Postpartum sexual life satisfaction not affected by mode of delivery

Key takeaways:

• Reported postpartum sexual life satisfaction was not significantly affected by mode of delivery.
• Associations between mode of delivery and satisfaction did not vary by time since delivery.

Mode of delivery did not affect self-perceived sexual life satisfaction overall or at any time postpartum, according to cohort study results published in the American Journal of Obstetrics and Gynecology.

“While there is evidence that sexual health-related outcomes generally improve with time since delivery, there is lack of data on the impact of delivery mode on such outcomes in the longer term,” Alma Larsdotter Zweygberg, MSc, research assistant in the Centre for Epidemiology and Community Medicine at Karolinska Institute in Stockholm, and colleagues wrote. “In addition, there are also knowledge gaps in relation to how self-perceived overall sexual life satisfaction may be affected by delivery mode since most studies have instead addressed sexual function.”

Larsdotter Zweygberg and colleagues conducted a population-based cohort study using data from 46,078 deliveries from the Swedish Medical Birth Registry matched with participants from the Stockholm Public Health Cohort. Researchers obtained mode of delivery data from the registry and obtained self-perceived sexual life satisfaction data from the Stockholm Public Health Cohort Questionnaire. In the questionnaire, participants were asked about their self-perceived postpartum sexual life satisfaction and responded with “very satisfactory,” “fairly satisfactory,” “neither satisfactory nor unsatisfactory,” “fairly unsatisfactory” or “very unsatisfactory.”

Mean time from delivery to outcome assessment was 18 years. In the cohort, 78.2% of deliveries were vaginal, 13.8% were cesarean and 8% were instrumental vaginal deliveries.

Researchers observed no statistically significant difference between delivery modes and postpartum sexual life satisfaction. Responses for very satisfactory and fairly satisfactory postpartum sexual life were observed for more than 50% of the cohort. Responses were similar for women with cesarean (57.3%), instrumental vaginal (57.1%) or vaginal (58.6%) deliveries.

Being fairly or very unsatisfied with postpartum sexual life was uncommon, occurring in less than 20% of all delivery groups.

In addition, researchers observed no strong evidence that associations between delivery mode and self-perceived postpartum sexual life satisfaction varied by length of time since delivery. In analyses stratified by time since delivery, adjusted prevalence differences of reporting self-perceived postpartum sexual life satisfaction as very unsatisfactory were small, with 2.5 percentage points for instrumental vaginal deliveries and 1.2 percentage points for cesarean deliveries at 2 years or more postpartum.

“Our findings contribute to other emerging evidence that cesarean delivery may not be a sexual health-preserving mode of delivery,” the researchers wrote. “This evidence may be valuable for birthing people’s antenatal decision-making, including for those contemplating a planned cesarean delivery in an uncomplicated pregnancy.”