Women's sexual health after childbirth

Barrett, Geraldine; Pendry, Elizabeth; Peacock, Janet L.; Victor, Christina; Thakar, R.; Manyonda, Isaac

doi:10.1111/j.1471-0528.2000.tb11689.x

Cited by 442 publications

(468 citation statements)

References 44 publications

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“…Other studies report on dyspareunia as common 6 months after childbirth [3,4]. We found that the number of women with dyspareunia was still high at 12 months postpartum.…”

Section: Discussionsupporting

confidence: 52%

“…The overall impression from published research is that dyspareunia is prevalent in the first 6 months after childbirth and after this period it gradually declines [5]. Associations between pre-pregnancy and postpartum dyspareunia have been found [3,6], but these results are based on retrospective studies.…”

contrasting

confidence: 39%

“…It has been found in about 15% of women between 30 and 50 years of age [2] and varies between 30 and 60% amongst women postpartum [3,4]. The overall impression from published research is that dyspareunia is prevalent in the first 6 months after childbirth and after this period it gradually declines [5].…”

mentioning

confidence: 81%

“…Dyspareunia occurring during pregnancy and childbirth may be a result of morphological and hormonal changes of the pelvic floor [8,3,6], and has shown to correlate with delivery mode [6,9]. In women breastfeeding, a reduction in estrogen may lead to reduced vaginal lubrication as a response to sexual stimulation [10].…”

mentioning

confidence: 99%

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Dyspareunia and pelvic floor muscle function before and during pregnancy and after childbirth

et al. 2014

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This file was dowloaded from the institutional repository Brage NIH -brage.bibsys.no/nih Tennfjord, M. K., Hilde, G., Staer-Jensen, J., Ellstrøm Engh, M., Bø, K. (2014).Dyspareunia and pelvic floor muscle function before and during pregnancy and during pregnancy and after childbirth. ABSTRACT Introduction and hypothesis:There is limited knowledge on dyspareunia during pregnancy and postpartum and the role of the pelvic floor muscles (PFM) in women with dyspareunia. Aims of the study were to investigate presence of dyspareunia before, during pregnancy and postpartum and to compare vaginal resting pressure (VRP), PFM strength and endurance between women with and without dyspareunia. It was hypothesized that there is no difference in PFM variables between women with and without dyspareunia. Methods: Three hundred nulliparous women participated in this prospective cohort and answered questions about dyspareunia and level of bother at gestational weeks 22 and 37, 6 and 12 months postpartum and retrospectively prior to their pregnancies using ICIQFLUTSsex. PFM variables were assessed by manometer at gestational week 22, 6 and 12 months postpartum. Comparisons between groups were analyzed using independent-samples t test.Results: Twenty-eight and 30% of the women reported dyspareunia at pre-pregnancy and at gestational week 22, respectively. At gestational week 37, 6 and 12 months postpartum, the number was 40%, 45% and 33%, respectively. No difference in PFM variables were found between women with or without dyspareunia. Level of bother was higher postpartum than before and during pregnancy. Conclusion: Symptoms of dyspareunia were common at all time points. No link could be made between PFM function and dyspareunia. Women suffering from dyspareunia postpartum reported it as bothersome. Our findings suggest that women should be asked about symptoms of dyspareunia related to pregnancy, and that future research should aim for preventative and treatment strategies.

