Sexual function, delivery mode history, pelvic floor muscle exercises and incontinence: A cross-sectional study six years post-partum


: Professor Don Wilson, Obstetrics and Gynaecology, Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin 9054, New Zealand. Email:


Background: There is controversy over the effect of mode of delivery, pelvic floor muscle exercises (PFME), incontinence and sexual function.

Aim: To investigate the relationship of sexual function with delivery mode history, PFMEs and incontinence.

Methods: This was a cross-sectional postal survey of women, six years post-partum, who had given birth in maternity units in Aberdeen, Birmingham and Dunedin and had answered a previous questionnaire. Each sexual function question was analysed separately by anova.

Results: At six years post-index delivery, 4214 women responded, of whom 2765 (65%) answered the optional ten sexual function questions. Although there was little association between delivery mode history and most sexual function questions, women who had delivered exclusively by caesarean section scored significantly better on the questions relating to their perception of vaginal tone for their own (P-value < 0.0001) and partner's (P-value 0.002) sexual satisfaction, especially when compared with women who had had vaginal and instrumental deliveries. Women who reported that they were currently performing PFME scored significantly better on seven questions. Women with urinary or faecal incontinence scored significantly poorer on all sexual function questions.

Conclusions: Mode of delivery history appeared to have minimal effect on sexual function. Current PFME performance was positively associated with most aspects of sexual function, however, all aspects were negatively associated with urinary and faecal incontinence.