Introduction
Dyspareunia, a common complaint, reported by 7.5% of sexually active
women (1), is a multifactorial bio-psychosocial phenomenon and carries
extensive physical, mental and social implications. Causes include
bio-medical factors such as vulvovaginal skin conditions, iatrogenic
factors, and hormonal changes (2). The most common aetiologies of
long-standing dyspareunia are provoked vestibulodynia (PVD), a chronic
vulvar pain condition, with prevalence ranges of 10%-28% in women of
reproductive age (3,4), and vaginismus, a reflexive, involuntary pelvic
muscle tightening with prevalence ranges of 5%-17% (5).
Despite the high prevalence of dyspareunia, surprisingly few studies
have addressed reproductive function in women with this condition, with
inconsistent results. Some studies have shown dyspareunia to be related
to a higher need for assisted reproductive techniques (ART) (7,8), while
others have not identified such an association (9). Studies in women
with dyspareunia have observed a higher risk for cesarean section,
instrumental delivery (8) and perineal lacerations (10,11). Women with
dyspareunia were also found to experience postpartum perineal pain
longer than comparisons (9).
So far, studies on reproductive outcomes in women with dyspareunia have
focused mainly on obstetrical parameters. There are indications that
women with dyspareunia express fear of delivery (12), yet reports on
their actual experience of labor are restricted to pain and anxiety
levels and largely based on midwives’ impressions (11). Excluding a
single study which used a qualitative methodology (13), no research has
focused on emotional and cognitive parameters or on maternal adjustment
after childbirth in women with dyspareunia. The aim of this study was to
assess obstetrical outcomes, perceptions of childbirth experience and
emotional adjustment following childbirth, among women with a history of
dyspareunia.