Absence of conception after caesarean section: Voluntary or involuntary?

Authors: Bhattacharya, S., Porter, M., Harrild, K., Naji, A., Mollison, J., Van Teijlingen, E., Campbell, D.M., Hall, M.H. and Templeton, A.

Journal: BJOG: An International Journal of Obstetrics and Gynaecology

Volume: 113

Issue: 3

Pages: 268-275

eISSN: 1471-0528

ISSN: 1470-0328

DOI: 10.1111/j.1471-0528.2006.00853.x

Abstract:

Background: Women who deliver by caesarean section have been shown to be less likely to have a subsequent pregnancy. It is not clear whether this is due to a direct effect of the procedure on future fertility or due to deliberate avoidance of a future pregnancy. Objective: To investigate whether absence of conception following caesarean section is voluntary or involuntary. Design: Follow up of a population-based retrospective cohort. Setting: Grampian region, Scotland. Population: Women who had no further viable pregnancies within 5 years of an initial delivery. Methods: Cases included women who delivered their first child by caesarean section between 1980 and 1995 but had no further viable pregnancies by December 2000. Controls included women who delivered their first child during the same period, by means of either spontaneous vaginal delivery (SVD) or instrumental vaginal delivery (IVD), and who had no further viable pregnancies by December 2000. Eligible women were identified from the Aberdeen Maternity and Neonatal Databank (AMND) and sent postal questionnaires to determine the extent to which not conceiving after first delivery was voluntary and the reasons for avoiding further pregnancies. Characteristics of the different mode of delivery groups were compared using univariate techniques. Main outcome measures: Extent to which absence of conception following an initial delivery by caesarean section is voluntary. Results: Questionnaires were returned by 3204 (60%) of 5300 women identified from the AMND. Of these, 1675 women had not conceived at all during the follow-up period (median duration = 13 years). Absence of conception was voluntary in 488 (69%; 95% CI 66-73%) women following caesarean section, 340 (71%; 95% CI 67-76%) following SVD and 354 (72%; 95% CI 68-76%) following IVD. Few women considered seeking fertility treatment (caesarean section = 72 [10%], SVD = 50 [11%], IVD = 39 [8%]). Of the women who decided to delay or avoid a further pregnancy, fewer women who delivered by SVD reported that the birth experience influenced their decision (caesarean section = 163 [32%], SVD = 67 [18%], IVD = 136 [35%]; P < 0.001). Conclusions: Irrespective of mode of delivery, not conceiving following the birth of the first child is mainly voluntary. The experience of the previous birth is one of several factors affecting women's decisions to avoid a subsequent pregnancy. © RCOG 2006 BJOG An International Journal of Obstetrics and Gynaecology.

Source: Scopus

Absence of conception after caesarean section: voluntary or involuntary?

Authors: Bhattacharya, S., Porter, M., Harrild, K., Naji, A., Mollison, J., van Teijlingen, E., Campbell, D.M., Hall, M.H. and Templeton, A.

Journal: BJOG

Volume: 113

Issue: 3

Pages: 268-275

ISSN: 1470-0328

DOI: 10.1111/j.1471-0528.2006.00853.x

Abstract:

BACKGROUND: Women who deliver by caesarean section have been shown to be less likely to have a subsequent pregnancy. It is not clear whether this is due to a direct effect of the procedure on future fertility or due to deliberate avoidance of a future pregnancy. OBJECTIVE: To investigate whether absence of conception following caesarean section is voluntary or involuntary. DESIGN: Follow up of a population-based retrospective cohort. SETTING: Grampian region, Scotland. POPULATION: Women who had no further viable pregnancies within 5 years of an initial delivery. METHODS: Cases included women who delivered their first child by caesarean section between 1980 and 1995 but had no further viable pregnancies by December 2000. Controls included women who delivered their first child during the same period, by means of either spontaneous vaginal delivery (SVD) or instrumental vaginal delivery (IVD), and who had no further viable pregnancies by December 2000. Eligible women were identified from the Aberdeen Maternity and Neonatal Databank (AMND) and sent postal questionnaires to determine the extent to which not conceiving after first delivery was voluntary and the reasons for avoiding further pregnancies. Characteristics of the different mode of delivery groups were compared using univariate techniques. MAIN OUTCOME MEASURES: Extent to which absence of conception following an initial delivery by caesarean section is voluntary. RESULTS: Questionnaires were returned by 3204 (60%) of 5300 women identified from the AMND. Of these, 1675 women had not conceived at all during the follow-up period (median duration = 13 years). Absence of conception was voluntary in 488 (69%; 95% CI 66-73%) women following caesarean section, 340 (71%; 95% CI 67-76%) following SVD and 354 (72%; 95% CI 68-76%) following IVD. Few women considered seeking fertility treatment (caesarean section = 72 [10%], SVD = 50 [11%], IVD = 39 [8%]). Of the women who decided to delay or avoid a further pregnancy, fewer women who delivered by SVD reported that the birth experience influenced their decision (caesarean section = 163 [32%], SVD = 67 [18%], IVD = 136 [35%]; P < 0.001). CONCLUSIONS: Irrespective of mode of delivery, not conceiving following the birth of the first child is mainly voluntary. The experience of the previous birth is one of several factors affecting women's decisions to avoid a subsequent pregnancy.

Source: PubMed

Absence of conception after caesarean section: voluntary or involuntary?

Authors: Bhattacharya, S., Porter, M., Harrild, K., Naji, A., Mollison, J., van Teijlingen, E., Campbell, D.M., Hall, M.H. and Templeton, A.

