Pelvic pain and mode of delivery.
OBJECTIVE
We sought to determine the long-term effect of mode of delivery on the prevalence and severity of pelvic pain.


METHODS
Six to eleven years after a first delivery, pelvic pain (dysmenorrhea, dyspareunia, and pelvic pain not related to menses or intercourse) was measured using the Oxfordshire Women's Health Study Questionnaire. Obstetrical exposures were assessed by review of the hospital delivery record. The prevalence of moderate to severe pelvic pain was compared between the 577 women who delivered via cesarean for all births and the 538 who delivered at least 1 child vaginally. Other obstetrical exposures were also studied.


RESULTS
Prevalence of pelvic pain was similar between women who delivered vaginally and by cesarean. Among women who delivered vaginally, those who experienced at least 1 forceps delivery and women who delivered at least 1 baby ≥4 kg vaginally reported a higher rate of dyspareunia. Perineal trauma was not associated with dyspareunia.


CONCLUSIONS
Forceps delivery and a vaginal delivery of a baby ≥4 kg are associated with dyspareunia 6-11 years after vaginal birth. Vaginal birth is not associated with a higher rate of pelvic pain when compared to cesarean delivery.
Department of Gynecology, Greater Baltimore Medical Center, Baltimore, MD.
Joan L
JL
Blomquist
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Kelly
K
McDermott
Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD.
Victoria L
VL
Handa
D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods*; D004412:Dysmenorrhea / Q000453:epidemiology; D004414:Dyspareunia / Q000453:epidemiology; D005260:Female; D006801:Humans; D009772:Obstetrical Forceps; D017699:Pelvic Pain / Q000453:epidemiology*; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires
dysmenorrhea; dyspareunia; mode of delivery; pelvic pain