The Effects of Perineal Tears during Childbirth on Women's Sex Life.

Perineal tears during childbirth - especially the third- and fourth-degree perineal tears - can cause annoying symptoms such as urinary or fecal incontinence and sexual discomfort. Our review revealed that little research has been published on the views and experiences of women in Greece with regards to perineal tears. The aim of our research was to study women's experiences regarding the effects of third- and fourth-degree perineal tears on their sexual activity as well as their attitudes towards future pregnancies, and to compare them with the experiences and attitudes of women with lower-grade perineal tears. Both complications and the methods of treating perineal tears were also studied. A quantitative primary and correlational research was performed between groups in an experimental design using a closed-ended questionnaire and the Likert scale. The statistical tests chi square, independent samples t-test and Mann Whitney were used at a significance level of 5%. The sample of our study consisted of 159 women who had suffered perineal tears during childbirth. With most women, labor began spontaneously. Epidural or spinal anesthesia was administered along with other medications, while most of them reported they had an episiotomy. Most women reported pain in the perineal area after childbirth, experienced nausea, urinary and fecal incontinence and half of them had difficulty in voiding their bladder. Rehabilitation methods for the perineal tears were rarely applied after leaving the maternity hospital. A moderate proportion of the sample consequently considered that medical liability played a role in them sustaining perineal tears at childbirth and subsequently going through a lengthy recovery. However, the results regarding the attitudes of women towards a future pregnancy were optimistic. Sexual activity issues were observed on a very small portion of the sample. A statistically significant correlation was found regarding the degree of perineal tears and the body weight of the newborn in the first childbirth (p=0.042), constipation (p=0.001), dyspareunia (p=0.010), urinary incontinence after labor (p=0.001), urinary leakage after labor (p <0.001), surgical rehabilitation of the scars after healing (p=0.016), prescription of antibiotics and painkillers (p <0.001), systematically performing Kegel exercises at home (p=0.001), a specific diet plan (p=0.004), medical liability on the prevention and rehabilitation of perineal tears (p <0.001), women's attitude towards a future pregnancy (p <0.001) and the quality of their sexual activity (p <0.001). Women who suffered a severe perineal tear gave birth to a newborn with a larger body weight (about 200 grams heavier), had more perineal tear related complications after childbirth - and in particular difficulty in voiding their bladder, dyspareunia, as well as urinary and fecal incontinence. In addition, it was found that women who had suffered a severe perineal tear had to undergo surgical rehabilitation of the scar after healing, take antibiotics and painkillers, systematically apply Kegel exercises at home and follow a specific diet plan. Furthermore, women who had suffered a severe perineal tear believed more that there was medical liability, which also affected the rehabilitation of their perineal tears. They also had a less positive attitude toward future pregnancies. They finally reported having had more sexual activity related issues.