The Role of Mode of Delivery in Postpartum Sexuality

Abstract

This research program explored the role of mode of delivery in postpartum sexuality. The first study was an online survey of nulliparous individuals’ perceptions of how childbirth impacts sexuality (Chapter 2). The results indicated that approximately one in five nulliparous individuals perceive vaginal birth to be harmful to their future sexuality. The second and third studies (Chapters 3 and 4) took place in the Sexual Health Research Laboratory and empirically tested the hypothesis that the physiological impact of vaginal birth on the genitopelvic region is harmful to one’s future sex life using a mixed-methodology approach. These laboratory-based studies used self-report, sexual psychophysiological, and psychophysical methodologies to examine differences in self-reported sexual function, genital response, and genitopelvic sensitivity across three groups of women recruited from the local community: 1) women who were within two years of their first delivery and had a vaginal birth; 2) women who were within two years of their first delivery and had a C-section; and 3) an age-matched group of nulliparous women. The sexual psychophysiology study presented in Chapter 3 evaluated women’s sexual response genitally (using the laser Doppler imager) and subjectively (using continuous as well as discrete self-reported change scores of arousal ratings) while watching erotic audio-visual stimuli. Findings suggested that genital response may be impaired following a vaginal birth; however, subjective ratings of sexual arousal did not differ as a function of mode of delivery. The study described in Chapter 4 assessed sensitivity of genitopelvic regions innervated by the pudendal nerve using quantitative sensory testing (QST) to measure sensory thresholds. Results from Chapter 4 do not provide support for the hypothesis that vaginal birth is associated with decreased genitopelvic sensitivity. Taken together, the findings from the current research program suggest that there is a sizeable minority of North American nulliparous individuals who subscribe to the belief that vaginal birth will be harmful to their future sex life; however, this belief was not substantiated by the empirical studies reported in Chapters 3 and 4. The disconnect has relevant implications to the conversation regarding the rising rates of C-sections worldwide.