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.