Effects of Mode of Delivery on Sexual Functions of

Parturient in Nigeria:

A Prospective Cohort Study

Authors & Affiliation:

Ugwu EOV, Dim CC, Eleje GU, Duru VC, Iloghalu EI,
Ekwueme PC
Obstetrics and Gynaecology Department, UNTH, Ituku/ Ozalla, Enugu.
Nigeria
 Introduction
• Female sexual function disorders (FSFDs) refers to
difficulties women experience during their sexual response
cycles that prevent them from experiencing satisfaction
from sexual activity
• Diagnostic criteria is still controversial, hence difficult to
estimate the prevalence
• FSFDs key disorders:
– desire (libido)
– Arousal
– Lubrication
– pain (discomfort)
– Orgasm
– satisfaction
 Introduction
• The few reports in literature on the effects of delivery on
FSFDs are inconclusive

• Most literature is on the effect of vaginal delivery (VD) on

sexual function, and studies on the effects of caesarean
Section (CS) are generally lacking

• Hence, the study was aimed at comparing the postpartum

sexual functions of women after CS and VD in Enugu,
South East Nigeria
Methodology
• Prospective cohort of postnatal mothers at UNTH and
ESUTH, Parklane, over a 5-month period

• Intervention group = women delivered via CS

• Control group = had VD matched for age, parity and
gestational age category at delivery
• Both groups were followed monthly up to 3months to
determine the time to first coitus and other FSFs using a
validated questionnaire.
• Eligibility = uncomplicated CS for any indications or a VD
at the two study centers were eligible
• Excluded = early neonatal deaths
Methodology
• Primary outcome measure = the mean time in days from
childbirth to first coitus

• Secondary measures =
– the mean FSFI total score at 6 weeks and 3 months postpartum
– mean FSFI domain scores at 6 weeks and 3 months postpartum
Results
• 6 weeks postpartum, mean time (days) to first coitus was
shorter in the CS than in the VD group (29.2 ± 4.3 vs 32.1 ±
4.9; t = 2.38; p = 0.02)
• No difference was observed at 3months (37.3 ± 8.7 vs 40.9
± 9.9; t = 1.83; p = 0.07)
• There were no differences in mean Female Sexual Function
Index (FSFI) total scores at 6 weeks and 3 months (p >
0.05)
• Mean FSFI domain scores at 6 weeks for orgasm,
satisfaction, and pain were significantly higher in the CS
group (p <0.05)
• However, there were no differences in any of the domain
scores at 3 months (p > 0.05).
 Discussion
• This study has demonstrated that there is no difference
inmean time to first coitus by 3 months postpartum between
women having a CS and those having a VD. Also, there is
no difference in their sexual function by this period. These
observations are similar to some previous related studies.

• The clinical implication of this finding is that it may not be

appropriate to recommend a CS for women merely for early
resumption of coitus or preservation/maintenance of sexual
function after childbirth
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Thank you