Association between perineal birth trauma and postpartum SEXUAL FUNCTION among women in Kapenguria County Referral Hospital, West Pokot, Kenya

Abstract

Introduction: Childbirth is associated with a number of changes to a mother's overall health and well-being. Among the adverse experiences that mothers go through in childbirth is perineal birth trauma. Perineal birth trauma involves any type of damage to the female genitalia during labour, which can occur spontaneously or iatrogenically. This is a major attribute of sexual dysfunction and predisposes the women to concerns like sexual dissatisfaction, pain and affects their social and emotional wellbeing. This study was focused on the sexual experience of women who sustain perineal birth trauma. Objective: To determine the prevalence of perineal birth trauma, to describe factors associated with perineal birth trauma, to describe the sexual function of women who experience perineal birth trauma and to describe the association between perineal birth trauma and sexual function. Methods: The study was conducted in Kapenguria County Referral Hospital in West Pokot County in western Kenya. 304 women were consecutively sampled to participate in the study which employed a cross-sectional study design. A questionnaire comprising the Female Sexual Function Index was administered to the respondents; Descriptive statistics were used to describe the prevalence of perineal birth trauma in percentages while the association between categorical variables was assessed using chi square. Continuous variables were compared using independent samples t-test with a level of significance of p-value < .05. Results: The study showed that the prevalence of perineal trauma in Kapenguria County referral Hospital is 205(67.4%). Perineal Birth trauma was statistically significantly associated with age χ2 (3, N = 304) = 14.835, p =.002, marital status χ2 (4, N = 304) = 14.440, p =.006, education level χ2 (3, N = 304) = 12.341, p = .006, occupation χ2 (2, N = 304) = 7.451, p =.024, weight of the child χ2(2, N = 304) = 6.438, p =.04 and parity χ2(6, N = 304) = 28.012, p =.000). The study further revealed that perineal trauma experience is statistically significantly associated with sexual satisfaction χ2(1, N = 304) = 6.556, p =.01 and sexual pain χ2(1, N = 304) = 5.322, p =.021. There was a significant difference between those women who experienced perineal birth trauma and those who did not in terms of sexual function where satisfaction t(302) =1.6780, p =.01 and pain t(302) = 1.581, p =.021 Conclusions: Perineal trauma was highly prevalent in labour and delivery, and almost half the cases were due to episiotomies. Factors significantly associated with Perineal Birth Trauma included age, marital status, education level, occupation, weight of the child and parity. Among the women who experienced perineal birth trauma, there was significant sexual pain and low sexual satisfaction. Compared to the women who did not experience perineal birth trauma, those who experienced perineal birth trauma reported significantly low sexual satisfaction and low sexual pain. Recommendations: The study recommends that health care workers limit perineal trauma during delivery for ease of resumption of optimum sexual intercourse after childbirth. The County Reproductive Health Department to train health care workers on minimizing factors associated with Perineal Birth Trauma. The study recommends that programs such as extended postpartum counselling for women who experience Perineal Birth Trauma should be included in the targeted postpartum care policy.