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

Figures & data

Figure 1 Strobe diagram.

Notes: Diagram showing recruitment into the EMRLD study, drop out late postpartum, and response to the survey. Note that recruitment differs from the Low et al¹² study by n=2 due to the inclusion of two women who missed the early postpartum MRI in this report.
Abbreviations: EMRLD, Evaluating Maternal Recovery from Labor and Delivery; MRI, magnetic resonance image.

Figure 2 Distribution of responses to individual VSBE questions.

Notes: Vertical bar chart showing the percentage of women who gave each response for the ten VSBE questions. All responses are highly skewed toward the “strongly disagree” category, indicating positive genital body image with the exception of the question regarding interference with sexual enjoyment, which has a higher proportion that agreed with this statement compared to other questions.
Abbreviation: VSBE, Vaginal Changes Sexual and Body Esteem.

Table 1 Sample characteristics

Study variable	Respondents (n=69)
	Total	Mean (SD) or % (N)
Demographics
Maternal age (years)	69	30.28 (5.45)
Race	68
Black/African American		3% (2)
White		90% (61)
Asian		3% (2)
Other races		4% (3)
Non-Hispanic/non-Latino	68	100% (68)
BMI (kg/m^2)	66
<18.5		6% (4)
18.5–24.9		45% (30)
25.0–29.9		29% (19)
>30.0		20% (13)
Education	67
High school graduate or less		7% (5)
Some college		19% (13)
College/technical school graduate		27% (18)
Graduate school		46% (31)
Annual income	66
<$20,000		14% (9)
$20,000–$40,999		15% (10)
$41,000–$60,000		14% (9)
>$60,000		58% (38)
Birth variables
Infant’s weight (g)	68	3,421.01 (509.62)
Infant’s head circumference (cm)	67	34.24 (1.67)
Anal tear	69	33% (23)
Episiotomy	69	22% (15)
Vacuum	69	6% (4)
Forceps	69	4% (3)
Second stage (minutes)	68	164.7 (132.04)
LA tear severity	68
No LA tear		57% (39)
Low severity LA tear		10% (7)
Moderate severity LA tear		19% (13)
High severity LA tear		13% (8)
POP-Q
Anterior vaginal wall descent (cm)	66	−2.14 (0.71)
Cervix descent (cm)	65	−7.57 (0.94)
Genital hiatus (cm)	66	4.67 (0.90)
Urethra to anus (cm)	66	6.88 (1.11)
Posterior vaginal wall descent (cm)	66	−2.32 (0.64)
Total vaginal length (cm)	65	11.85 (1.31)

Abbreviations: BMI, body mass index; LA, levator ani; POP-Q, pelvic organ prolapse quantification.

Figure 3 Distribution of VSBE scores by selected birth characteristics.

Notes: Box plots of VSBE score showing the mean (circle), median (line in box), and first and third quartiles (edges of box). Whiskers extend to 1.5 times the interquartile range. Scores for women with episiotomies were significantly lower (worse) than scores for women who did not have episiotomies (P=0.01), while there was no difference in scores for women with and without anal sphincter tears (P=0.78). Women with the most severe LA tears (grade III) showed a trend toward lower (worse) scores, but this did not reach statistical significance (P=0.23).
Abbreviations: LA, levator ani; VSBE, Vaginal Changes Sexual and Body Esteem.

Table S1 Vaginal Changes Sexual and Body Esteem Scale

	Strongly agree	Agree	Neutral	Disagree	Strongly disagree	No vaginal/rectal changes
1. I feel that the changes to my vaginal/rectal area may cause interference with my sexual enjoyment.	1	2	3	4	5	n/a
2. If I were looking for a sexual partner it may be harder to find one because I have these kinds of changes to my vaginal/rectal area.	1	2	3	4	5	n/a
3. I would like to hide the changes to my vaginal/rectal area as much as possible.	1	2	3	4	5	n/a
4. I feel sexually frustrated because of the changes to my vaginal/rectal area.	1	2	3	4	5	n/a
5. I feel that the changes to my vaginal/rectal area are likely to prevent me from satisfying a sexual partner.	1	2	3	4	5	n/a
6. I feel my sexual expression may be limited by the changes to my vaginal/rectal area.	1	2	3	4	5	n/a
7. I feel that a sexual partner might not be as sexually interested in me because of the changes to my vaginal/rectal area.	1	2	3	4	5	n/a
8. I envy people with an unchanged vagina/rectum.	1	2	3	4	5	n/a
9. I believe that I may experience rejection from a sexual partner because of the changes to my vaginal/rectal area.	1	2	3	4	5	n/a
10. I would do a swap for an unchanged vagina/rectum if I could.	1	2	3	4	5	n/a

Abbreviation: n/a, not applicable.

LowLKZielinskiRTaoYGaleckiABrandonCJMillerJMPredicting birth-related levator ani tear severity in primiparous women: evaluating maternal recovery from labor and delivery (EMRLD Study)Open J Obstet Gynecol20144626627825379356

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