Episiotomy and women's sexual function 2–5 years after childbirth: A study from the Czech Republic

Abstract

Background: Episiotomy is one of the most common interventions during the second stage of labour. Some studies have identified episiotomy as a risk factor for pain during sexual intercourse. Aims: The aim of this cross-sectional study was to establish the effect of episiotomy on the sexual function of women 2–5 years after a vaginal birth. Methods: Women with episiotomy were compared with four control groups: women with intact perineum, women with first-degree perineal tear, women with second-degree perineal tear and women with third- and fourth-degree perineal tear. Data were collected from 13 private gynaecological clinics in three regions in the Czech Republic during August–September 2013. The Female Sexual Function Index (FSFI) was used. Response rate was 41% (246/600 questionnaires); 35 questionnaires were excluded, so the final sample was 211 women. The Kruskal–Wallis test was performed on all women in the study (n = 211) and then again for only the primiparous women (n = 112). Findings: In all samples in women with second-degree perineal tears, lower score values were found in the domains of arousal and orgasm, and these women had a lower total FSFI score compared to those with first-degree perineal tears and women who received an episiotomy. However, in primiparous women only, there was no difference between these groups. Conclusions: Further research is required to establish the effect of episiotomy on women's sexual function.