title: The relationship between mode of delivery and sexual health outcomes after childbirth.
abstract: BACKGROUND
  Several factors are implicated in the women's sexuality after childbirth. Nevertheless, there is conflicting evidence about the influence of mode of delivery (MD) AIM: To prospectively evaluate the relationship between MD and sexual health outcomes after childbirth
  
  
  METHODS
  A prospective cohort study conducted between May 2005 and March 2007 included 831 pregnant women recruited from primary care clinics of the public sector in São Paulo, Brazil. The exposure variable was MD: uncomplicated vaginal delivery (spontaneous vaginal delivery without episiotomy or any kind of perineal laceration); complicated vaginal delivery (either forceps or normal, with episiotomy or any kind of perineal laceration) and cesarean delivery. Socio-demographic and obstetric data were obtained through a questionnaire applied during the antenatal and postnatal period. Crude and adjusted risk ratios, with 95% confidence intervals, were calculated using Poisson regression to examine the associations between MD and sexual health outcomes.
  
  
  METHODS
  The three main sexual health outcomes were later resumption of sexual life, self-perception of decline of sexual life (DSL), and presence of sexual desire.
  
  
  RESULTS
  One hundred and forty-one women (21.9%) resumed sexual life 3 or more months after delivery. Although 87.1% of women had desire, DSL occurred in 21.1% of the cohort. No associations were found between MD and sexual health outcomes.
  
  
  CONCLUSIONS
  Women's sexuality after childbirth were not influenced by the type of delivery. Efforts to improve the treatment of sexual problems after childbirth should focus beyond MD.
authors: Preventive Medicine Department, University of São Paulo, São Paulo, Brazil.
authors: Alexandre
authors: A
authors: Faisal-Cury
authors: Preventive Medicine Department, University of São Paulo, São Paulo, Brazil.
authors: Paulo Rossi
authors: PR
authors: Menezes
authors: Preventive Medicine Department, University of São Paulo, São Paulo, Brazil.
authors: Julieta
authors: J
authors: Quayle
authors: Preventive Medicine Department, University of São Paulo, São Paulo, Brazil.
authors: Alicia
authors: A
authors: Matijasevich
authors: Maternal and Child Health Department, University of São Paulo, São Paulo, Brazil.
authors: Simone Grilo
authors: SG
authors: Diniz
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002585:Cesarean Section / Q000009:adverse effects / Q000523:psychology; D003075:Coitus / Q000523:psychology; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000523:psychology; D004841:Episiotomy / Q000009:adverse effects / Q000523:psychology; D005260:Female; D006801:Humans; D007989:Libido; D036801:Parturition; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy; D011446:Prospective Studies; D060728:Reproductive Health; D012649:Self Concept; D012725:Sexual Behavior; D019529:Sexuality; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
keywords: Childbirth; Mode of Delivery; Postpartum Depression; Sexual Functioning