Mode of delivery and maternal sexual wellbeing: a longitudinal study

Flo Martin; Paul C Madley-Dowd; Viktor H Ahlqvist; Egill Jónsson Bachmann; Abigail Fraser; Harriet J Forbes

doi:10.1111/1471-0528.17262

Mode of delivery and maternal sexual wellbeing: a longitudinal study

Flo Martin^*
, Paul C Madley-Dowd
, Viktor H Ahlqvist
, Egill Jónsson Bachmann
, Abigail Fraser
, Harriet J Forbes

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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Abstract

Objectives
To investigate the association between mode of delivery and subsequent maternal sexual wellbeing.

Design
Prospective birth cohort study.

Setting
Avon (in Bristol area), UK.

Population
Participants in the Avon Longitudinal Study of Parents and Children (ALSPAC).

Methods
Mode of delivery was abstracted from obstetric records and sexual wellbeing measures were collected via a self-report questionnaire. Missing data were imputed using multiple imputation, and ordinal logistic regression models for ordered categorical outcomes were adjusted for the covariates maternal age at delivery, pre-pregnancy body mass index, diabetes during pregnancy, socio-economic position, parity, depression and anxiety.

Main outcome measures
Sexual enjoyment and frequency at four time points postpartum (between 33 months and 18 years) and two types of sex-related pain (pain in the vagina during sex and elsewhere after sex) at 11 years postpartum.

Results
We found no association between mode of delivery and sexual enjoyment (e.g. adjusted odds ratio [OR] 1.11, 95% confidence interval [95% CI] 0.97–1.27 at 33 months) or sexual frequency (OR 0.99, 95% CI 0.88–1.12 at 33 months). Caesarean section was associated with an increased odds of pain in the vagina during sex at 11 years postpartum as compared with vaginal delivery in the adjusted model (OR 1.74, 95% CI 1.46–2.08).

Conclusions
These findings provide no evidence supporting associations between caesarean section and sexual enjoyment or frequency. However, mode of delivery was shown to be associated with dyspareunia, which may not be limited to abdominal scarring.

Original language	English
Pages (from-to)	2010-2018
Number of pages	9
Journal	British Journal of Obstetrics and Gynaecology
Volume	129
Issue number	12
Early online date	20 Jul 2022
DOIs	https://doi.org/10.1111/1471-0528.17262
Publication status	Published - 17 Oct 2022

Bibliographical note

Funding Information:
The UK Medical Research Council, the Wellcome Trust (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of authors, FZM, HF and AF will act as guarantors for the contents of this paper. This research was funded in whole, or in part, by the Wellcome Trust (Grant number: 218495/Z/19/Z). For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. A comprehensive list of grants funding is available on the ALSPAC website ( http://www.bristol.ac.uk/alspac/external/documents/grant‐acknowledgements.pdf ). The funders of this project had no role in the design or conduct (including analysis or interpretation) of this study, or in the decision to submit this manuscript for publication.

Publisher Copyright:
© 2022 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.

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10.1111/1471-0528.17262Licence: CC BY

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@article{50ae009211e7496c9b72c5165552178d,

title = "Mode of delivery and maternal sexual wellbeing: a longitudinal study",

abstract = "Objectives To investigate the association between mode of delivery and subsequent maternal sexual wellbeing. Design Prospective birth cohort study. Setting Avon (in Bristol area), UK. Population Participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Methods Mode of delivery was abstracted from obstetric records and sexual wellbeing measures were collected via a self-report questionnaire. Missing data were imputed using multiple imputation, and ordinal logistic regression models for ordered categorical outcomes were adjusted for the covariates maternal age at delivery, pre-pregnancy body mass index, diabetes during pregnancy, socio-economic position, parity, depression and anxiety. Main outcome measures Sexual enjoyment and frequency at four time points postpartum (between 33 months and 18 years) and two types of sex-related pain (pain in the vagina during sex and elsewhere after sex) at 11 years postpartum. Results We found no association between mode of delivery and sexual enjoyment (e.g. adjusted odds ratio [OR] 1.11, 95\% confidence interval [95\% CI] 0.97{\textendash}1.27 at 33 months) or sexual frequency (OR 0.99, 95\% CI 0.88{\textendash}1.12 at 33 months). Caesarean section was associated with an increased odds of pain in the vagina during sex at 11 years postpartum as compared with vaginal delivery in the adjusted model (OR 1.74, 95\% CI 1.46{\textendash}2.08). Conclusions These findings provide no evidence supporting associations between caesarean section and sexual enjoyment or frequency. However, mode of delivery was shown to be associated with dyspareunia, which may not be limited to abdominal scarring.",

author = "Flo Martin and Madley-Dowd, \{Paul C\} and Ahlqvist, \{Viktor H\} and \{J{\'o}nsson Bachmann\}, Egill and Abigail Fraser and Forbes, \{Harriet J\}",

