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

ORCID
0000-0002-8316-6422
Affiliation
Department of Public Health, Interuniversity Centre for Health Economics Research (I-CHER), Vrije Universiteit Brussel
Fobelets, Maaike;
ORCID
0000-0002-6689-4479
Affiliation
Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel & Department of Nursing and Midwifery, Nursing and Midwifery research group, Universitair Ziekenhuis Brussel
Beeckman, Katrien;
ORCID
0000-0002-6598-9505
Affiliation
Department of Public Health, Biostatistics and Medical Informatics Research group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel
Buyl, Ronald;
Affiliation
School of Nursing and Midwifery, Trinity College Dublin
Daly, Déirdre;
ORCID
0000-0003-4444-1505
Affiliation
University of Ulster, Institute of Nursing and Health Research, Jordanstown
sinclair, marlene;
ORCID
0000-0003-0865-7050
Affiliation
School of Nursing and Midwifery, National University of Ireland
Healy, Patricia;
GND
1152273736
ORCID
0000-0001-5652-6886
Affiliation
Medizinische Hochschule Hannover, Forschungs- und Lehreinheit Hebammenwissenschaft
Grylka-Baeschlin, Susanne;
Affiliation
Universita degli Studi di Genova
Nicoletti, Jane;
GND
123346924
ORCID
0000-0001-6348-0054
Affiliation
Medizinische Hochschule Hannover, Forschungs- und Lehreinheit Hebammenwissenschaft
Groß, Mechthild;
ORCID
0000-0002-2690-1347
Affiliation
IRCCS Azienda Ospedaliera Universitaria S. Martino IST
Morano, Sandra;
ORCID
0000-0002-7235-3759
Affiliation
Department of Public Health, Interuniversity Centre for Health Economics Research (I-CHER), Vrije Universiteit Brussel
Putman, Koen

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.

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