Obstetric Outcome and Emotional Adjustment to Childbirth in Women with Dyspareunia: A Cross-sectional Study

Abstract

Objective: To assess obstetrical outcomes, perceptions of childbirth experience and emotional adjustment in women with dyspareunia. Design: Cross-sectional study. Setting: The maternity ward of a single medical center. Population: Four-hundred forty women, recruited within two days postpartum. Methods: We administered self-report questionnaires addressing demographic and reproductive background, dyspareunia, pain and perceived threat during delivery, sense of control during labour, perceived professional support, and maternal adjustment (i.e., perinatal dissociation, acute stress disorder (ASD), bonding, anticipated maternal self-efficacy depression and positive and negative affect). Obstetrical information was retrieved from clinical files. Main outcomes measures: Obstetrical outcomes and emotional adjustment to childbirth in women with dyspareunia versus comparisons. Results: Three-hundred eighty-eight women filled the dyspareunia questionnaire. The dyspareunia group included 71 women (18.3%) and the comparison group 317 (81.7%). Demographic data were similar between groups. No difference was observed in labour onset, analgesia, route of delivery and perineal tears. More participants with dyspareunia had premature delivery versus comparisons (14.1% vs 5.6%, p=0.02). Women with dyspareunia reported lower sense of control (p=0.01), lower perceived support (p<0.001), more perinatal dissociation (p<0.001), ASD symptoms (p<0.001), depression (p=0.02), negative affect (p<0.001), lower maternal bonding (p<0.001) and anticipated maternal self-efficacy (p=0.01). Women who experienced pain during pelvic exams were less likely to have spontaneous labor onset, more likely to need cervical ripening (p=0.02), and reported higher levels of negative affect (p=0.03). Conclusion: Dyspareunia was associated with more premature deliveries, more emotional distress and poorer maternal adjustment. Perinatal caregivers should be cognizant of such emotional reactions during prenatal care.