by University of Bristol

Illustration depicting Caesarean section. Credit: BruceBlaus/Wikipedia/CC BY 3.0

Sexual enjoyment in the years following childbirth is unaffected by the way in which the baby is delivered, according to new research. The study, published in BJOG: An International Journal of Obstetrics & Gynaecology, was led by researchers at the University of Bristol and Karolinska Institutet in Sweden and used data from Children of the 90s—a longitudinal study of over 14,000 individuals.

The study sought to address whether cesarean sections maintain sexual well-being compared to vaginal delivery, due to the reduced risk of tearing and the maintenance of vaginal tone. Findings from previous studies suggest little difference in sexual outcomes between women who had cesarean sections or vaginal delivery by six months following birth. However, few studies had ventured into the post-birth period long-term.

This latest study investigated the relationship between mode of delivery and sexual well-being outcomes, including sexual enjoyment, sexual frequency, and sex-related pain, at a range of timepoints post-birth.

Researchers assessed women in different delivery groups up to 18 years following birth and found no difference between cesarean section and vaginal delivery for sexual enjoyment or frequency at any timepoint after childbirth (known as postpartum). However, it was shown that those who delivered via cesarean section were more likely to report sex-related pain at 11 years postpartum, specifically pain in the vagina during sex.

The study did not have access to measures of prenatal sex-related pain for each mother and, therefore, it is unknown from this study whether cesarean section causes sex-related pain, as suggested by the findings, or whether prenatal sex-related pain predicts both cesarean section and postnatal sex-related pain.

Flo Martin, Wellcome Trust Ph.D. Student in Epidemiology and lead study author says that "rates of cesarean section have been rising over the last 20 years due to many contributing factors and importantly, it has been suggested that cesarean section maintains sexual well-being compared to vaginal delivery. It is crucial that a whole range of maternal and fetal outcomes following cesarean section are investigated, including sexual well-being, to appropriately inform decision-making both pre- and postnatally."

"This research provides expectant mothers, as well as women who have given birth, with really important information and demonstrates that there was no difference in sexual enjoyment or sexual frequency at any timepoint postpartum between women who gave birth via cesarean section and those who delivered vaginally. It also suggests that a cesarean section may not help protect against sexual dysfunction, as previously thought, where sex-related pain was higher among women who gave birth via cesarean section more than 10 years postpartum."

Lynn Molloy, Chief Operating Officer at Children of the 90s, says that "it is through longitudinal studies like Children of the 90s, that researchers can provide evidence to help expectant mothers' make well informed decisions about their preferred choice of delivery in uncomplicated pregnancies, and to support women postnatally if choice was not an option for them in the delivery suite."

More information: Florence Z. Martin et al, Mode of delivery and maternal sexual wellbeing: A longitudinal study, BJOG: An International Journal of Obstetrics & Gynaecology (2022). DOI: 10.1111/1471-0528.17262

Provided by University of Bristol