changes, especially with regard to baby care. CONCLUSION Sexuality during postpartum is influenced by multiple factors: physical, psychological, and sociocultural. Our findings offer a deeper understanding of how the transition to parenthood affects sexual relationships during the postpartum period. Implications regarding caring for and promoting the sexual health of individuals and couples after childbirth are discussed, and some medical recommendations for parents are offered. Serrano Drozdowskyj E, Gimeno Castro E, Trigo López E, et al. Factors Influencing Couples' Sexuality in the Puerperium: A Systematic Review. Sex Med Rev 2020;8:38-47.
Collapse
Affiliation(s)
- Elena Serrano Drozdowskyj
- Perinatal Mental Health Unit, Consulta Dr Carlos Chiclana, Madrid, Spain; Universidad Pontificia de Comillas, Madrid, Spain
| | | | - Elena Trigo López
- Perinatal Mental Health Unit, Consulta Dr Carlos Chiclana, Madrid, Spain
| | - Inés Bárcenas Taland
- Perinatal Mental Health Unit, Consulta Dr Carlos Chiclana, Madrid, Spain; Universidad Francisco de Victoria, Madrid, Spain
| | - Carlos Chiclana Actis
- Perinatal Mental Health Unit, Consulta Dr Carlos Chiclana, Madrid, Spain; Universidad San Pablo CEU, Madrid, Spain
| |
Collapse
|
24
|
Ollivier RA, Aston ML, Price SL. Exploring postpartum sexual health: A feminist poststructural analysis. Health Care Women Int 2019; 41:1081-1100. [PMID: 31373883 DOI: 10.1080/07399332.2019.1638923] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Postpartum sexual health has historically been viewed and discussed in specific ways, often dominated by biomedical discourse. There is a need to expand understandings of sexual health for postpartum women in the context of interdisciplinary health care. Research surrounding postpartum sexual health is largely focused on physical measures, such as vaginal lubrication or initiation of intercourse, without accounting for the diverse and subjective ways that sexuality and sexual health are experienced during the postpartum period. This critical analysis uses feminist post-structuralism to critique and analyze current health research and practice surrounding postpartum sexual health. Agency, subjectivity, gender and sex considerations, relations of power, and discourse are essential to understanding postpartum sexual health in a more holistic, woman-centered way. This includes awareness of dominant discourses that have shaped how health researchers, practitioners, postpartum women, and health institutions care for, support, and promote postpartum sexual health. There is a need to move beyond physically focused, reductionist, heteronormative understandings of sexual health to better promote overall postpartum health and wellbeing.
Collapse
Affiliation(s)
- Rachel A Ollivier
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Megan L Aston
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sheri L Price
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
25
|
McDonald EA, Gartland D, Woolhouse H, Brown SJ. Resumption of sex after a second birth: An Australian prospective cohort. Birth 2019; 46:173-181. [PMID: 29907972 DOI: 10.1111/birt.12363] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 05/15/2018] [Accepted: 05/15/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Few longitudinal studies have examined women's experiences of sex after childbirth. Much of the advice given to couples about what to expect in relation to sex after childbirth is based on cross-sectional studies. OBJECTIVE To investigate timing of resumption of sex after a second birth and assess associations with obstetric factors (method of birth and perineal trauma) and time interval between first and second births. METHOD Prospective cohort of 1507 nulliparous women recruited before 25 weeks' gestation in Melbourne, Australia followed up at 3, 6, 9, and 12 months after first births, and 6 and 12 months after second births. Measures include: obstetric factors and resumption of vaginal sex after first and second births. RESULTS By 8 weeks after their second birth, 56% of women had resumed vaginal sex, compared with 65% after their first birth. Women were more likely to resume sex later than 8 weeks postpartum if they had a spontaneous vaginal birth with episiotomy or sutured perineal tear (aOR: 2.21, 95% CI: 1.5-3.2), operative vaginal birth (aOR: 2.60, 95% CI: 1.3-5.3) or cesarean delivery (aOR: 2.15, 95% CI: 1.4-3.3) compared with a vaginal birth with minimal or no perineal trauma. There was no association between timing of resumption of sex and the time interval between births. CONCLUSION For almost half of the cohort, sex was not resumed until at least 8 weeks after the second birth. Timing of resumption of sex was influenced by obstetric factors, but not the time interval between births.
