Mode of First Delivery and Women's Intentions for Subsequent Childbearing: Findings from the First Baby Study

Authors

  • Kristen H. Kjerulff,

    Corresponding author
    1. Department of Obstetrics and Gynecology, College of Medicine, Penn State University, Hershey, PA
    • Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA
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  • Diana L. Velott,

    1. Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA
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  • Junjia Zhu,

    1. Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA
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  • Cynthia H. Chuang,

    1. Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA
    2. Department of Medicine, College of Medicine, Penn State University, Hershey, PA
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  • Marianne M. Hillemeier,

    1. Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA
    2. Department of Health Policy and Administration, College of Medicine, Penn State University, Hershey, PA
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  • Ian M. Paul,

    1. Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA
    2. Department of Pediatrics, College of Medicine, Penn State University, Hershey, PA
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  • John T. Repke

    1. Department of Obstetrics and Gynecology, College of Medicine, Penn State University, Hershey, PA
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Correspondence:

Kristen Kjerulff, Department of Public Health Sciences, College of Medicine, Penn State University, A210, 600 Centerview Drive, PO Box 855, Hershey, PA 17033, USA.

E-mail: khk2@psu.edu

Abstract

Background

More than a dozen studies have reported a reduced rate of childbearing after caesarean delivery (CD). It has been hypothesised that this is because women who deliver by CD are less likely to intend to have subsequent children than women who deliver vaginally – either before childbirth or as a consequence of CD. Little research has addressed either of these hypotheses.

Methods

As part of an ongoing prospective study, we interviewed 3006 women in their third trimester and 1 month after first childbirth to assess subsequent childbearing intentions.

Results

Women who delivered by CD were similar to those who delivered vaginally in intent to have at least one additional child, both before childbirth (90.1% vaginal, 89.9% CD; P = 0.97) and after (87.8% vaginal, 87.1% CD; P = 0.87); however, women who had CD were less likely to intend two or more additional children, both before childbirth (34.7% vaginal, 29.2% CD; P = 0.03) and after (32.2% vaginal, 26.1% CD; P = 0.01). Among women who intended to have at least one additional child before childbirth, 5.0% reported intending to have no additional children 1 month after delivery (5.1% vaginal, 4.6% CD; P = 0.52).

Conclusions

Women whose first delivery is by CD are less likely to intend a relatively large family of three or more children than those who deliver vaginally, but delivery by CD does not decrease women's intentions to have at least one more child any more than does vaginal delivery, at least in the short term.

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