Women's sexual health after childbirth

BJOG. 2000 Feb;107(2):186-95. doi: 10.1111/j.1471-0528.2000.tb11689.x.


Objective: To investigate the impact of childbirth on the sexual health of primiparous women and identify factors associated with dyspareunia.

Design: Cross-sectional study using obstetric records, and postal survey six months after delivery.

Setting: Department of Obstetrics and Gynaecology, St George's Hospital, London.

Population: All primiparous women (n = 796) delivered of a live birth in a six month period.

Methods: Quantitative analysis of obstetric and survey data.

Main outcome measures: Self reported sexual behaviour and sexual problems (e.g. vaginal dryness, painful penetration, pain during sexual intercourse, pain on orgasm, vaginal tightness, vaginal looseness, bleeding/irritation after sex, and loss of sexual desire); consultation for postnatal sexual problems.

Results: Of the 484 respondents (61% response rate), 89% had resumed sexual activity within six months of the birth. Sexual morbidity increased significantly after the birth: in the first three months after delivery 83% of women experienced sexual problems, declining to 64% at six months, although not reaching pre-pregnancy levels of 38% . Dyspareunia in the first three months after delivery was, after adjustment, significantly associated with vaginal deliveries (P = 0 x 01) and previous experience of dyspareunia (P = 0 x 03). At six months the association with type of delivery was not significant (P = 0 x 4); only experience of dyspareunia before pregnancy (P < 0 x 0001) and current breastfeeding were significant (P = 0 x 0006). Only 15% of women who had a postnatal sexual problem reported discussing it with a health professional.

Conclusions: Sexual health problems were very common after childbirth, suggesting potentially high levels of unmet need.

MeSH terms

  • Adolescent
  • Adult
  • Breast Feeding
  • Coitus
  • Contraception Behavior
  • Cross-Sectional Studies
  • Delivery, Obstetric
  • Dyspareunia / psychology*
  • Female
  • Health Status*
  • Health Surveys
  • Humans
  • Interpersonal Relations
  • Maternal Health Services / statistics & numerical data
  • Parity
  • Patient Acceptance of Health Care
  • Postnatal Care
  • Pregnancy
  • Sexual Behavior* / psychology