Evaluating genital body image and sexual esteem following childbirth

Few studies have examined women’s body image after giving birth, and those that have suggest that many women experience negative body image. Even less well understood is the relationship between genital changes associated with childbirth, body image, and sexual health.

In a recent paper published in the International Journal of Women’s Health, investigators began assessing genital body image and sexual esteem in women after vaginal birth using the Vaginal Changes Sexual and Body Esteem (VSBE) scale, which was previously developed for women to evaluate their body with questions recognizing potential vaginal/rectal changes due to pelvic organ prolapse. The current study was performed as part of a larger study of women with higher risk for having a levator ani tear during childbirth.

Among women who perceived genital changes post-childbirth, most reported positive body image, although 31% felt that these changes interfered with sexual enjoyment. Those who had an episiotomy, an incision made in the perineum during childbirth, generally had more negative sexual and body esteem compared to those who did not. This result suggests that cutting the skin has more negative impact on genital body image than childbirth-related anal sphincter tears or partial levator ani tears.

“One of the perceived benefits of routine episiotomy is that it prevents negative changes to the vagina and perineum,” said lead author Dr. Ruth Zielinski. “However, our findings underscore that episiotomy does not benefit women’s sexual health or their body image.”

The authors conclude that the VSBE scale performed well as a measure of women’s sexual/body esteem specific to the genital area post-childbirth. Although testing the VSBE in a more diverse sample is warranted, future use of the scale in studies of childbirth may increase our understanding of genital area changes postpartum and the impact of those changes on those who experience them.

CITATION:Zielinski R, Kane Low L, Smith AR, Miller JM. Body after baby: a pilot survey of genital body image and sexual esteem following vaginal birth. Int J Womens Health. 2017 April 13;9:189-198.
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