Archives of Gynecology and Obstetrics

, Volume 288, Issue 4, pp 785–792 | Cite as

Sexual function after childbirth by the mode of delivery: a prospective study

  • Samuel LurieEmail author
  • Michal Aizenberg
  • Vicky Sulema
  • Mona Boaz
  • Michal Kovo
  • Abraham Golan
  • Oscar Sadan
Maternal-Fetal Medicine



The objective of the present study was to evaluate sexual behavior longitudinally in the postpartum period by mode of delivery.


In this prospective study, five groups were defined: women who delivered vaginally without an episiotomy (n = 16), women who delivered vaginally with an episiotomy (n = 14), women who delivered by instrumental delivery (n = 16), women who delivered by an emergent cesarean section (n = 19), and women who delivered by an elective cesarean section (n = 17). Sexual behavior was assessed by the female sexual function index (FSFI) questionnaire at 6, 12, and 24 weeks postpartum and by the timing of resumption of sexual intercourse.


The mean ± SD self-reported timing of resumption of sexual activity was 4.5 ± 1.8, 7.9 ± 3.0, 7.3 ± 3.4, 6.1 ± 2.6, and 6.1 ± 2.4 weeks in the vaginal delivery without an episiotomy group, in the vaginal delivery with an episiotomy group, in the instrumental delivery group, in the elective cesarean delivery group, and in the emergent cesarean delivery group, respectively (p = 0.013). The FSFI total score in the entire study group (n = 82) was 14.1 ± 10.8, 24.6 ± 7.6, and 27.7 ± 5.1 at 6, 12, and 24 weeks postpartum, respectively (p < 0.05). The FSFI total score did not differ significantly across types of mode of delivery at 6, 12, or 24 weeks postpartum.


The significance by delivery mode difference in the postpartum resumption of sexual activity was not accompanied by difference in sexual function scores. Specifically, elective cesarean delivery was not associated with a protective effect on sexual function after childbirth.


Sexual function Cesarean section Instrumental delivery Vaginal delivery Episiotomy 


Conflict of interest

None of the authors of the above manuscript has declared any conflict of interest.


