Sexual Function and Mode of Delivery

According to the abstract and news reports, researchers in Iran have found that planned cesarean sections are associated with the lowest rate of long-term maternal and paternal sexual dysfunction in the year following childbirth. Normally, I do not blog about new research studies unless I have had a chance to read the study carefully. However, The Journal of Sexual Health embargoes its issues for a full year from the major medical school library from which I have access to medical journals. Thank goodness only a few medical journals do this. I have so many questions about this study. From where were the women and their husbands recruited? For the women who had spontaneous vaginal deliveries, was pushing spontaneous or coached? Researchers from the University of Texas Southwestern Medical School have found that “coached pushing” results in damage to the pelvic floor. I can understand that the first episode of sexual intercourse was most painful for those women who had operative vaginal deliveries. But I would like to see more information (and numbers) about sexual function after the first intercourse. Earlier studies have found temporary effects on the pelvic floor after vaginal delivery as compared to cesarean surgery, but there is controversy as to whether those effects were caused by the vaginal delivery alone or were caused by common interventions such as coached pushing, episiotomy, and/or instrumental delivery. Many new parents report changes in the frequency of intercourse and sexual desire as they juggle the demands of parenthood with all the other things going on in their lives. I can’t even begin to list all the factors that might impact the father’s sexual function. I will wait on drawing any conclusions about mode of delivery and sexual satisfaction until we have a lot more evidence.

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