Inter-relationships between sexual abuse, female sexual function and childbirth.
BACKGROUND
the present quantitative longitudinal study focuses on the inter-relationships between sexual abuse, distressed female sexual function and childbirth. Additional variables studied include depression, mode of delivery, subjective birth experience and traumatic life events other than sexual abuse.


METHODS
data collection for the study was extended across three time periods: during the third trimester of pregnancy and approximately one and six months postpartum. Self-reported questionnaire responses of 300 women from two medical centres in Israel, as well as hospital records regarding their mode of childbirth, were included in the data analysis. Measures incorporated in the study included the Female Sexual Distress Scale-Revised, the Beck Depression Inventory and modified versions of the Traumatic Events Questionnaire, the Sexual Experiences Survey, and the Subjective Birth Experience Questionnaire.


RESULTS
findings demonstrated that women with a lifetime history of sexual abuse compared to women without such history, are at an increased risk for distressed antenatal and postpartum female sexual function (Odds Ratio OR=2.66 and OR=2.26, respectively); and postpartum depression (OR=2.36). Antenatal depression was likewise shown to be significantly associated with antenatal and postpartum distressed female sexual function (OR=4.32 and OR=10.4, respectively), as well as with a more negatively experienced childbirth (T-Ratio, T=1.98, p<0.05). Moreover, distressed antenatal female sexual function was found to increase the risk for a more negatively experienced childbirth (T=2.04, p<0.05), and caesarean childbirth (OR=3.34).


CONCLUSIONS
the current study enriches the understanding of the inter-relationships between the antenatal, childbirth and postpartum variables studied herein; and has implications for evidence based practice in both preventative and intervention efforts. Recommendations for future research are presented and discussed.
Emili Sagol Creative Arts Therapies Research Center, University of Haifa, 3478601 Haifa, Israel; Faculty of Social Welfare and Health Sciences, University of Haifa, 3478601 Haifa, Israel. Electronic address: ruth@gottfrieds.com.
Ruth
R
Gottfried
Emili Sagol Creative Arts Therapies Research Center, University of Haifa, 3478601 Haifa, Israel; Faculty of Social Welfare and Health Sciences, University of Haifa, 3478601 Haifa, Israel.
Rachel
R
Lev-Wiesel
Department of Obstetrics and Gynecology, Hillel-Yaffe Medical Center, 38100 Hadera, Israel; Ruth & Bruce Rappaport School of Medicine, Technion - Israel Institute of Technology, 3525433, Haifa, Israel.
Mordechai
M
Hallak
Emili Sagol Creative Arts Therapies Research Center, University of Haifa, 3478601 Haifa, Israel; 'Tene' Center for the Treatment of the Sexually Abused, Obstetrics and Gynecology Department, the Baruch Padeh-Poriya Medical Center, 15208 Tiberias, Israel; Faculty of Medicine in the Galilee, Bar-Ilan University, 1311502 Safed, Israel.
Nessia
N
Lang-Franco
D000328:Adult; D019052:Depression, Postpartum / Q000209:etiology*; D005260:Female; D006801:Humans; D007557:Israel; D008137:Longitudinal Studies; D036801:Parturition / Q000523:psychology*; D011247:Pregnancy; D012307:Risk Factors; D057566:Self Report; D012742:Sex Offenses / Q000523:psychology*; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires
Childbirth; Depression; Female sexual function; Pregnancy; Sexual abuse; Subjective birth experience