  1. 1.
    Lurie S (2005) The changing motives of cesarean section from ancient times to 21st century. Arch Gynecol Obstet 271:281–285PubMedCrossRefGoogle Scholar
  2. 2.
    Wagner M (2000) Choosing cesarean section. Lancet 356:677–680Google Scholar
  3. 3.
    Handelzalts JE, Fisher S, Lurie S, Shalev A, Golan A, Sadan O (2012) Personality, fear of childbirth and cesarean delivery on. Acta Obstet Gynecol Scand 91:16–21PubMedCrossRefGoogle Scholar
  4. 4.
    Nama V, Wilcock F (2011) Caesarean section on maternal request: is justification necessary? The Obstet Gynaecol 13:263–269CrossRefGoogle Scholar
  5. 5.
    Al-Mufti R, McCarthy A, Fisk NM (1996) Obstetricians’ personal choice and mode of delivery. Lancet 347:544PubMedCrossRefGoogle Scholar
  6. 6.
    Serati M, Salvatore S, Siesto G et al (2010) Female sexual function during pregnancy and after childbirth. J Sex Med 7:2782–2790PubMedCrossRefGoogle Scholar
  7. 7.
    Handa VL (2006) Sexual function and childbirth. Semin Perinatol 30:253–256PubMedCrossRefGoogle Scholar
  8. 8.
    Woranitat W, Taneepanichskul S (2007) Sexual function during the postpartum period. J Med Assoc Thai 90:1744–1748PubMedGoogle Scholar
  9. 9.
    Wiklund I, Edman G, Andolf E (2007) Cesarean section on maternal request: reasons for the request, self-estimated health, expectations, experience of birth and signs of depression among first-time mothers. Acta Obstet Gynecol Scand 86:451–456PubMedCrossRefGoogle Scholar
  10. 10.
    Hannah ME, Whyte H, Hannah WJ et al (2004) Term breech trial collaborative group. Maternal outcomes at 2 years after planned cesarean section versus planned vaginal birth for breech presentation at term: the international randomized term breech trial. Am J Obstet Gynecol 191:917–927PubMedCrossRefGoogle Scholar
  11. 11.
    Brubaker L, Handa VL, Bradley CS, Connolly A, Moalli P, Brown MB (2008) Weber a; pelvic floor disorders network. Sexual function 6 months after first delivery. Obstet Gynecol 111:1040–1044PubMedCrossRefGoogle Scholar
  12. 12.
    Klein K, Worda C, Leipold H, Gruber C, Husslein P, Wenzl R (2009) Does the mode of delivery influence sexual function after childbirth? J Women Health 18:1227–1231CrossRefGoogle Scholar
  13. 13.
    Barrett G, Peacock J, Victor CR, Manyonda I (2005) Cesarean section and postnatal sexual health. Birth 32:306–311PubMedCrossRefGoogle Scholar
  14. 14.
    Liebling RE, Swingler R, Patel RR, Verity L, Soothill PW, Murphy DJ (2004) Pelvic floor morbidity up to one year after difficult instrumental delivery and cesarean section in the second stage of labor: a cohort study. Am J Obstet Gynecol 191:4–10PubMedCrossRefGoogle Scholar
  15. 15.
    Buhling KJ, Schmidt S, Robinson JN, Klapp C, Siebert G, Dudenhausen JW (2006) Rate of dyspareunia after delivery in primiparae according to mode of delivery. Eur J Obstet Gynecol Reprod Biol 124:42–46PubMedCrossRefGoogle Scholar
  16. 16.
    Dean N, Wilson D, Herbison P, Glazener C, Aung T, Macarthur C (2008) Sexual function, delivery mode history, pelvic floor muscle exercises and incontinence: a cross-sectional study six years post-partum. Aust N Z J Obstet Gynaecol 48:302–311PubMedCrossRefGoogle Scholar
  17. 17.
    Rosen R, Brown C, Heiman J et al (2000) The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26:191–208PubMedCrossRefGoogle Scholar
  18. 18.
    Abraham S (1990) Recovery after childbirth. Med J Aust 152:387PubMedGoogle Scholar
  19. 19.
    Signorello LB, Harlow BL, Chekos AK et al (2001) Postpartum sexual functioning and its relationship to perineal trauma: a retrospective cohort study of primiparous women. Am J Obstet Gynecol 184:881–888PubMedCrossRefGoogle Scholar
  20. 20.
    Barrett G, Pendry E, Peacock J et al (2000) Women’s sexual health after childbirth. Br J Obstet Gynaecol 107:186–195CrossRefGoogle Scholar
  21. 21.
    Connolly A, Thorp J, Pahel L (2005) Effects of pregnancy and childbirth on postpartum sexual function: a longitudinal prospective study. Int Urogynecol J Pelvic Floor Dysfunct 16:263–267PubMedCrossRefGoogle Scholar
  22. 22.
    Olsson A, Lundqvist M, Faxelid E, Nissen E (2005) Women’s thoughts about sexual life after childbirth: focus group discussions with women after childbirth. Scand J Caring Sci 19:381–387PubMedCrossRefGoogle Scholar
  23. 23.
    Safarinejad MR, Kolahi AA, Hosseini L (2009) The effect of the mode of delivery on the quality of life, sexual function, and sexual satisfaction in primiparous women and their husbands. J Sex Med 6:1645–1667PubMedCrossRefGoogle Scholar
  24. 24.
    Minkoff H, Chervenak FA (2003) Elective primary cesarean delivery. N Engl J Med 348:946–950PubMedCrossRefGoogle Scholar
  25. 25.
    Hicks TL, Goodall SF, Quattrone EM, Lyndon-Rochelle MT (2004) Postpartum sexual functioning and method of delivery: summary of the evidence. J Midwifery Womens Health 49:430–436PubMedCrossRefGoogle Scholar
  26. 26.
    Pauls RN, Occhino JA, Dryfhout VL (2008) Effects of pregnancy on female sexual function and body image: a prospective study. J Sex Med 5:1915–1922PubMedCrossRefGoogle Scholar
  27. 27.
    Leeman LM, Rogers RG (2012) Sex after childbirth. Postpartum sexual function. Obstet Gynecol 119:647–655PubMedCrossRefGoogle Scholar
  28. 28.
    Saisto T, Halmesmäki E (2003) Fear of childbirth: a neglected dilemma. Acta Obstet Gynecol Scand 82:201–208PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Samuel Lurie
    • 1
    • 2
    Email author
  • Michal Aizenberg
    • 2
  • Vicky Sulema
    • 1
  • Mona Boaz
    • 2
    • 3
  • Michal Kovo
    • 1
    • 2
  • Abraham Golan
    • 1
    • 2
  • Oscar Sadan
    • 1
    • 2
  1. 1.Department of Obstetrics and GynecologyEdith Wolfson Medical CenterHolonIsrael
  2. 2.Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
  3. 3.Epidemiology and Statistics UnitEdith Wolfson Medical CenterHolonIsrael

Personalised recommendations