Mode of birth and postnatal health‐related quality of life after one previous cesarean in three European countries

摘要

Abstract Background How a woman gives birth can affect her health‐related quality of life ( HRQ oL). This study explored HRQ oL 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 HRQ oL up to 3?months postpartum. The Short‐Form Six‐Dimensions ( SF ‐6D) was used to measure HRQ oL, 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 HRQ oL 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 HRQ oL score ( P ??.01) contributes to poorer HRQ oL scores. More specifically, women with a spontaneous vaginal birth had significantly higher HRQ oL 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 HRQ oL 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.