Collapse
Affiliation(s)
- Ellie A McDonald
- Healthy Mothers Healthy Families Research Group, Murdoch Children's Research Institute, Parkville, Vic., Australia
| | - Deirdre Gartland
- Healthy Mothers Healthy Families Research Group, Murdoch Children's Research Institute, Parkville, Vic., Australia
| | - Hannah Woolhouse
- Healthy Mothers Healthy Families Research Group, Murdoch Children's Research Institute, Parkville, Vic., Australia
| | - Stephanie J Brown
- Healthy Mothers Healthy Families Research Group, Murdoch Children's Research Institute, Parkville, Vic., Australia.,Departments of Paediatrics and General Practice, The University of Melbourne, Parkville, Vic., Australia
| |
Collapse
|
26
|
Pereira TRC, Dottori EH, Mendonça FMDAF, Beleza ACS. Assessment of female sexual function in remote postpatum period: a cross-sectional study. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2018. [DOI: 10.1590/1806-93042018000200003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: (i) to evaluate female sexual function in remote postpartum period within Brazilian women and (ii) to compare female sexual dysfunction in relation to the mode of delivery. Methods: in this cross-sectional study, two groups of remote postpartum women, who underwent vaginal delivery (n=30) and cesarean (n=48), were studied. The sexual function of participants was assessed through an online Brazilian version of FSFI between 45 and 180 days after delivery. Data were analyzed by descriptive and inferential statistics using Fisher exact test, and Student t test. Results: based on the data of 78 women who completed the online questionnaire, 78% (n=61) showed sexual dysfunction on remote postpartum period being that the FSFI mean score for vaginal postpartum was 22.17 and for cesarean postpartum, 21.12 (p=0.443). Conclusions: the majority of remote postpartum women showed sexual dysfunction. There was no significant difference found on female sexual function between modes of delivery.
Collapse
|
27
|
Crookall R, Fowler G, Wood C, Slade P. A systematic mixed studies review of women's experiences of perineal trauma sustained during childbirth. J Adv Nurs 2018; 74:2038-2052. [PMID: 29791012 DOI: 10.1111/jan.13724] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 03/15/2018] [Indexed: 12/14/2022]
Abstract
AIM To explore the quantitative/qualitative literature on women's experiences of perineal trauma sustained during childbirth and the impact it may have on psychological/emotional wellbeing BACKGROUND: Obstetric complications during childbirth can be a risk factor for postpartum psychological distress. Perineal trauma is one of the most frequent obstetric complications and it is important to understand any impact on psychological/emotional wellbeing. DESIGN A convergent qualitative design using a hybrid deductive-inductive thematic synthesis approach to data transformation was used. DATA SOURCES Web of knowledge, CINAHL, MEDLINE, AMED, PsyArticles, PsycInfo until May 2017. REVIEW METHODS Stage 1: transforming findings from the qualitative, quantitative and mixed methods studies into themes using thematic synthesis. Stage 2: integrating themes from the quantitative studies into those derived from the qualitative studies RESULTS: Records (N=2152) found of which 11 qualitative 22 quantitative and 1 mixed methods were included in this review. Five themes were derived from thematic synthesis of qualitative studies 'The mystery of perineal trauma', 'The misery of perineal suturing', 'The postnatal perineum', 'Normalisation and feeling dismissed' and 'Adjusting to a new normal - Coping and compromise' and five themes identified from the quantitative studies, experience of birth (N=4), Sexual functioning (N=12), Social functioning (N=2), Psychological health (N=8) and Quality of Life (N=5). CONCLUSION Perineal trauma can have a negative impact on psychological/emotional wellbeing, however the literature is conflicted and in need of clarification. Future research should clearly describe the perineal status of the women in the sample, use validated measures and consider the timing of such measures. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
| | - Gillian Fowler
- Consultant Urogynaecologist, Liverpool Women's NHS Foundation Trust
| | - Caroline Wood
- Specialist Urogynaecological link midwife, Liverpool Women's NHS Foundation Trust