Journal: BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY

Volume: 113

Issue: 3

Pages: 268-275

ISSN: 1470-0328

DOI: 10.1111/j.1471-0528.2006.00853.x

Source: Web of Science (Lite)

Absence of conception after caesarean section: voluntary or involuntrary?

Authors: Bhattacharya, S., Porter, M., Harrild, K., Naji, A.A., Mollison, J., van Teijlingen, E., Campbell, D.M.E., Hall, M. and Templeton, A.A.

Journal: BJOG: An International Journal of Obstetrics & Gynaecology

Volume: 113

Pages: 268-275

ISSN: 1470-0328

DOI: 10.1111/j.1471-0528.2006.00853.x

Abstract:

Background Women who deliver by caesarean section have been shown to be less likely to have a subsequent pregnancy. It is not clear whether this is due to a direct effect of the procedure on future fertility or due to deliberate avoidance of a future pregnancy.

Objective To investigate whether absence of conception following caesarean section is voluntary or involuntary.

Design Follow up of a population-based retrospective cohort.

Setting Grampian region, Scotland.

Population Women who had no further viable pregnancies within 5 years of an initial delivery.

Methods Cases included women who delivered their first child by caesarean section between 1980 and 1995 but had no further viable pregnancies by December 2000. Controls included women who delivered their first child during the same period, by means of either spontaneous vaginal delivery (SVD) or instrumental vaginal delivery (IVD), and who had no further viable pregnancies by December 2000. Eligible women were identified from the Aberdeen Maternity and Neonatal Databank (AMND) and sent postal questionnaires to determine the extent to which not conceiving after first delivery was voluntary and the reasons for avoiding further pregnancies. Characteristics of the different mode of delivery groups were compared using univariate techniques.

Main outcome measures Extent to which absence of conception following an initial delivery by caesarean section is voluntary.

Results Questionnaires were returned by 3204 (60%) of 5300 women identified from the AMND. Of these, 1675 women had not conceived at all during the follow-up period (median duration = 13 years). Absence of conception was voluntary in 488 (69%; 95% CI 66–73%) women following caesarean section, 340 (71%; 95% CI 67–76%) following SVD and 354 (72%; 95% CI 68–76%) following IVD. Few women considered seeking fertility treatment (caesarean section = 72 [10%], SVD = 50 [11%], IVD = 39 [8%]). Of the women who decided to delay or avoid a further pregnancy, fewer women who delivered by SVD reported that the birth experience influenced their decision (caesarean section = 163 [32%], SVD = 67 [18%], IVD = 136 [35%]; P < 0.001).

Conclusions Irrespective of mode of delivery, not conceiving following the birth of the first child is mainly voluntary. The experience of the previous birth is one of several factors affecting women's decisions to avoid a subsequent pregnancy

Source: Manual

Preferred by: Edwin van Teijlingen

Absence of conception after caesarean section: voluntary or involuntary?

Authors: Bhattacharya, S., Porter, M., Harrild, K., Naji, A., Mollison, J., van Teijlingen, E., Campbell, D.M., Hall, M.H. and Templeton, A.

Journal: BJOG : an international journal of obstetrics and gynaecology

Volume: 113

Issue: 3

Pages: 268-275

eISSN: 1471-0528

ISSN: 1470-0328

DOI: 10.1111/j.1471-0528.2006.00853.x

Abstract:

Background

Women who deliver by caesarean section have been shown to be less likely to have a subsequent pregnancy. It is not clear whether this is due to a direct effect of the procedure on future fertility or due to deliberate avoidance of a future pregnancy.

Objective

To investigate whether absence of conception following caesarean section is voluntary or involuntary.

Design

Follow up of a population-based retrospective cohort.

Setting

Grampian region, Scotland.

Population

Women who had no further viable pregnancies within 5 years of an initial delivery.

Methods

Cases included women who delivered their first child by caesarean section between 1980 and 1995 but had no further viable pregnancies by December 2000. Controls included women who delivered their first child during the same period, by means of either spontaneous vaginal delivery (SVD) or instrumental vaginal delivery (IVD), and who had no further viable pregnancies by December 2000. Eligible women were identified from the Aberdeen Maternity and Neonatal Databank (AMND) and sent postal questionnaires to determine the extent to which not conceiving after first delivery was voluntary and the reasons for avoiding further pregnancies. Characteristics of the different mode of delivery groups were compared using univariate techniques.

Main outcome measures

Extent to which absence of conception following an initial delivery by caesarean section is voluntary.

Results

Questionnaires were returned by 3204 (60%) of 5300 women identified from the AMND. Of these, 1675 women had not conceived at all during the follow-up period (median duration = 13 years). Absence of conception was voluntary in 488 (69%; 95% CI 66-73%) women following caesarean section, 340 (71%; 95% CI 67-76%) following SVD and 354 (72%; 95% CI 68-76%) following IVD. Few women considered seeking fertility treatment (caesarean section = 72 [10%], SVD = 50 [11%], IVD = 39 [8%]). Of the women who decided to delay or avoid a further pregnancy, fewer women who delivered by SVD reported that the birth experience influenced their decision (caesarean section = 163 [32%], SVD = 67 [18%], IVD = 136 [35%]; P < 0.001).

Conclusions

Irrespective of mode of delivery, not conceiving following the birth of the first child is mainly voluntary. The experience of the previous birth is one of several factors affecting women's decisions to avoid a subsequent pregnancy.

Source: Europe PubMed Central