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Media release: Caesareans more likely to lead to pain during sex post-childbirth

Women who have a caesarean section, forceps or vacuum extraction are more likely to experience persisting pain during sex in the year after childbirth than women who have a vaginal birth.

The findings from a longitudinal study by the Murdoch Children's Research Institute showed that women who had an emergency caesarean or vacuum extraction were twice as likely to experience pain during sex at 18 months postpartum, compared to women who had a vaginal birth with no medical intervention.

The vast majority of women (86%) experienced pain the first time they had sex after childbirth. Women who had a caesarean section or vacuum extraction experienced pain for a longer period. 

According to lead author Doctor Ellie McDonald, the unexpected finding dispels the common myth that caesarean section results in fewer sexual problems after childbirth.

“Almost all women experience some pain during sex following childbirth,” Doctor McDonald said. “Our findings show that this was equally true whether couples resumed sex at six weeks or six months postpartum.”

For most women pain does resolve over time, but for around one in three women having a caesarean section or vacuum extraction pain persists to 18 months postpartum.

The Maternal Health Study included a cohort of 1244 first time mothers from across Melbourne, with data taken from questionnaires completed in early pregnancy and at three, six, 12 and 18 months after birth. The study was published in BJOG: An International Journal of Obstetrics and Gynaecology.

Of the women sampled, 49% had a spontaneous vaginal birth, 11% had an operative vaginal birth using vacuum extraction 11% gave birth assisted by forceps. Additionally, 10% underwent an elective caesarean section, and 20% had an emergency caesarean.

Lead investigator Associate Professor Stephanie Brown said the study provides new evidence regarding the extent and nature of common maternal physical and sexual health problems after childbirth.

“It may be reassuring for women experiencing pain during sex after childbirth to know that they are not alone. There is a need for better information for couples about what’s normal, and what to expect in the first 12 to 18 months postpartum.”