# Development and Pilot Validation of the Sexual Satisfaction and Emotional Impact After Cesarean Section Scale (SSEI-CS-24): A Pilot Study

## TL;DR

This study created and tested a new tool to measure how cesarean section scars affect sexual satisfaction and emotional well-being.

## Contribution

The SSEI-CS-24 is a new, multidimensional scale for assessing post-cesarean emotional and sexual outcomes.

## Key findings

- The SSEI-CS-24 showed excellent internal consistency (Cronbach’s α=0.89) and good test-retest reliability (ICC=0.84).
- Factor analysis supported a five-domain structure explaining 68% of variance.
- Results showed normal distributions without floor or ceiling effects.

## Abstract

Background

Cesarean section (CS) scars may negatively affect sexual function, body image, and emotional well-being, yet no validated tool specifically addresses these outcomes.

Objective

To develop and pilot-validate the Sexual Satisfaction and Emotional Impact after Cesarean Section Scale (SSEI-CS-24), a 24-item instrument assessing sexual, psychological, and relational adaptation after CS.

Methods

The SSEI-CS-24 was developed through literature review, qualitative interviews, and expert consensus. Content validity was quantified with the Content Validity Index. Fifty women completed the scale at 40 days postpartum. Reliability was assessed with Cronbach’s α and intraclass correlation coefficient (ICC), while construct validity was examined using exploratory factor analysis (principal component analysis with Varimax rotation).

Results

The SSEI-CS-24 demonstrated excellent internal consistency (Cronbach’s α=0.89) and good test-retest reliability (ICC=0.84). Factor analysis supported a five-domain structure - sexual satisfaction, body image/self-esteem, anxiety and stress, interpersonal relationships, and support/resources - explaining 68% of variance. Distributions were normal without floor or ceiling effects.

Conclusions

The SSEI-CS-24 demonstrates strong preliminary psychometric properties and shows promise as a multidimensional tool for assessing the sexual and emotional impact of cesarean section scars. Further confirmatory validation in larger, multicenter cohorts is warranted before routine clinical use.