The impact of mode of delivery on the sexual function of primiparous women: a prospective study.
OBJECTIVE
The purpose of this study was to evaluate the impact of mode of delivery on the sexual function of women using the Female Sexual Function Index (FSFI).


METHODS
This was a prospective study of 452 nulliparous women, comparing their sexual function before and after birth. A Turkish version of the FSFI questionnaire was administered within the first 8 weeks of pregnancy, at 3 and 6 months postpartum in a face-to-face manner and subsequently at the 12th month and 24th month over the telephone.


RESULTS
Age, BMI, education level, house income, duration of marriage, birthweight, and feeding at each time point were similar between group 1 [vaginal birth and mediolateral episiotomy (MLE)] and group 2 [caesarean section (CS)]. In the postpartum period, there were 265 and 138 participants at 3rd month, 216 and 121 participants at 6th month, 189 and 111 participants at 12th month, and 133 and 85 participants at 24th month in group 1 and 2, respectively. The FSFI total scores decreased at 3 and 6 months postpartum in both groups (27.3 to 23.1 in group 1 and 27.5 to 25 in group 2; p < 0.05 for both). Desire, arousal, lubrication, satisfaction and pain scores were significantly decreased at 3 months postpartum in group (1) In group 1, desire, arousal and pain scores remained decreased at the 6th month compared to initial scores. Group 2 had significantly lower desire, lubrication, satisfaction and pain scores at 3 months postpartum compared to their initial scores. Decline in desire and lubrication domains persisted at the 6th month for group (2) None of the FSFI domain scores differed after 6th months when compared to pre-delivery scores in both groups. Compared with the caesarean group, the vaginal birth with MLE group had lower satisfaction and higher pain levels at 3 months postpartum (p < 0.0001, for both). None of the FSFI domains differed at the 6th, 12th or the 24th month between the groups.


CONCLUSIONS
Our study revealed that caesarean section is not superior to vaginal birth in terms of preservation of normal sexual function, regardless of short-term postpartum effects. Women should be informed that, irrespective of their type of delivery, sexual function 6 months after childbirth is similar to that in pre-pregnancy.
Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty Istanbul University, Fatih, Istanbul, Turkey. ilkerkahramanoglu@hotmail.com.
Ilker
I
Kahramanoglu
Department of Obstetrics and Gynecology, Suleymaniye Women's Health Training and Research Hospital, Istanbul, Turkey.
Merve
M
Baktiroglu
Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty Istanbul University, Fatih, Istanbul, Turkey.
Kubra
K
Hamzaoglu
Department of Obstetrics and Gynecology, Suleymaniye Women's Health Training and Research Hospital, Istanbul, Turkey.
Ozge
O
Kahramanoglu
Department of Obstetrics and Gynecology, Suleymaniye Women's Health Training and Research Hospital, Istanbul, Turkey.
Fatma Ferda
FF
Verit
Department of Obstetrics and Gynecology, Suleymaniye Women's Health Training and Research Hospital, Istanbul, Turkey.
Oguz
O
Yucel
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects; D003268:Contraception Behavior / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000379:methods; D004841:Episiotomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D010146:Pain; D010298:Parity; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology* / Q000209:etiology; D014421:Turkey
Caesarean section; Delivery; Episiotomy; FSFI; Sexual function