ABSTRACT: Background:Cesarean delivery avoids perineal trauma and has therefore often been assumed to protect sexual function after childbirth. We sought to examine this assumption by using data from a study of women's sexual health after childbirth to assess whether women who underwent cesarean section experienced better sexual health in the postnatal period than women with vaginal births. Methods:A cross-sectional study was conducted of 796 primiparous women, employing data from obstetric records and a postal survey 6 months after delivery. Results:Any protective effect of cesarean section on sexual function was limited to the early postnatal period (0–3 months), primarily to dyspareunia-related symptoms. At 6 months the differences in dyspareunia-related symptoms, sexual response-related symptoms, and postcoital problems were much reduced or reversed, and none reached statistical significance. Conclusions:Outcomes from this study provide no basis for advocating cesarean section as a way to protect women's sexual function after childbirth. (BIRTH 32:4 December 2005)