Risk of non-resumption of vaginal sex and dyspareunia among cesarean-delivered women

CONTEXT: Many women have postpartum sexual dysfunction. The mode of delivery is an important determinant. AIMS: To calculate the risk ratio of non-resumption of vaginal sex and dyspareunia during the postpartum period among cesarean-delivered women. SETTINGS AND DESIGN: This large multisite study was conducted in 13 selected hospitals in Pune District during 2017–19. METHODS AND MATERIAL: A total of 3,112 women (half cesarean delivered and half vaginally) were interviewed by trained health workers using a structured questionnaire. Women were interviewed at 4 weeks, 6 weeks, and 6 months. STATISTICAL ANALYSIS USED: Chi-square test was applied. A risk ratio with a 95% confidence interval was calculated. RESULTS: At 6 weeks, the risk ratio of non-resumption of vaginal sex was significantly high among cesarean-delivered participants (1.14). Cesarean-delivered women had a lesser risk ratio of dyspareunia at both follow-ups (0.59, 0.49). Even at 6 months, about one-third vaginally delivered women had dyspareunia. The proportion of women non-resuming vaginal sex gradually decreased from 6 weeks to 6 months. The proportion of women having dyspareunia also decreased from 6 weeks to 6 months following childbirth. Residence in the rural area and cesarean delivery were the significant determinants of an early resumption of vaginal sex. Dyspareunia was significantly high among vaginal delivered than cesarean. About 25% of women continued to have dyspareunia up to 6 months. CONCLUSIONS: A large number of women suffer from dyspareunia; hence antenatal and postnatal care should include some counseling and management about the resumption of sex and dyspareunia.