| | - Pauline Slade
- Clinical Psychology/Consultant Clinical Psychologist, University of Liverpool
| |
Collapse
|
28
|
Triviño-Juárez JM, Romero-Ayuso D, Nieto-Pereda B, Forjaz MJ, Oliver-Barrecheguren C, Mellizo-Díaz S, Avilés-Gámez B, Arruti-Sevilla B, Criado-Álvarez JJ, Soto-Lucía C, Plá-Mestre R. Resumption of intercourse, self-reported decline in sexual intercourse and dyspareunia in women by mode of birth: A prospective follow-up study. J Adv Nurs 2017; 74:637-650. [DOI: 10.1111/jan.13468] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2017] [Indexed: 01/23/2023]
Affiliation(s)
| | - Dulce Romero-Ayuso
- Department of Physical Therapy; Faculty of Health Science; University of Granada (UGR); Granada Spain
| | - Beatriz Nieto-Pereda
- Preventive Medicine Service; Hospital General Universitario Gregorio Marañón; Gregorio Marañón Health Research Institute (IiSGM); Madrid Spain
| | - Maria João Forjaz
- National School of Public Health; Carlos III Institute of Health and REDISSEC; Carlos III Institute of Health; Madrid Spain
| | - Cristina Oliver-Barrecheguren
- Obstetrics and Gynecology Service; Hospital General Universitario Gregorio Marañon; Gregorio Marañon Health Research Institute (IiSGM); Madrid Spain
| | - Sonia Mellizo-Díaz
- Obstetrics and Gynecology Service; Hospital General Universitario Gregorio Marañon; Gregorio Marañon Health Research Institute (IiSGM); Madrid Spain
| | | | | | | | - Consuelo Soto-Lucía
- Obstetrics and Gynecology Service; Hospital General Universitario Gregorio Marañon; Gregorio Marañon Health Research Institute (IiSGM); Madrid Spain
| | - Rosa Plá-Mestre
- Preventive Medicine Service; Hospital General Universitario Gregorio Marañón; Gregorio Marañón Health Research Institute (IiSGM); Madrid Spain
| |
Collapse
|
29
|
Jawed-Wessel S, Sevick E. The Impact of Pregnancy and Childbirth on Sexual Behaviors: A Systematic Review. JOURNAL OF SEX RESEARCH 2017; 54:411-423. [PMID: 28166416 DOI: 10.1080/00224499.2016.1274715] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The purpose of this review was to examine and synthesize the available quality evidence to provide researchers, educators, and clinicians an overview of what is known about sexual behaviors during pregnancy and the year after childbirth. Search engines were used to identify peer-reviewed, English-language articles that met the inclusion criteria. A total of 56 prospective, retrospective, and qualitative studies published after 1996 were reviewed. A gradual decline in vaginal intercourse from prepregnancy to first trimester to third trimester was found. Most couples resume vaginal intercourse by eight weeks after childbirth, but this behavior does not occur at prepregnancy frequencies until closer to 12 months postchildbirth. Future studies should consider assessing sexual behaviors beyond vaginal intercourse and increase efforts in recruitment of diverse samples including non-White, nonheterosexual pregnant individuals, and partners of pregnant individuals.
Collapse
Affiliation(s)
| | - Emily Sevick
- a School of Health and Kinesiology, University of Nebraska at Omaha
| |
Collapse
|
30
|
Kahramanoglu I, Baktiroglu M, Hamzaoglu K, Kahramanoglu O, Verit FF, Yucel O. The impact of mode of delivery on the sexual function of primiparous women: a prospective study. Arch Gynecol Obstet 2017; 295:907-916. [DOI: 10.1007/s00404-017-4299-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 01/13/2017] [Indexed: 10/20/2022]
|
31
|
Labbok MH. Postpartum Sexuality and the Lactational Amenorrhea Method for Contraception. Clin Obstet Gynecol 2016; 58:915-27. [PMID: 26457855 DOI: 10.1097/grf.0000000000000154] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
This chapter reviews the literature on postpartum coital behavior, anovulatory and ovulatory bleeding episodes, and the methodology and efficacy of Lactational Amenorrhea Method and progesterone-only oral contraceptives. Of interest is the finding that breastfeeding women may resume coital behavior earlier postpartum, but report increased discomfort over time. The high efficacy of the Lactational Amenorrhea Method is confirmed and data illustrating possible relaxation of some criteria are presented. The conflicting guidance of CDC and WHO concerning immediate postpartum use of progestin-only methods is presented. The dearth of recent studies calls for new research on these topics.
