There is not an association between mode of delivery and subsequent self-perceived sexual life satisfaction, according to a recent study published in the American Journal of Obstetrics & Gynecology.1
Takeaways
- The mode of delivery (vaginal, instrumental vaginal, or cesarean) does not significantly affect long-term self-perceived sexual life satisfaction.
- Rates of satisfactory sexual life were similar across all delivery modes, with 57.3% for cesarean, 57.1% for instrumental vaginal, and 58.6% for vaginal deliveries.
- Less than 20% of participants in each group reported being fairly or very unsatisfied with their sex life, indicating overall high levels of satisfaction regardless of delivery method.
- Adjusting for sociodemographic variables and birth characteristics, differences in sexual satisfaction between delivery methods were not significant.
- More comprehensive future studies are recommended, including broader participant representation and detailed information on the type of cesarean delivery.
Worldwide, significant increases in cesarean delivery use have been observed because of factors such as higher parental age at delivery and higher parental body mass index, as well as concerns about risks associated with vaginal delivery. One factor increasing cesarean delivery use may be concerns about vaginal delivery adversely impacting sexual life.
Data about the impact of mode of delivery on sexual health-related outcomes has grown, but long-term data remains lacking. More data is necessary to support evidence-informed decision making in obstetrical health care settings.
There are multiple risks associated with cesarean delivery.2 These include an above average blood loss, blood clots in the legs, uterine lining infections, increased hospital stay, increased risk of future cesarean delivery, increased pain, and additional complications.
To determine the association between mode of delivery and subsequent sexual life satisfaction, investigators conducted a population-based longitudinal study based on the Stockholm Public Health Cohort (SPHC).1 Participants completed postal or web-based questionnaires about health-related and lifestyle topics.
Recruitment for SPHC occurred every 4 years, and participants recruited in 2006, 2010, and 2014 were included in the current analysis. Alongside self-reported information, data was obtained from national health data and administrative registers.
The mode of delivery was reported as the primary outcome, and included spontaneous vaginal delivery, instrumental vaginal delivery, and cesarean delivery. Sexual life satisfaction was determined by the survey question, “How do you assess your sex life?”1
Responses to the survey question included very satisfactory, fairly satisfactory, neither satisfactory nor unsatisfactory, fairly unsatisfactory, and very unsatisfactory. Covariates included gestational age at delivery, parity, education level, household disposable income, and country of birth.
Of deliveries, 78.2% were vaginal, 13.8% were cesarean, and 8% were instrumental vaginal. Most sociodemographic variables did not differ based on delivery, though patients undergoing cesarean delivery were often older. Vaginal deliveries were most frequent among first-time birthing individuals.1
The mean duration between delivery and outcome assessment was 18 years. Patients with cesarean delivery or instrumental delivery had slightly increased risks of reduced subsequent sexual life satisfaction, with odds ratios of 1.18 and 1.25, respectively, for reporting a very unsatisfactory sexual life.
These differences were not significant when adjusting for sociodemographic factors and birth characteristics. Rates of very satisfactory and fairly satisfactory outcomes were similar between groups, at 57.3% for cesarean delivery, 57.1% for instrumental vaginal delivery, and 58.6% for vaginal delivery.1
All 3 groups reported being fairly or very unsatisfied with sex life in under 20%, and no evidence indicated the association between mode of delivery and subsequent sexual life satisfaction would shift over time. Absolute adjusted prevalence differences were low, at 2.5 and 1.2 for instrumental vaginal and cesarean delivery, respectively, vs vaginal delivery.
Similar outcomes were reported in the sensitivity analyses. An elevated OR was found for the lowest level of satisfaction in the cesarean delivery group vs vaginal delivery, but the predicted prevalence was low at 0.9.
These results indicated that the mode of delivery does not impact self-perceived sexual life satisfaction across various time periods after delivery. Investigators recommended future research have a broader representation and include more information about factors such as the type of cesarean delivery.1
References
- Larsdotter Zweygberg A, Martin FZ, Brynedal B, et al. Mode of delivery and subsequent self-perceived sexual life satisfaction: a population-based cohort study. Am J Obstet Gynecol. 2024;231:107.e1-19. doi:10.1016/j.ajog.2024.02.015
- Caesarean section. BetterHealth. Accessed July 10, 2024. https://www.betterhealth.vic.gov.au/health/healthyliving/caesarean-section#risks-and-complications-of-a-caesarean-section
