The Impact of Mode of Birth, and Episiotomy, on Postpartum Sexual Function in the Medium- and Longer-Term: An Integrative Systematic Review

Int J Environ Res Public Health. 2023 Mar 24;20(7):5252. doi: 10.3390/ijerph20075252.

Abstract

(1) Background: Sexual function can be affected up to and beyond 18 months postpartum, with some studies suggesting that spontaneous vaginal birth results in less sexual dysfunction. This review examined the impact of mode of birth on sexual function in the medium- (≥6 months and <12 months postpartum) and longer-term (≥12 months postpartum). (2) Methods: Literature published after January 2000 were identified in PubMed, Embase and CINAHL. Studies that compared at least two modes of birth and used valid sexual function measures were included. Systematic reviews, unpublished articles, protocols and articles not written in English were excluded. Quality was assessed using the Newcastle Ottawa Scale. (3) Results: In the medium-term, assisted vaginal birth and vaginal birth with episiotomy were associated with worse sexual function, compared to caesarean section. In the longer-term, assisted vaginal birth was associated with worse sexual function, compared with spontaneous vaginal birth and caesarean section; and planned caesarean section was associated with worse sexual function in several domains, compared to spontaneous vaginal birth. (4) Conclusions: Sexual function, in the medium- and longer-term, can be affected by mode of birth. Women should be encouraged to seek support should their sexual function be affected after birth.

Keywords: delivery; midwifery; mothers; obstetric; physiological; postpartum period; pregnancy; sexual behaviour; sexual health.

Publication types

  • Review
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cesarean Section* / adverse effects
  • Delivery, Obstetric / adverse effects
  • Delivery, Obstetric / methods
  • Episiotomy* / adverse effects
  • Female
  • Humans
  • Parturition
  • Postpartum Period
  • Pregnancy

Grants and funding

This work was supported by EUCAN-connect, A federated FAIR platform enabling large-scale analysis of high-value cohort data connecting Europe and Canada in personalised health. This project received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 824989. L.T. was supported by the European Regional Development Fund—Project “Creativity and Adaptability as Conditions of the Success of Europe in an Interrelated World” (No. CZ.02.1.01/0.0/0.0/16_019/0000734).