English Polski
Vol 12, No 2 (2014)
Research paper
Published online: 2015-03-06

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Quality of sexual life versus self-assessment of perineum and vulva in women 6 months after vaginal delivery

Kinga Filipek, Marek E. Marcyniak, Joanna Kuran-Ohde
Seksuologia Polska 2014;12(2).


INTRODUCTION: Pelvic floor or perineum is a musculofascial structure surrounding urethra, vagina and rectum that is of high importance for women sexual function. Vaginal delivery is a factor influencing negatively aesthetics and function of perineum. Passage of the presenting part of the foetus through the birth canal and vaginal introitus causes irreversible changes to their condition. Vaginal delivery causes inevitably extension and consequently permanent relaxation of muscles and fasciae. For this reason the management of deliveries by doctors and midwives should aim at reducing this adverse effect.

MATERIAL AND METHODS: In the years 2010−2014 the data was collected. Dedicated questionnaire was prepared and distributed to women 6 or more months postpartum who started sexual activity after delivery. Out of 2000 questionnaires 1370 (68.50%) were entirely completed. There were 548 (40.00%) primiparas, 426 (31.10%) women who gave birth for the second time and 396 (28.90%) who gave birth three or more times. In the group of primigravidas there were 396 (72.26%) with higher education. Among respondns after second delivery there were 203 (47.65%) and among those after there or more deliveries 145 (36.62%).

RESULTS: Among respondents there is decreasing number of multiparas, especially with higher education. It can indicate at national trends to promote more common model of partnerships „two plus one”, which is evident wasting of biological potential of the mentioned social group. In the group of 548 primiparas only 16.24% declared full satisfaction after assessment of the aesthetics of the anatomy of their perineum and vulva 6 months after delivery. Among 426 women who gave birth for the second time the satisfaction rate was 22.54% and in the group of 396 women who gave birth three or more times it was 29.80%. 17.88% of primiparas described satisfaction from sexual life (taking into account the condition of perineum and vulva) as comparable to the situation before delivery , in the group of women after second delivery the rate was 25.35% and after three or more deliveries 28.28%.


ONCLUSIONS: 1. Impairment of quality of sexual life after vaginal delivery related to changes in the perineum and vulva is a frequent phenomenon. 2. Large number of respondents declaring mediocre or lack of satisfaction from postartum condition of perineum and vulva in relation to resuming sexual activity is not a sign of discontent of polish women but an acknowledgement of existing problem. 3. High rate of women declaring mediocre or lack of satisfaction after assessment of their perineum and vulva together with impairment of sexual life quality 6 months after vaginal delivery indicates at errors in the management of vaginal deliveries. 4. Because of lack of education in the field of sexuology, doctors and midwives managing vaginal deliveries do not take sexual life quality postpartum into account. 5. Excessive promoting of spontaneous deliveries, without episiotomy, not considering its negative impact is a harmful phenomenon. 6. Incompetent, incorrect episiotomy and its repair done by youngest, unskilled, unqualified, unsupervised doctors damages anatomical aesthetics and function, also sexual, of perineum and vulva.

The Authors did not aim to discourage polish women from vaginal deliveries, but to help midwives and doctors realize the importance of special care for perineum and vulva condition of parturients in relation to resuming sexual activity postpartum.