note = "Funding Information: The UK Medical Research Council, the Wellcome Trust (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of authors, FZM, HF and AF will act as guarantors for the contents of this paper. This research was funded in whole, or in part, by the Wellcome Trust (Grant number: 218495/Z/19/Z). For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. A comprehensive list of grants funding is available on the ALSPAC website ( http://www.bristol.ac.uk/alspac/external/documents/grant‐acknowledgements.pdf ). The funders of this project had no role in the design or conduct (including analysis or interpretation) of this study, or in the decision to submit this manuscript for publication. Publisher Copyright: {\textcopyright} 2022 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley \& Sons Ltd.",

year = "2022",

month = oct,

day = "17",

doi = "10.1111/1471-0528.17262",

language = "English",

volume = "129",

pages = "2010--2018",

journal = "British Journal of Obstetrics and Gynaecology",

issn = "0306-5456",

publisher = "Wiley-Blackwell",

number = "12",

}

TY - JOUR

T1 - Mode of delivery and maternal sexual wellbeing

T2 - a longitudinal study

AU - Martin, Flo

AU - Madley-Dowd, Paul C

AU - Ahlqvist, Viktor H

AU - Jónsson Bachmann, Egill

AU - Fraser, Abigail

AU - Forbes, Harriet J

N1 - Funding Information: The UK Medical Research Council, the Wellcome Trust (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of authors, FZM, HF and AF will act as guarantors for the contents of this paper. This research was funded in whole, or in part, by the Wellcome Trust (Grant number: 218495/Z/19/Z). For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. A comprehensive list of grants funding is available on the ALSPAC website ( http://www.bristol.ac.uk/alspac/external/documents/grant‐acknowledgements.pdf ). The funders of this project had no role in the design or conduct (including analysis or interpretation) of this study, or in the decision to submit this manuscript for publication. Publisher Copyright: © 2022 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.

PY - 2022/10/17

Y1 - 2022/10/17

N2 - Objectives To investigate the association between mode of delivery and subsequent maternal sexual wellbeing. Design Prospective birth cohort study. Setting Avon (in Bristol area), UK. Population Participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Methods Mode of delivery was abstracted from obstetric records and sexual wellbeing measures were collected via a self-report questionnaire. Missing data were imputed using multiple imputation, and ordinal logistic regression models for ordered categorical outcomes were adjusted for the covariates maternal age at delivery, pre-pregnancy body mass index, diabetes during pregnancy, socio-economic position, parity, depression and anxiety. Main outcome measures Sexual enjoyment and frequency at four time points postpartum (between 33 months and 18 years) and two types of sex-related pain (pain in the vagina during sex and elsewhere after sex) at 11 years postpartum. Results We found no association between mode of delivery and sexual enjoyment (e.g. adjusted odds ratio [OR] 1.11, 95% confidence interval [95% CI] 0.97–1.27 at 33 months) or sexual frequency (OR 0.99, 95% CI 0.88–1.12 at 33 months). Caesarean section was associated with an increased odds of pain in the vagina during sex at 11 years postpartum as compared with vaginal delivery in the adjusted model (OR 1.74, 95% CI 1.46–2.08). Conclusions These findings provide no evidence supporting associations between caesarean section and sexual enjoyment or frequency. However, mode of delivery was shown to be associated with dyspareunia, which may not be limited to abdominal scarring.

AB - Objectives To investigate the association between mode of delivery and subsequent maternal sexual wellbeing. Design Prospective birth cohort study. Setting Avon (in Bristol area), UK. Population Participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Methods Mode of delivery was abstracted from obstetric records and sexual wellbeing measures were collected via a self-report questionnaire. Missing data were imputed using multiple imputation, and ordinal logistic regression models for ordered categorical outcomes were adjusted for the covariates maternal age at delivery, pre-pregnancy body mass index, diabetes during pregnancy, socio-economic position, parity, depression and anxiety. Main outcome measures Sexual enjoyment and frequency at four time points postpartum (between 33 months and 18 years) and two types of sex-related pain (pain in the vagina during sex and elsewhere after sex) at 11 years postpartum. Results We found no association between mode of delivery and sexual enjoyment (e.g. adjusted odds ratio [OR] 1.11, 95% confidence interval [95% CI] 0.97–1.27 at 33 months) or sexual frequency (OR 0.99, 95% CI 0.88–1.12 at 33 months). Caesarean section was associated with an increased odds of pain in the vagina during sex at 11 years postpartum as compared with vaginal delivery in the adjusted model (OR 1.74, 95% CI 1.46–2.08). Conclusions These findings provide no evidence supporting associations between caesarean section and sexual enjoyment or frequency. However, mode of delivery was shown to be associated with dyspareunia, which may not be limited to abdominal scarring.

UR - https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/1471-0528.17262

U2 - 10.1111/1471-0528.17262

DO - 10.1111/1471-0528.17262

M3 - Article (Academic Journal)

C2 - 35856885

SN - 0306-5456

VL - 129

SP - 2010

EP - 2018

JO - British Journal of Obstetrics and Gynaecology

JF - British Journal of Obstetrics and Gynaecology

IS - 12

ER -

Mode of delivery and maternal sexual wellbeing: a longitudinal study

Abstract

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Mode of delivery and maternal sexual wellbeing: a longitudinal investigation of the UK ALSPAC cohort

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Mode of delivery and maternal sexual wellbeing: a longitudinal investigation of the UK ALSPAC cohort

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