Collapse
Affiliation(s)
- Miriam H Labbok
- Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina
| |
Collapse
|
32
|
Cappell J, MacDonald TK, Pukall CF. For new mothers, the relationship matters: Relationship characteristics and postpartum sexuality. CANADIAN JOURNAL OF HUMAN SEXUALITY 2016. [DOI: 10.3138/cjhs.252-a5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Postpartum sexuality has traditionally been studied using a biomedical framework, which focuses on how the physical and biological changes that occur during pregnancy and childbirth affect the resumption of pain-free intercourse. The current study sought to use a more inclusive and contextual approach by investigating how relationship characteristics are related to postpartum sexual desire and predict the resumption of a variety of sexual activities. A total of 188 new mothers who were within one year postpartum completed an online study. The Sexual Desire Inventory was used to measure solitary and dyadic sexual desire. Relationship satisfaction was measured using the Relationship Assessment Scale and perception of partner's sexual desire was measured using three modified questions from the Sexual Desire Inventory. New mothers were also asked to report when they resumed a variety of sexual activities in the postpartum period. Relationship satisfaction and perceptions of partner's desire were negatively correlated with solitary sexual desire, and relationship satisfaction was positively correlated with dyadic sexual desire. Birth-related factors were not related to postpartum sexual desire. New mothers' perception of their partner's desire predicted the resumption of most sexual activities in the postpartum (i.e., manual stimulation of new mother's and partner's genitals, oral stimulation of partner's genitals, penile-vaginal intercourse). Relationship satisfaction predicted the resumption of oral stimulation of the new mother's genitals. The results of this study support the incorporation of contextual factors, such as relationship characteristics, and the inclusion of non-penetrative sexual activities in the study of postpartum sexuality.
Collapse
Affiliation(s)
- Jaclyn Cappell
- Department of Psychology, Queen's University, Kingston, ON
| | | | | |
Collapse
|
33
|
Brotto L, Atallah S, Johnson-Agbakwu C, Rosenbaum T, Abdo C, Byers ES, Graham C, Nobre P, Wylie K. Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction. J Sex Med 2016; 13:538-71. [DOI: 10.1016/j.jsxm.2016.01.019] [Citation(s) in RCA: 196] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 01/16/2016] [Accepted: 01/19/2016] [Indexed: 12/11/2022]
|
34
|
[What do we know about perinatal sexuality? A scoping review on sexoperinatality - Part 2]. ACTA ACUST UNITED AC 2016; 45:809-820. [PMID: 26989006 DOI: 10.1016/j.jgyn.2015.11.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/30/2015] [Accepted: 11/04/2015] [Indexed: 02/04/2023]
Abstract
The intimate and sexual dimension of future and new parenting couples' relationship is the most affected and the most vulnerable during the transition to parenthood. The purpose of this scoping review is to present the portrait of perinatal sexuality through 123 empirical articles published in the last 15 years. This second article in a series of two is about sexuality during labor and birth, during the postpartum, and in relation to breastfeeding. A total of 29 sexual variables were analyzed. Sexuality during the intrapartal and postnatal periods is very diversified. Some recurring items, however, can be identified: a period of non-sexuality in the first postnatal months, followed by a gradual return of sexuality from 3 to 6 months postpartum and continuing until 12 months or more. Sexuality during the intrapartum is considered taboo and couples' experiences can be at opposite ends: some couples' experiences are sensual and erotic during childbirth, while others experience birth trauma with a negative sexual impact postnatally. Sexuality during breastfeeding is also taboo with a negative impact on women's sexuality. In all of these circumstances, women's and men's sexuality are affected and a multitude of simultaneous physiological and psychological factors affect their experiences. Fluctuations in the intimate and sexual dimensions of the conjugal relationship are considered as a natural phenomenon but temporary. Sexoperinatal interventions should be part of holistic perinatal health care in order to help couples maintain a positive intimate and sexual relationship.
