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Caesareans: a Short-Lived Honeymoon, Says Study into Sexual Function

A new study from Brunel University and St George's Healthcare NHS Trust overturns current perception on sexual function following childbirth. The study, which was conducted by Dr Geraldine Barrett and Prof. Janet Peacock at Brunel's School of Health Sciences and Social Care and by Mr Isaac Manyonda, Consultant Obstetrician and Gynaecologist at St George's Healthcare NHS Trust, reveals that there is little difference in the postnatal sexual experiences of women who have caesareans and those who give birth naturally. This belies the current belief – held by ‘lay people' and obstetricians alike - that a caesarean will protect sexual function.

There is currently a dearth of data on postnatal sexual health. However, it is widely held that electing for a caesarean, rather than a natural birth, will least affect the mother's sexual function. Elective caesareans are much discussed in the media, with celebrities such as Britney Spears, Victoria Beckham and Madonna opting for caesarean section births. Recent decades have seen a steady increase in the incidences of caesarean sections – according to the NHS maternity statistics for England in 2003 – 2004, 10% of births were by elective caesarean, with C-sections accounting for 23% of all births. In the 1950s, under 3% of all births were by caesarean.

Dr Geraldine Barrett explains: "In 2004 – 2005, over 130,000 caesarean sections were performed in NHS hospitals in England . There's a lot of discussion about why the instances of caesareans are increasing – and the benefits of them, both for mothers and their children. However, whilst there are studies about other medical aspects of the operation, this is the first study of its kind to look in such detail at the sexual outcomes of differing birth methods."

This study will, we hope, dispel a few myths about C-sections. It's not correct to assume that retaining sexual function is high up the list of factors that women consider when opting for a section: this study is unlikely to change the instances of elective caesarean. However, what we hope it will do is to ensure that healthcare professionals have the scientific data available to help them provide informed medical advice to women who are approaching childbirth for the first time."

Survey Results
The study surveyed nearly 500 first-time mothers in the UK, six months after having given birth. The new mothers were asked to recall any sexual problems they experienced in the year before pregnancy and in the first three and six months after delivery. The nine problems investigated included: pain on penetration, pain during sexual intercourse, pain on orgasm, vaginal tightness, lack of vaginal lubrication, difficulty in reaching orgasm, loss of sexual desire, vaginal looseness/lack of muscle tone, and bleeding or irritation after sexual intercourse.

Of the women surveyed 50% had natural births, 25% had a forceps or ventouse assisted delivery and 25% gave birth by caesarean section. The majority of new mothers resumed sexual intercourse in the postnatal period and there were no significant differences in the timing of resumption by type of birth.

The comparison of painful sex-related problems, sexual response-related symptoms and post coital problems in the first three months after birth according to the type of birth, did suggest that women with caesarean sections were less likely to experience problems on each of these three groups of symptoms, however only the problems relating to painful sex were significantly less. At six months, however, the differences between caesarean section and vaginal birth were much reduced, or even reversed, and none reached statistical significance.

The research findings clearly show that any apparent protective effects of caesarean section in terms of sexual health are largely limited to improving problems of painful sex in the earlier postnatal period and are probably due to absence of perineal injury during childbirth.