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.