Collapse
|
35
|
Barbara G, Pifarotti P, Facchin F, Cortinovis I, Dridi D, Ronchetti C, Calzolari L, Vercellini P. Impact of Mode of Delivery on Female Postpartum Sexual Functioning: Spontaneous Vaginal Delivery and Operative Vaginal Delivery vs Cesarean Section. J Sex Med 2016; 13:393-401. [DOI: 10.1016/j.jsxm.2016.01.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 11/20/2015] [Accepted: 11/22/2015] [Indexed: 02/01/2023]
|
36
|
Lurie S. Caesarean delivery is associated with higher risk of depressive symptoms, pain and sexual dysfunction. Evid Based Nurs 2016; 19:70. [PMID: 26862111 DOI: 10.1136/eb-2015-102267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Samuel Lurie
- Department of Obstetrics & Gynecology, Edith Wolfson Medical Center, Tel Aviv University, Holon, Israel
| |
Collapse
|
37
|
Andreucci CB, Bussadori JC, Pacagnella RC, Chou D, Filippi V, Say L, Cecatti JG. Sexual life and dysfunction after maternal morbidity: a systematic review. BMC Pregnancy Childbirth 2015; 15:307. [PMID: 26596506 PMCID: PMC4657322 DOI: 10.1186/s12884-015-0742-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 11/17/2015] [Indexed: 12/13/2022] Open
Abstract
Background Because there is a lack of knowledge on the long-term consequences of maternal morbidity/near miss episodes on women´s sexual life and function we conducted a systematic review with the purpose of identifying the available evidence on any sexual impairment associated with complications from pregnancy and childbirth. Methods Systematic review on aspects of women sexual life after any maternal morbidity and/or maternal near miss, during different time periods after delivery. The search was carried out until May 22nd, 2015 including studies published from 1995 to 2015. No language or study design restrictions were applied. Maternal morbidity as exposure was split into general or severe/near miss. Female sexual outcomes evaluated were dyspareunia, Female Sexual Function Index (FSFI) scores and time to resume sexual activity after childbirth. Qualitative syntheses for outcomes were provided whenever possible. Results A total of 2,573 studies were initially identified, and 14 were included for analysis after standard selection procedures for systematic review. General morbidity was mainly related to major perineal injury (3rd or 4th degree laceration, 12 studies). A clear pattern for severity evaluation of maternal morbidity could not be distinguished, unless when a maternal near miss concept was used. Women experiencing maternal morbidity had more frequently dyspareunia and resumed sexual activity later, when compared to women without morbidity. There were no differences in FSFI scores between groups. Meta-analysis could not be performed, since included studies were too heterogeneous regarding study design, evaluation of exposure and/or outcome and time span. Conclusion Investigation of long-term repercussions on women’s sexual life aspects after maternal morbidity has been scarcely performed, however indicating worse outcomes for those experiencing morbidity. Further standardized evaluation of these conditions among maternal morbidity survivors may provide relevant information for clinical follow-up and reproductive planning for women.
Collapse
Affiliation(s)
- Carla B Andreucci
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, Brazil. .,Federal University of Sao Carlos, Sao Carlos, Brazil.
| | | | - Rodolfo C Pacagnella
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, Brazil.
| | - Doris Chou
- Reproductive Health Research unit, World Health Organization, Geneva, Switzerland.
| | - Veronique Filippi
- London School of Hygiene and Tropical Medicine, University of London, London, England, UK.
| | - Lale Say
- Reproductive Health Research unit, World Health Organization, Geneva, Switzerland.
| | - Jose G Cecatti
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, Brazil.
