ORIGINAL RESEARCH—COUPLES' SEXUAL DYSFUNCTIONS: The Effect of the Mode of Delivery on the Quality of Life, Sexual Function, and Sexual Satisfaction in Primiparous Women and Their Husbands


Mohammad Reza Safarinejad, MD, P.O. Box 19395-1849, Tehran, Iran. Tel: +98 21 22454499; Fax: +98 21 2456845; E-mail: Safarinejad@urologist.md


Introduction.  Exploring the hypothesis that “sexual function” is associated with mode of delivery is important, because sexual health is an integral part of general health.

Aim.  The aim of this study was to quantify the relationship between mode of delivery and subsequent incidence of sexual dysfunction and impairment of quality of life (QOL) both in women and their husbands.

Main Outcome Measures.  Sexual function of pregnant women and their husbands was assessed using Female Sexual Function Index (FSFI), and International Index of Erectile Function (IIEF), respectively. All women and their husbands were also asked to indicate their sexual satisfaction on a scale of 0–5 as proposed by Kim and Paick. QOL was also assessed by Short Form-36 Health Survey.

Methods.  A total of 912 pregnant women (mean age 26 ± 2, range 21–32 years, parity I) and their husbands were recruited in this prospective study. The subjects were subdivided into five groups according to their mode of delivery, including: group A, spontaneous vaginal delivery (SVD) without injuries (group SVD, N = 184); group B, vaginal delivery with episiotomy (VDE) or perineal laceration (group VDE, N = 182); group C, operative vaginal delivery (OVD) (instrumental delivery) (group OVD, N = 180), group D, planned cesarean section (PCS) (group PCS, N = 182); and group E, emergency cesarean section (ECS) (group ECS, N = 184).

Results.  Of women in groups A, B, C, D, and E, 72 (42.6%), 62 (37.1%), 54 (32.7%), 108 (64.3%), and 64 (38.3%) resumed sexual intercourse (SI) within 8 weeks after delivery. Women with vaginal delivery and emergency cesarean section had statistically significant lower FSFI scores as compared with PCS women. Women who experienced a PCS had lowest pain scores, and women who had OVD had highest pain scores at first SI (P = 0.001). The IIEF domains scores for erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction with sex life did differ significantly between particular groups. The research has shown that the QOL parameters for PCS women were generally higher than for the other groups, and this concerns almost all categories.

Conclusions.  In healthy women with normal singleton pregnancies at term, instrumental deliveries are associated with the highest and PCS associated with the lowest rate of long-term maternal and paternal sexual dysfunction. Safarinejad MR, Kolahi AA, and Hosseini L. 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 2009;6:1645–1667.