Frequency Of Dyspareunia After Normal Vaginal Delivery With Episiotomy

Background:Episiotomy, though widely practiced during vaginal delivery, remains controversial due to uncertain benefits and well-documented complications. Dyspareunia, or pain during sexual intercourse, is a significant yet under-recognized morbidity that can adversely affect postpartum quality of life. Local data on its frequency following episiotomy are limited in Pakistan.To determine the frequency and severity of dyspareunia six weeks after normal vaginal delivery with episiotomy in women at a tertiary care center in Mardan, Pakistan. Methods:This descriptive, cross-sectional study included 131 women aged 15–35 years who underwent normal vaginal delivery with mediolateral episiotomy at Bacha Khan Medical College/Mardan Medical Complex. Women with pre-existing gynecologic, obstetric, or medical conditions likely to confound outcomes were excluded. Dyspareunia was assessed at six weeks postpartum using the validated Visual Analog Scale (VAS), with pain severity classified as mild (1–3), moderate (4–6), or severe (>6). Data were analyzed using SPSS v19.0; frequencies, percentages, and stratified analyses (Chi-square/Fisher’s exact) were performed, with p ≤ 0.05 considered significant. Results:Of 131 participants, 36 (27.5%) reported dyspareunia at six weeks postpartum. Most cases were classified as mild (13/131, 9.9%) or moderate (15/131, 11.5%), with severe pain in 8 (6.1%). No statistically significant associations were observed between dyspareunia and maternal age, BMI, education, residence, or neonatal factors. The majority of women reported resolution or substantial improvement of symptoms by the end of follow-up. Conclusion: Dyspareunia is a common complication following episiotomy in this population, affecting more than one in four women at six weeks postpartum. While most cases are mild to moderate, the impact on postpartum recovery and quality of life is considerable. These findings underscore the