| | | | | |
Collapse
|
38
|
Inter-relationships between sexual abuse, female sexual function and childbirth. Midwifery 2015; 31:1087-95. [DOI: 10.1016/j.midw.2015.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 06/13/2015] [Accepted: 07/20/2015] [Indexed: 12/31/2022]
|
39
|
Chang SR, Chen KH, Ho HN, Lai YH, Lin MI, Lee CN, Lin WA. Depressive symptoms, pain, and sexual dysfunction over the first year following vaginal or cesarean delivery: A prospective longitudinal study. Int J Nurs Stud 2015; 52:1433-44. [PMID: 26008134 DOI: 10.1016/j.ijnurstu.2015.04.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 04/13/2015] [Accepted: 04/28/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Childbirth has a significant impact on maternal health, and the high rate of cesarean delivery is a global health concern. Few studies have used validated measures to explore depression, pain, and sexual dysfunction following vaginal or cesarean delivery over a prolonged time period. OBJECTIVE We examined the associations between vaginal and cesarean delivery and depressive symptoms, pain, and sexual function during the 1-year postpartum period. DESIGN A prospective, five-time-point longitudinal study. SETTING Maternity unit at a medical center. PARTICIPANTS A total of 351 of 736 women completed a questionnaire that described demographic characteristics, depressive symptoms, and pain levels at 3-5 days postpartum, and updated personal data, depressive symptoms, pain levels, and sexual function at 4-6 weeks and at 3, 6, and 12 months after delivery. METHODS Differences between the vaginal and cesarean groups in depressive symptoms, pain, and sexual function and trends of changes in these factors over the first postpartum year were examined. RESULTS Compared with the vaginal birth group, the cesarean birth group had a significantly higher prevalence of depressive symptoms at 3 months (p=0.03); higher scores for non-localized pain at 3-5 days (p<0.001), 4-6 weeks (p=0.03), and 3 months (p=0.046); higher scores for abdominal pain at 3-5 days (p<0.001), 4-6 weeks (p<0.001), and 6 months (p=0.01); lower perineal pain scores at 3-5 days (p <0.001); and higher sexual desire scores (p=0.04) but lower sexual satisfaction scores (p=0.02) at 4-6 weeks. Differences between the vaginal and cesarean groups were significant (p=0.01, p=0.049, respectively) in terms of the decrease in non-localized pain from 3-5 days to 4-6 weeks postpartum and the increase in sexual desire from 4-6 weeks to 3 months postpartum. CONCLUSIONS Cesarean delivery was associated with an increased prevalence of depressive symptoms at 3 months and higher pain levels that persisted at 6 months postpartum in Taiwan. We found no difference in sexual function between vaginal and cesarean delivery after 6 weeks postpartum, and no differences in the trends related to depressive symptoms or in sexual functioning (except for desire) within 1 year postpartum.
Collapse
Affiliation(s)
- Shiow-Ru Chang
- School of Nursing, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan.
| | - Kuang-Ho Chen
- Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Hong-Nerng Ho
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
| | - Ming-I Lin
- Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chien-Nan Lee
- Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
| | - Wei-An Lin
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
| |
Collapse
|
40
|
Eid MA, Sayed A, Abdel-Rehim R, Mostafa T. Impact of the mode of delivery on female sexual function after childbirth. Int J Impot Res 2015; 27:118-20. [PMID: 25672800 DOI: 10.1038/ijir.2015.2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 10/20/2014] [Accepted: 01/07/2015] [Indexed: 02/08/2023]
Abstract
This cohort study aimed to assess the effect of the mode of delivery on female sexual function (FSF) after childbirth. Out of 256 primiparous women, 200 subjects that completed the study were divided into two groups; women that delivered vaginally and women that had elective cesarean section (CS). They were subjected to a translated version of female sexual function index (FSFI) questionnaire evaluating desire, lubrication, orgasm, satisfaction, pain both antenatally and 12 weeks postpartum. The mean FSFI total score of the two investigated groups demonstrated nonsignificant difference 12 weeks after delivery compared with these scores antenatally. Women that delivered vaginally demonstrated significant decreases in the scores of desire, arousal and lubrication domains 12 weeks after delivery compared with these scores antenatally where other scores demonstrated nonsignificant differences. Women that delivered by CS demonstrated a significant difference in desire domain 12 weeks after delivery compared with these scores antenatally where other scores demonstrated nonsignificant differences. It is concluded that the mode of delivery has nonsignificant effect on the FSF 12 weeks after childbirth. Specifically, vaginal delivery is associated with significant decrease in the desire, arousal and lubrication domains where elective CS is associated with significant decrease in the desire domain.
