| Background:The rate of cesarean section raised rapidly in the world in recent20years. The rate in the United States and the United Kingdom now was about22%. In China, it was about40%, which was even more than60%in few hospitals. Caesarean requirements asked by maternities are mainly due to underlying misunderstanding. First, the maternity pains less in caesarean section than vaginal natural childbirth due to the expansion of birth canal in vaginal delivery. Second, the child’s intelligence will be affected by the extrusion of birth canal during vaginal delivery. Third, the unspeakable factors existed in maternity and her families’mind, such as the fear of affection on future sexual life caused by vaginal delivery. There are many young maternities think that, their body shape will recover easier after cesarean section. According to study,10%pregnant women choose to take cesarean delivery in worldwide, which mainly because the hopes of maintaining their good sexual function. However, only about10%-15%of the mothers really needed Cesareans according to the World Health Organization. British researchers found that, women who took cesarean delivery have less sexual health problem than the other females after three months of delivery. But when it comes to6months, the difference between cesarean delivery and vaginal delivery was significantly reduced.Objectives:To examine the influence of three different delivery modes including normal vaginal delivery (NVD), normal vaginal delivery with Episiotomy (NVD/EPI) and caesarean section(C/S). Understand the quality, satisfaction, willing and Recovery of sexual life at the third month, sixth month and ninth month after delivery. Try to understand the status of primiparous sexual health after delivery. Change primiparas’misunderstanding of choosing cesarean section to maintain good sexual function after delivery, to improve the quality of sexual life after childbirth and to provide basic data for further clinical intervention.Methods:Choose women who giving birth in Department of Gynecology and Obstetrics at The Second Hospital of Baotou College on February2010to September2010, the delivery modes include NVD, NVD/EPI and C/S. Take preliminary screening according to the including and eliminating standard of research object. The including standard includes full-term pregnancy, non-pathological pregnancy, delivery mode:NVD, NVD/EPI or C/S,22-35years old, no history of psychological disorders, no medical and surgical complications, both couples have no history of asexual dysfunction and the postpartum perinea incision or abdominal incision Grade healing. The eliminating standard includes the happening of harmful events that affect the quality of life or sexual life such as trauma, suffering from systemic diseases, genital mutilation acute or chronic inflammation which may affect the quality of life, pelvic floor disorders, pregnant again during follow-up, postpartum depression, social or family conflicts, divorce, etc which may result in psychological trauma, couple separated in different places after delivery, quite study or loose contact. After explaining the importance of the survey and commitment to the principle of confidentiality of the study, we surveyed a total of397cases. The questionnaire included general information such as age, educational attainment, occupation and survey of postpartum sexual function such as Recovery and frequency of sexual life, sexual arousal, orgasm, sexual satisfaction, sexual willing, vaginal lubrication and pain during sexual life. In this cross-sectional study, the forms of face-to-face questionnaire, letter or telephone were used. Investigating officers are from the same clinical obstetrics and gynecology, so they can provide relate explanations and helps to maternities. Maternities were divided into three groups according to different delivery modes:NVD group (150), NVD/EPI group (119), and C/S group (128). All data were quantified into scores according to standard for evaluation. Use SPSS17.0to analyze, analysis of variance, non-parametric test, Chi-square test and SNK test were used according to different types of data.Main Results:1. Sexual function of primiparas with different delivery modes in different time periods:①AAfter three months of delivery, the questionnaire total score of different delivery modes were (28.6±3.9),(24.8±3.2) and (27.9±2.8).The total score of NVD/EPI group was significantly lower than NVD group and C/S group (P<0.05), while no significant differences exists between NVD group and C/S group (P>0.05). There exits significant differences in these groups in the dimension of pain during sexual life, sexual willing, vaginal lubrication, and sexual satisfaction.②The score of NVD/EPI group is the lowest after sixth months of delivery (27.8±3.8), there exits significant difference when compared with NVD group (31.7±4.1) and C/S group (31.5±3.7), while no significant differences exists between NVD group and C/S group (P>0.05). There exits significant differences in these groups in the dimension of pain during sexual life, orgasm, and sexual satisfaction.③After nine months of childbirth, FSFI total scores had no significant difference in three groups.2. FSD rates of primiparas with different modes of delivery in different time periods:①After three months of delivery, the FSD rate of NVD/EPI group was69.7%, which was significantly higher than NVD group(42.7%) and C/S group(46.1%)(P<0.05), while there was no significant difference exits between NVD group and C/S group(P>0.05).②After six months of delivery, FSD rate of three groups were27.3%,47.1%and30.5%. The FSD rate of NVD/EPI group was significantly higher than NVD group and C/S group, while no significant difference exists between NVD group and C/S group.③After nine months of childbirth, the FSD rate had no significant difference in three groups.3. Sexual frequency of primiparas with different modes of delivery in different time periods:After three months of delivery, compared with the time before delivering, the dimension of "far less than before" was the highest chosen in sexual frequency, they were43.3%,73.9%and57.0%, there exits significant differences among three groups. While no significant difference exists after nine months of childbirth.4. Recovery of sexual life of primiparas with different modes of delivery:After three months of delivery, the number of maternities who had recovered sexual life of NVD group, NVD/EPI group and C/S group werel27,72and93, account for84.7%,60.5%and75.0%. There exits significant differences among three groups in the recovery time of sexual life. After six months of delivery, the rate of recovery of sexual life was significantly raised, while there exit no statistically difference. After nine months of childbirth, all maternities had recovered their sexual life. Conclusions:1In terms of sexual function. The lowest score of NVD/EPI group occurred before six months, there exits the most problems in this period, which was significant highly than other groups. While no significant differences exist between NVD group and C/S group. The lowest score occurred in the dimension of pain during sexual life, sexual willing, vaginal lubrication, and sexual satisfaction. After nine months of childbirth, the level of sexual function and the FSD rates had no statistically difference in three groups.2In the terms of sexual frequency and recovery of sexual life. After three months of delivery, the rate of sexual life recovery and sexual frequency of NVD/EPI group were the lowest. After six months of delivery, there exit no statistically difference in three groups. After nine months of childbirth, all maternities had recovered their sexual life. It shows that, the integrity of perineum is closely related to primiparas’ sexual health.3Sexual problems of maternities gradually reduced with the lapse of time, the level of sexual function also increased and the rate of FSD reduced slowly. While there still a considerable number of maternities had FSD after nine months. |
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