title: Pregnancy after Caesarean section: fewer or later?
abstract: BACKGROUND
  It is unclear whether having a Caesarean section results in fewer subsequent pregnancies with longer intervals between pregnancies, an effect which may impact on the reproductive performance of a population. Our aim was to determine the implications of a Caesarean section on the subsequent fecundity and interpregnancy interval.
  
  
  METHODS
  This is a cohort study. The obstetric follow-up of primiparous women who delivered by a Caesarean section of a singleton infant in breech presentation is compared with the follow-up of women who delivered vaginally of a singleton infant after a physiological, uncomplicated pregnancy.
  
  
  RESULTS
  A total of 279 women delivered a singleton infant in breech presentation at term. From these women, 165 (59.1%) had a Caesarean section. In this group, 131 (79.4%) women had a subsequent pregnancy. In the reference group of 268 women who delivered vaginally, 208 (77.6%) became pregnant again. The median interval between birth of the first child and the beginning of the next pregnancy was 20 months for the Caesarean section group and 18 months for the reference group. No significant difference in interpregnancy interval between the different groups was found.
  
  
  CONCLUSIONS
  Women who delivered by Caesarean section at term in their first pregnancy do not have fewer second pregnancies compared with women who delivered vaginally. The interpregnancy interval between first and second pregnancy was not prolonged.
authors.affiliation: Department of Obstetrics and Gynaecology, Deventer Ziekenhuis, PO Box 5001, Deventer 7400 GC, The Netherlands.
authors.forename: J J H
authors.initials: JJ
authors.lastname: Eijsink
authors.forename: L
authors.initials: L
authors.lastname: van der Leeuw-Harmsen
authors.forename: P J Q
authors.initials: PJ
authors.lastname: van der Linden
mesh_terms: D000328:Adult; D001946:Breech Presentation / Q000453:epidemiology; D002585:Cesarean Section / Q000009:adverse effects / Q000706:statistics & numerical data; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005298:Fertility; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D013997:Time Factors