Collapse
Affiliation(s)
- M A Eid
- Department of Andrology & Sexology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - A Sayed
- Department of Gynecology & Obstetrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - R Abdel-Rehim
- Department of Dermatology & Reproduction, National Research Center, Giza, Egypt
| | - T Mostafa
- Department of Andrology & Sexology, Faculty of Medicine, Cairo University, Cairo, Egypt
| |
Collapse
|
41
|
De Souza A, Dwyer PL, Charity M, Thomas E, Ferreira CHJ, Schierlitz L. The effects of mode delivery on postpartum sexual function: a prospective study. BJOG 2015; 122:1410-8. [PMID: 25752211 DOI: 10.1111/1471-0528.13331] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the effect of mode of delivery and perineal injury on sexual function at 6 and 12 months postpartum. DESIGN Prospective cohort study. SETTING Tertiary women's hospital in Melbourne, Australia. POPULATION A cohort of 440 primigravid women. METHODS The Female Sexual Function Index (FSFI) was completed at first visit (7-19 weeks of gestation), and at 6 and 12 months postpartum. MAIN OUTCOME MEASURES A statistically significant difference in total FSFI or domain scores over time according to mode of delivery or perineal injury. RESULTS In this cohort 54% of women had a normal vaginal delivery, 21% had an instrumental delivery, and 25% gave birth by caesarean section. No difference was found in total FSFI or domain scores according to mode of delivery over time between antenatal assessment and 12 months postpartum. Pain was decreased in the caesarean group only at 6 months postpartum. All groups showed pain scores at 12 months that were comparable with antenatal levels. For those who gave birth vaginally, 27% had an intact perineum, 50% had an episiotomy, and 6%, 14%, and 3% had first, second, and third-degree tears, respectively. The only differences between groups were found over time according to perineal injury at 6 months in the arousal domain. At 12 months, total FSFI and domain scores were no different to initial scores. CONCLUSIONS At 12 months postpartum sexual function has returned to early pregnancy levels, irrespective of mode of delivery or perineal injury.
Collapse
Affiliation(s)
- A De Souza
- Department of Urogynaecology, Mercy Hospital for Women, Melbourne, Vic., Australia
| | - P L Dwyer
- Department of Urogynaecology, Mercy Hospital for Women, Melbourne, Vic., Australia.,The University of Melbourne, Melbourne, Vic., Australia
| | - M Charity
- Institute of Sport Exercise and Active Living, Victoria University, Melbourne, Vic., Australia.,School of Health Sciences and Psychology, Federation University Australia, Ballarat, Vic., Australia
| | - E Thomas
- Department of Urogynaecology, Mercy Hospital for Women, Melbourne, Vic., Australia
| | - C H J Ferreira
- Department of Urogynaecology, Mercy Hospital for Women, Melbourne, Vic., Australia.,Ribeirao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | - L Schierlitz
- Department of Urogynaecology, Mercy Hospital for Women, Melbourne, Vic., Australia
| |
Collapse
|
42
|
Amiri FN, Omidvar S, Bakhtiari A, Yazdani S, Hajiahmadi M. Comparison of Sexual Function in Primiparous Women Pre-Pregnancy and Postpartum: Difference of the Sexual Function after the Normal Vaginal Delivery and the Cesarean Section. Health (London) 2015. [DOI: 10.4236/health.2015.710152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
43
|
Song M, Ishii H, Toda M, Tomimatsu T, Katsuyama H, Nakamura T, Nakai Y, Shimoya K. Association between sexual health and delivery mode. Sex Med 2014; 2:153-8. [PMID: 25548646 PMCID: PMC4272246 DOI: 10.1002/sm2.46] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Introduction Female sexual function changes considerably during pregnancy and the postpartum period. In addition, women's physical and mental health, endocrine secretion, and internal and external genitalia vary during these times. However, there are limited studies on the relationship between delivery and sexual function. Aim The present study aimed to demonstrate the association between sexual function and delivery mode. Methods Mothers who delivered a single baby at term were recruited for the study, and 435 mothers were analyzed. Main Outcome Measures The Female Sexual Function Questionnaire (SFQ28) scores and mothers' backgrounds were assessed at 6 months after delivery. Results The delivery mode affected the SFQ28 partner domain. Episiotomy affected the arousal (sensation) domain. Multiple regression analysis revealed that maternal age and cesarean section were significantly associated with several SHQ28 domains. Conclusion This study suggests that routine episiotomies at delivery should be avoided to improve postpartum maternal sexual function. Maternal age and cesarean section were found to affect postpartum sexual health.
