[Women's dyspareunia after childbirth: a case study in a hospital in Acapulco, Mexico]

To identify the factors associated with dyspareunia, during the 60-180 days following childbirth, in women with a history of one or two childbirths.

A case study of 304 women, matched by age and parity who visited family planning services in a hospital in Acapulco, State of Guerrero, Mexico, 60-180 days after giving birth. A questionnaire was administered to assess socioeconomic status (age, level of education, partner's level of education, marital status, employment, social security, and homeownership), obstetric history (type of birth, parity, location of the birth, tearing, episiotomy, and complications), and gynecological status (constricted introitus, scar tissue at the episiotomy site, symptoms of vaginitis, vaginal dryness, contraceptive use, and breast feeding duration). Cases were defined as those women who related pain, burning, or bleeding following vaginal intercourse after childbirth. An unconditional logistic regression model was applied and odd ratios (OR) and 95% confidence interval were calculated.

Of the 368 women who had reinitiated sexual relations, 152 (41.3%) mentioned dyspareunia. The factors associated with dyspareunia were: an infection with or without episiorrhaphy dehiscence (OR=34.09; CI95%: 10.59-109.78); symptoms of vaginitis (OR=7.43; CI95%: 3.68-14.99); tightness in the introitus of the vagina (OR=6.38; CI95%: 2.92-13.94), and breast feeding exclusively (OR=4.86; CI95%: 2.44- 9.69).

Dyspareunia was related to complications with episiotomy and its possible sequelae, such as infection, episiorrhaphy dehiscence, and constricted introitus. More attention should be given to the episiotomy site during the postpartum period and greater selectivity is needed when deciding which women require an episiotomy.