Women who deliver through caesarean section experience more pain during first sexual intercourse after childbirth than those who give birth naturally, says a study.
Operative birth is associated with persisting pain during or after sexual intercourse known as dyspareunia.
"Our findings show the extent to which women report persisting dyspareunia at 6 and 18 months postpartum is influenced by events during labour and birth, in particular caesarean section and vacuum extraction delivery," explained Ellie McDonald from the Murdoch Childrens Research Institute, Victoria, Australia.
The fact that dyspareunia is more common among women experiencing operative procedures points to the need for focusing clinical attention on ways to help women experiencing ongoing morbidity, and increased efforts to prevent postpartum morbidity where possible, they added.
For the study, a cohort of 1,244 first-time mothers in Melbourne was used.
Of the women sampled, 49% had a spontaneous vaginal birth.
Additionally, 9.7% were delivered by elective caesarean section and 19.9% were delivered by emergency caesarean section.
Results showed that 78% of the study population had resumed sexual intercourse by three months, 94% by six months, 97% by 12 months and 98% by 18 months postpartum.
Compared to women who had a spontaneous vaginal delivery, women who had an emergency caesarean section, vacuum extraction or elective caesarean section had double the risk of reporting dyspareunia at 18 months postpartum, adjusting for maternal age and other risk factors.
The study was published in BJOG: An International Journal of Obstetrics and Gynaecology.
"This study provides us with robust evidence about the extent and persistence of postpartum dyspareunia and associations with mode of delivery and perineal trauma," concluded Patrick Chien, deputy editor-in-chief of BJOG.