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Published on: August 29, 2025
The development and validation of a new postpartum sexual function and dyspareunia assessment tool: The Carol Scale
Carolina López-Lapeyrere1, Noelia Serna-Gómez1, Ana Belén Hernández-López1
1Obstetric and Ginecology Service, Puerta de Hierro Majadahonda University Hospital, C/ Joaquín Rodrigo, 2, 28222 Majadahonda, Madrid, Spain.
Objective:
The aim is to develop a new tool to evaluate postpartum sexual function and dyspareunia which will facilitate better evaluation of perineal pain in woman after vaginal delivery.
Design:
The development and validation of the Carol Postpartum Sexual Function and Dyspareunia Assessment Scale.
Setting:
The Obstetrics and Gynecology Service of a University Hospital in central Spain.
Participants:
102 women after being attended for vaginal birth, and 5 midwife assessors.
Findings:
81women reinitiated sexual activity (with vaginal intercourse) during the first three months postpartum. The Carol Postpartum Sexual Function and Dyspareunia Assessment Scale (Carol Scale) was internally reliable with a Cronbach-α value of 0.79 (95%CI0.72-0.85). Cronbach-α coefficients for Carol Scale domains were: preparation for the sexual activity 0.69 (95%CI0.55-0.79), pain or discomfort on caressing the vulval area 0.86 (95%CI0.79-0.91), pain or discomfort related to vaginal intercourse 0.93 (95%CI0.90-0.95) and pain or discomfort after vaginal intercourse 0.86 (95%CI0.78-0.91).
Conclusions:
The Carol Postpartum Sexual Function and Dyspareunia Assessment Scale is valid and reliable for measuring sexual function and postpartum dyspareunia in women after being attended for vaginal birth.
Implications For Practice:
The Carol Scale could be used both clinically and in research to improve the quality of care for the mother after childbirth. The scale could help to identify problems in the reinitiation of postpartum sexual activity and, therefore, could contribute to widening the clinical information about these women and help in decision making.
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