Mode of birth and postnatal health‐related quality of life after one previous cesarean in three European countries. Issue 2 (5th December 2017)

• Record Type: Journal Article
• Authors: Fobelets, Maaike; Beeckman, Katrien; Buyl, Ronald; Daly, Déirdre; Sinclair, Marlene; Healy, Patricia; Grylka‐Baeschlin, Susanne; Nicoletti, Jane; Gross, Mechthild M.; Morano, Sandra; Putman, Koen
• Is Part Of: Birth. Volume 45:Issue 2(2018)
• Page Start: 137
• Page End: 147
• Publication Date: 2017-12-05
• Subjects: Europe (MeSH) -- obstetric delivery (MeSH) -- perinatal care (MeSH) -- pregnancy (MeSH) -- quality of life (MeSH); Childbirth -- Periodicals; Obstetrics -- Periodicals; Newborn infants -- Care -- Periodicals; Natural childbirth -- Periodicals; 618.1
• DOI: 10.1111/birt.12324
• Languages: English
• ISSNs: 0730-7659

Abstract

Abstract: Background: How a woman gives birth can affect her health‐related quality of life (HRQoL). This study explored HRQoL at 3 months postpartum in women with a history of one previous cesarean in three European countries. Methods: A prospective longitudinal survey, embedded within a cluster randomized trial in three countries, exploring women's postnatal HRQoL up to 3 months postpartum. The Short‐Form Six‐Dimensions (SF‐6D) was used to measure HRQoL, and multivariate analyses were used to examine the relationship with mode of birth. Results: Complete data were available from 880 women. Women with a spontaneous vaginal birth had the highest HRQoL scores, whereas women with an emergency repeat cesarean ( P = .01) had the lowest. Postnatal readmission of the mother ( P = .03), having public health insurance ( P = .04), and a low antenatal HRQoL score ( P < .01) contributes to poorer HRQoL scores. More specifically, women with a spontaneous vaginal birth had significantly higher HRQoL scores on the vitality dimension compared with women with an emergency repeat cesarean ( P = .04). Conclusions: In women with low‐risk factors, repeat cesareans result in a poorer HRQoL compared with vaginal birth. When there are no contraindications for vaginal birth, women with a history of one previous cesarean should be encouraged to give birth vaginally rather than have an elective repeat cesarean.