Does birth center care during a woman's first pregnancy have any impact on her future reproduction?
BACKGROUND
Women's experiences of childbirth may affect their future reproduction, and the model of care affects their experiences, suggesting that a causal link may exist between model of care and future reproduction. The study objective was to examine whether the birth center model of care during a woman's first pregnancy affects whether or not she has a second baby, and on the spacing to the next birth.


METHODS
Between October 1989 and July 1993, a total of 1860 women at low medical risk in early pregnancy, who participated in a randomized controlled trial of in-hospital birth center care versus standard care, gave birth. The 1063 primiparas in the trial, 543 in the birth center group and 520 in the standard care group, were included in a secondary analysis in which women's personal identification codes were linked to the Swedish National Birth Register, which included information about their subsequent birth during the following 7 to 10 years. Time to an event curves were constructed by means of the Kaplan Meier method.


RESULTS
The observation period after the first birth was on average 8.8 years in the birth center group and 8.7 years in the standard care group. No statistical difference was found between the groups in time to second birth, which was 2.85 and 2.82 years, respectively (median; log-rank 1.26; p=0.26).


CONCLUSIONS
A woman's model of care, such as birth center care, during her first pregnancy does not seem to be a sufficiently important factor to affect subsequent reproduction in Sweden.
Gottvall
Karin
K
Department of Nursing, Karolinska Institutet, Stockholm, Sweden.
Waldenström
Ulla
U
D000328:Adult; D001721:Birth Intervals; D016550:Birthing Centers / Q000458:organization & administration*; D003266:Continuity of Patient Care; D003696:Delivery Rooms / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration*; D016294:Models, Nursing; D009721:Nurse Midwives; D010298:Parity; D010348:Patient Care Team; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011247:Pregnancy; D012042:Registries; D012098:Reproduction; D011795:Surveys and Questionnaires; D013548:Sweden