International Journal of Women's Health (2017-04-01)

Body after baby: a pilot survey of genital body image and sexual esteem following vaginal birth

  • Zielinski R,
  • Kane Low L,
  • Smith AR,
  • Miller JM

Journal volume & issue
Vol. Volume 9
pp. 189 – 198


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Ruth Zielinski,1 Lisa Kane Low,1–3 Abigail R Smith,4 Janis M Miller1,3 1Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA; 2Department of Women’s Studies, College of Literature, Science and the Arts, University of Michigan, Ann Arbor, MI, USA; 3Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA; 4Arbor Research Collaborative for Health, Ann Arbor, MI, USA Objective: The aim of this study was to determine acceptability of the Vaginal Changes Sexual and Body Esteem (VSBE) scale for women post childbirth and explore the association between childbirth events and sexual/body esteem.Design: This is a cross-sectional study within the Evaluating Maternal Recovery from Labor and Delivery study.Setting: This study was conducted in a community setting.Population: The study was conducted in women post first vaginal birth with birth events that posed risk factors for levator ani muscle tears.Methods: Survey, magnetic resonance images of levator ani, and physical examination were the data collected 8 months postpartum. Birth variables were collected by hospital chart review. Descriptive analysis of VSBE response rates and distribution of responses was conducted. An exploratory analysis of the potential association of demographic, birth, clinical, and magnetic resonance image characteristics with VSBE scores was conducted.Main outcome measures: The outcome measure used in this study is VSBE scale.Results: The majority of participants (97%) completed the scale, with responses to most questions skewed toward positive sexual/body esteem, with the exception of sexual enjoyment, where 38% indicated some interference due to genital changes. The scale showed high internal consistency (alpha =0.93). In the exploratory analysis of potential characteristics associated with VSBE, women with episiotomies had lower sexual/body esteem compared to those who did not (median VSBE scores 35 vs 42.5, P=0.01). Anal sphincter tear was not associated with sexual/body esteem (P=0.78). Additional study is indicated to further explore observed trends toward the association of severe levator ani tear, maternal age at childbirth, and forceps with VSBE scores.Conclusion: The VSBE is suitable for use to assess sexual/body esteem in women post childbirth. Most women in this sample did not indicate negative genital body image/sexual esteem. However, some indicated that the changes post birth negatively affected their sexual/body esteem, particularly those who had episiotomies. Keywords: childbirth, pelvic floor disorders, episiotomy, genital cosmetic surgery, scale development, pelvic organ prolapse, Kegel muscle