Collapse
Affiliation(s)
- Mihyon Song
- Department of Obstetrics and Gynecology, Kawasaki Medical School Kurashiki City, Okayama, Japan
| | - Hiroshi Ishii
- Department of Obstetrics and Gynecology, Kawasaki Medical School Kurashiki City, Okayama, Japan
| | - Masahiro Toda
- Department of Public Health, Wakayama Medical University Wakayama City, Wakayama, Japan
| | - Takuji Tomimatsu
- Department of Obstetrics and Gynecology, Kawasaki Medical School Kurashiki City, Okayama, Japan
| | - Hironobu Katsuyama
- Department of Public Health, Kawasaki Medical School Kurashiki City, Okayama, Japan
| | - Takafumi Nakamura
- Department of Obstetrics and Gynecology, Kawasaki Medical School Kurashiki City, Okayama, Japan
| | - Yuichiro Nakai
- Department of Obstetrics and Gynecology, Kawasaki Medical School Kurashiki City, Okayama, Japan
| | - Koichiro Shimoya
- Department of Obstetrics and Gynecology, Kawasaki Medical School Kurashiki City, Okayama, Japan
| |
Collapse
|
44
|
Colson MH. [Female sexuality and parenthood]. ACTA ACUST UNITED AC 2014; 42:714-20. [PMID: 25262091 DOI: 10.1016/j.gyobfe.2014.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 06/27/2014] [Indexed: 10/24/2022]
Abstract
From the child conception to the early years of life, couples generally present less sexual activity. Parenthood constraints are a burden for the couple's relationships. Generally, persistent sexual difficulties six months after delivery, despite those generated by depression or altered health raise the question of an alteration in the quality of the couple's relationships and lack of satisfaction of the mother with her partner's involvement in family life. Numerous parameters can be implied, especially with persistent trouble of desire, such as fatigue, body image problems and libido lessening of the partner due to modifications of his status. Women who presented sexual difficulties before pregnancy remain the same. In all cases, appropriate information can avoid the intimacy's difficulties and contribute to maintain pleasure and intimacy even when vaginal penetration remains difficult.
Collapse
Affiliation(s)
- M-H Colson
- Hôpital Sainte-Marguerite, 270, boulevard de Sainte-Marguerite, 13009 Marseille, France.
| |
Collapse
|
45
|
Do women notice the impact of childbirth-related levator trauma on pelvic floor and sexual function? Results of an observational ultrasound study. Int Urogynecol J 2014; 25:1389-98. [DOI: 10.1007/s00192-014-2331-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
|
46
|
[Post-partum sexuality. Living in black African couple analysis]. ACTA ACUST UNITED AC 2014; 44:280-5. [PMID: 24842644 DOI: 10.1016/j.jgyn.2014.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 11/28/2013] [Accepted: 01/07/2014] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The period of the post-partum arouses a lot of questioning in the couple in particular regarding sexuality. OBJECTIVE Analyze the real-life experience of the sexuality of the African black couples in the post-partum. PATIENTS AND METHOD It was about study type attitudes and practical knowledge which took place in the department of gynecology-obstetrics and andrology of the teaching hospital of Bouaké over the period going in September 30th, 2012 on April 30th, 2013. The study took place in two stages. The first stage had consisted in a pre-test which allowed validate the questionnaire which contained 16 items. The second stage consisted submitting it directly to the patients, in postnatal consultation, who had agreed to participate in the study after an informed consent. The data were analyzed with epi-info, 2002 version. RESULTS On 395 patients investigated, we noted the resumption of the sexual intercourse for 140 patients (34,2 %). The resumption was made on the initiative of the partner in 67,9 % of the cases, in particular after the return of menstruation (53,8 %). The reason to accept sexual intercourse was to satisfy the partner (60,7 %) and to maintain the harmony of the couple (57,1 %). However, the weekly frequency of the sexual intercourse had decreased in 75 % of the couples. This decrease was caused by the time dedicated to the child (66,7 %) and by the dyspareunia (57,1 %). We also observed a more important frequency of the anal sexual intercourse in the post-partum compared with the period before the childbirth (17,8 % vs. 3,57 %). Also, the use of subtleties, such as lubricants was observed more frequently in the post-partum (39,3 % vs. 3,6 %). Sixty-four comma three percent of the patients had found less satisfaction sexual intercourse. Dyspareunia was more frequent in case of episiotomy, perineal tear during the delivery and delivery assisted (vacuum). The patients, in 51 % of the cases, were themselves responsible for the refusal of the resumption of the sexual activity. The reasons of the refusal were of cultural and religious order and in touch with the absence of the return of menstruation in respectively 64,7 % and 54,9 % of the cases. CONCLUSION The delivery had a negative impact on the resumption of couple sexual activity. Also, we noted a strong influence of the cultural and religious faiths on the sexual practice of the post-partum in the absence of reliable information. A particular attention should be concerned by the medical profession on the question of sexuality in the post-partum.
Collapse
|