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Mode of delivery and the probability of subsequent childbearing: a population-based register study
Stockholm University, Faculty of Social Sciences, Department of Sociology.
Stockholm University, Faculty of Social Sciences, Department of Sociology.
2015 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 122, no 12, 1593-1600 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate the relationship between mode of first delivery and probability of subsequent childbearing.

Design: Population-based study.

Setting: Nationwide study in Sweden.

Population: A cohort of 771 690 women who delivered their first singleton infant in Sweden between 1992 and 2010.

Methods: Using Cox's proportional-hazards regression models, risks of subsequent childbearing were compared across four modes of delivery. Hazard ratios (HRs) were calculated, using 95% confidence intervals (95% CIs).

Main outcome measures: Probability of having a second and third child; interpregnancy interval.

Results: Compared with women who had a spontaneous vaginal first delivery, women who delivered by vacuum extraction were less likely to have a second pregnancy (HR 0.96, 95% CI 0.95–0.97), and the probabilities of a second childbirth were substantially lower among women with a previous emergency caesarean section (HR 0.85, 95% CI 0.84–0.86) or an elective caesarean section (HR 0.82, 95% CI 0.80–0.83). There were no clinically important differences in the median time between first and second pregnancy by mode of first delivery. Compared with women younger than 30 years of age, older women were more negatively affected by a vacuum extraction with respect to the probability of having a second child. A primary vacuum extraction decreased the probability of having a third child by 4%, but having two consecutive vacuum extraction deliveries did not further alter the probability.

Conclusions: A first delivery by vacuum extraction does not reduce the probability of subsequent childbearing to the same extent as a first delivery by emergency or elective caesarean section.

Place, publisher, year, edition, pages
2015. Vol. 122, no 12, 1593-1600 p.
Keyword [en]
Elective caesarean section, emergency caesarean section, mode of delivery, subsequent childbearing, vacuum extraction
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology) Obstetrics, Gynecology and Reproductive Medicine
Research subject
Sociological Demography
Identifiers
URN: urn:nbn:se:su:diva-123995DOI: 10.1111/1471-0528.13021ISI: 000363729300032PubMedID: 25135574OAI: oai:DiVA.org:su-123995DiVA: diva2:880028
Available from: 2015-12-09 Created: 2015-12-09 Last updated: 2016-01-20Bibliographically approved
In thesis
1. Parents, Children and Childbearing
Open this publication in new window or tab >>Parents, Children and Childbearing
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This doctoral thesis provides a set of studies of social influences on fertility timing. Swedish register data are used to link individuals to their parents and siblings, thereby allowing the study of impacts of family of origin, social background, and parental death on fertility. The Swedish Medical Birth Register is used to investigate the effect of mode of delivery on higher order births. The thesis consists of an introductory chapter with an overview of the consequences and predictors of the timing of childbearing, and a theoretical framework to explain these relationships. This chapter also includes a section where the contribution to existing knowledge, the relation of the findings to life course theory, and suggestion for further research are discussed. This chapter is followed by four original empirical studies. The first study applies sister and brother correlations to investigate and estimate the impact of family of origin on fertility. It shows that family of origin matters for fertility timing and final family size. The study also shows that the overall importance of family of origin has not changed over the approximately twenty birth cohorts that were studied. The second study introduces three dimensions of social background - occupational class, status, and education - into fertility research. It suggests that social background, independent of individuals’ own characteristics, matters for the timing of first birth and the risk of childlessness. The study also shows that different dimensions of social background should not be used interchangeably. The third study uses the Swedish Medical Birth Register to investigate the effect of mode of delivery on the propensity and birth interval of subsequent childbearing. It demonstrates that mode of delivery has an impact on the progression to the second and third births but that a first delivery by vacuum extraction does not reduce the propensity of subsequent childbearing to the same extent as a first delivery by emergency or elective caesarean section. The fourth study explores the effects of parental death on adult children's fertility. The findings reveal that parental death during reproductive ages can affect children’s fertility. The effects are moderated by the gender of the child and when in the life course bereavement occurs. The combined output of these four studies provides evidence that human fertility behavior is embedded in social relationships with kin and friends throughout life. Family of origin, social background, an older sibling's birth, and bereavement following parental death influence the adult child's fertility. These findings add knowledge to previous research on intergenerational and social network influences in fertility.

Place, publisher, year, edition, pages
Stockholm: Department of Sociology, Stockholm University, 2016. 95 p.
Series
, Stockholm University Demography Unit, ISSN 1404-2304 ; 14
Keyword
Demography, Sociology, Fertility, Intergenerational transmission, Intergenerational influences, Social background, Parental death, Timing of first birth, Mode of delivery, Sibling correlation, Event history analysis, Childlessness, Sweden
National Category
Sociology
Research subject
Sociological Demography
Identifiers
urn:nbn:se:su:diva-125936 (URN)978-91-7649-318-2 (ISBN)
Public defence
2016-02-26, De Geersalen, Geovetenskapens hus, Svante Arrhenius väg 14, Stockholm, 10:00
Opponent
Supervisors
Funder
Swedish Research Council, 2010-0831Swedish Research Council, 340-2013-5164Swedish Research Council, 349-2007-8701
Available from: 2016-02-03 Created: 2016-01-20 Last updated: 2016-01-26Bibliographically approved

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Dahlberg, JohanAndersson, Gunnar
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British Journal of Obstetrics and Gynecology
Sociology (excluding Social Work, Social Psychology and Social Anthropology)Obstetrics, Gynecology and Reproductive Medicine

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