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From delivery room to bedroom •How mode of childbirth affect a couple’s sex life

CHILDBIRTH can wreak havoc on a couple’s intimate relationship. Everything that happens during this euphoric yet agonising event in the delivery room can have lasting effects in the bedroom, so much that anticipation of postpartum sexual functions plays a role in some women’s selection of delivery mode or style?

According to Lisa Pastore, an epidemiologist in the University of Virginia’s obstetrics and genecology department, cesarean sections now make up 30 percent of deliveries in the US, and the number is increasing especially among first timers.  She stated that, most people who ask for cesarean sections do so because of other issues apart from the labour room

Lisa stated that a lot of people do not discuss matters of sexuality with their health-care providers and they might not even stop to think that various styles of delivery have different sexual side effects. In two surveys of obstetricians, a third of doctors say they would choose cesarean sections for themselves, according to her; one of their biggest concerns remains the issue of sex after delivery.

The Cesarean-Section:  A number of studies in recent years have looked at C-sections and sexual health. One Canadian study published in 2005 shows that three months after childbirth, first-time mothers who had a vaginal birth noted greater sexual dissatisfaction than those who had a C-section. 70 percent compared with 55 percent. A 2006 study found similar results in women two full years after birth. Another study published in 2005 found long-term differences in the strength of new mothers’ pelvic floors; the pelvic muscles and connective tissue supporting the bladder, intestines, and reproductive organs that contract involuntarily during orgasm and can intensify orgasm when contracted voluntarily. More than two years after giving birth, women who delivered vaginally had significantly lower pelvic floor muscle strength than those who delivered by cesarean section.

Kegels:  There are no studies showing that increasing pelvic floor strength directly improves sex because , “sexual function is such a complex thing,” says Linda Brubaker, a urogynecologist at Loyola University. It is known that pelvic floor exercises such as Kegels decrease incontinence, women with less incontinence, particularly coital incontinence; leaking of urine during intercourse, have better sex lives. “Feeling comfortable with yourself is key to feeling comfortable within a sexual relationship,” Brubaker says, “and fear of incontinence can be a devastating thing for a woman

Episiotomy:  One factor that complicates many of the studies comparing vaginal birth with cesarean section is that some women have episiotomies; incisions through the perineum to expand the vaginal opening. This procedure prevents rips, which are hard to repair, and limits stretching of the pelvic floor. In the US, about 30 percent of vaginal births occur with episiotomy. A 2005 JAMA survey of studies found little evidence that women who had episiotomies had better pelvic floor function in the months after childbirth. And they took longer to resume intercourse and suffered more pain during sex.

To be continued next week

Coutersy: WomensHealth