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“…Other studies report on dyspareunia as common 6 months after childbirth [3,4]. We found that the number of women with dyspareunia was still high at 12 months postpartum.…”

Section: Discussionsupporting

confidence: 52%

contrasting

confidence: 39%

mentioning

confidence: 81%

mentioning

confidence: 99%

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Dyspareunia and pelvic floor muscle function before and during pregnancy and after childbirth

et al. 2014

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“…20,21 Other bowel problems such as haemorrhoids 19,22,23 and constipation 24 are more common after IVD, as are perineal pain and dyspareunia. 24,25 Caesarean section has many adverse sequelae, but, with the exception of faecal incontinence, most of these symptoms are less likely to occur in association with this delivery mode. It is therefore important to investigate positive impacts as well as any possible negative impacts of upright positions in the second stage of labour on maternal health outcomes.…”

Section: Scientific Backgroundmentioning

confidence: 99%

A multicentre, randomised controlled trial of position during the late stages of labour in nulliparous women with an epidural: clinical effectiveness and an economic evaluation (BUMPES)

Bick

Briley

Brocklehurst

et al. 2017

Health Technol Assess

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BackgroundEpidural analgesia leads to increased risk of instrumental vaginal delivery (IVD). There is debate about whether or not posture in second-stage labour influences the incidence of spontaneous vaginal birth (SVB).ObjectivesIn nulliparous women with epidural analgesia, does a policy of adopting an ‘upright position’ throughout second-stage labour increase the incidence of SVB compared with a policy of adopting a ‘lying-down’ position?DesignTwo-arm randomised controlled trial.SettingMaternity units in England and Wales.ParticipantsNulliparous women aged ≥ 16 years, at ≥ 37 weeks’ gestation with singleton cephalic presentation and intended SVB, in second-stage labour with an epidural providing effective pain relief.Interventions(1) Upright position to maintain the pelvis in as vertical a plane as possible; and (2) lying-down position to maintain the pelvis in as horizontal a plane as possible.Main outcome measuresThe primary outcome measure was incidence of SVB. Secondary outcomes included augmentation, interventions to maintain blood pressure, duration of labour, episiotomy, genital tract trauma, post-partum haemorrhage, maternal satisfaction, neonatal metabolic acidosis, 5-minute Apgar score of < 4, resuscitation at birth and admission to neonatal unit. At 1 year for (1) women: urinary or faecal incontinence, dyspareunia and health-related quality of life; (2) for infants: major morbidity. A cost–consequences analysis with a time horizon of 1 year after the birth from a NHS perspective.ResultsBetween October 2010 and January 2014, 3236 women were randomised from 41 centres in England and Wales. There was a statistically significant difference in the incidence of SVB between groups, with 35.2% of women achieving a SVB in the upright group, compared with 41.1% in the lying-down group (adjusted risk ratio 0.86, 95% confidence interval 0.78 to 0.94). There was no evidence of differences in most of the secondary maternal or neonatal outcomes, or in long-term outcomes at the 12-month follow-up. No significant overall cost differences were observed between upright and lying-down positions for mothers or their babies.LimitationsMeasurement of adherence was challenging in this unmasked trial, and adherence could be influenced by midwives’ beliefs about the allocated positions. If adherence was poor, this would have diluted the difference between the two groups.ConclusionsThere is clear evidence of the benefit of adopting a lying-down position in second-stage labour in nulliparous women with epidural analgesia, with no apparent disadvantages in either short- or long-term outcomes for mother or baby, and this is cost neutral for the NHS.Future workQuestions remain about whether or not other positions could increase the incidence of SVB further in this group of women. The results also raise questions about the role of maternal position in second-stage labour in women without an epidural.Trial registrationCurrent Controlled Trials ISRCTN35706297.FundingThis project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published inHealth Technology Assessment, Vol 21, No. 65. See the NIHR Journals Library website for further project information.

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Antenatal perineal massage for reducing perineal trauma

Beckmann¹,

Garrett²

2005

Cochrane Database of Systematic Reviews

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Women's sexual health after childbirth

Cited by 442 publications

References 44 publications

Dyspareunia and pelvic floor muscle function before and during pregnancy and after childbirth

Dyspareunia and pelvic floor muscle function before and during pregnancy and after childbirth

A multicentre, randomised controlled trial of position during the late stages of labour in nulliparous women with an epidural: clinical effectiveness and an economic evaluation (BUMPES)

Antenatal perineal massage for reducing perineal trauma

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