title: Impact of Mode of Delivery on Female Postpartum Sexual Functioning: Spontaneous Vaginal Delivery and Operative Vaginal Delivery vs. Cesarean Section.
abstract: BACKGROUND
  Several studies have explored the association between modes of delivery and postpartum female sexual functioning, although with inconsistent findings.
  
  
  OBJECTIVE
  To investigate the impact of mode of delivery on female postpartum sexual functioning by comparing spontaneous vaginal delivery, operative vaginal delivery, and cesarean section.
  
  
  METHODS
  One hundred thirty-two primiparous women who had a spontaneous vaginal delivery, 45 who had an operative vaginal delivery, and 92 who underwent a cesarean section were included in the study (N = 269). Postpartum sexual functioning was evaluated 6 months after childbirth using the Female Sexual Function Index. Time to resumption of sexual intercourse, postpartum depression, and current breastfeeding also were assessed 6 months after delivery.
  
  
  METHODS
  Female Sexual Function Index total and domain scores and time to resumption of sexual intercourse at 6 months after childbirth.
  
  
  RESULTS
  Women who underwent an operative vaginal delivery had poorer scores on arousal, lubrication, orgasm, and global sexual functioning compared with the cesarean section group and lower orgasm scores compared with the spontaneous vaginal delivery group (P < .05). The mode of delivery did not significantly affect time to resumption of sexual intercourse. Women who were currently breastfeeding had lower lubrication, more pain at intercourse, and longer time to resumption of sexual activity.
  
  
  CONCLUSIONS
  Operative vaginal delivery might be associated with poorer sexual functioning, but no conclusions can be drawn from this study regarding the impact of pelvic floor trauma (perineal laceration or episiotomy) on sexual functioning because of the high rate of episiotomies. Overall, obstetric algorithms currently in use should be refined to decrease further the risk of operative vaginal delivery.
authors: Department of Obstetrics and Gynecology, "G. Fornaroli" Hospital, via Al Donatore di sangue 50, Magenta, Milan, Italy. Electronic address: giussy.barbara@gmail.com.
authors: Giussy
authors: G
authors: Barbara
authors: Urogynecology Unit, Department of Women's and Children's Health, Fondazione IRCCS Ca' Granda, Milan, Italy.
authors: Paola
authors: P
authors: Pifarotti
authors: Faculty of Psychology, Catholic University of Milan, Milan, Italy.
authors: Federica
authors: F
authors: Facchin
authors: Unit of Medical Statistics and Biometry, Department of Clinical Sciences and Community Health, Università degli Studi, Milan, Italy.
authors: Ivan
authors: I
authors: Cortinovis
authors: Department of Clinical Sciences and Community Health, Università degli Studi di Milano and Gynecology Unit, Department of Women's and Children's Health, Fondazione IRCCS Ca' Granda, Milan, Italy.
authors: Dhohua
authors: D
authors: Dridi
authors: Urogynecology Unit, Department of Women's and Children's Health, Fondazione IRCCS Ca' Granda, Milan, Italy.
authors: Camilla
authors: C
authors: Ronchetti
authors: Urogynecology Unit, Department of Women's and Children's Health, Fondazione IRCCS Ca' Granda, Milan, Italy.
authors: Luca
authors: L
authors: Calzolari
authors: Department of Clinical Sciences and Community Health, Università degli Studi di Milano and Gynecology Unit, Department of Women's and Children's Health, Fondazione IRCCS Ca' Granda, Milan, Italy.
authors: Paolo
authors: P
authors: Vercellini
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology*; D001942:Breast Feeding / Q000523:psychology*; D002585:Cesarean Section / Q000523:psychology* / Q000706:statistics & numerical data; D003075:Coitus / Q000502:physiology / Q000523:psychology*; D036861:Delivery, Obstetric / Q000523:psychology* / Q000706:statistics & numerical data; D019052:Depression, Postpartum / Q000503:physiopathology / Q000523:psychology*; D004841:Episiotomy; D005260:Female; D006801:Humans; D009948:Orgasm; D010298:Parity; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy
keywords: Cesarean Section; Mode of Delivery; Postpartum Female Sexual Function; Pregnancy; Vaginal Delivery