This was a secondary data analysis study, using data from the First Baby Study (FBS) [34 (link),35 (link)]. The FBS, was an observational prospective cohort study, designed to investigate the association between mode of first birth and subsequent childbearing. Information about the design of the FBS, sample size and power calculations, recruitment and enrollment, and sample representativeness have been reported previously [34 (link),35 (link)]. This paper followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The S1 Checklist can be seen in Supporting Information.
FBS participants were recruited through childbirth education classes, hospital tours, targeted mailings, intra-hospital postings, posters, flyers and newspaper ads throughout the state of Pennsylvania. Women were eligible to participate in the FBS if they were pregnant, expecting their first child, aged 18–35 years old, with a singleton pregnancy, English or Spanish speaking, and planning to deliver in a hospital in Pennsylvania. Women were not eligible if they were planning to deliver at home or in a birthing center not affiliated with a hospital, planning for the child to be adopted, planning to have a tubal ligation at the time of birth, or if they had a prior pregnancy of 20 weeks gestation or longer. Women who delivered before 34 weeks gestation were also excluded. These inclusion and exclusion criteria were chosen based on the primary goal of the FBS—to study the association between mode of first birth (vaginal or cesarean) and subsequent childbearing [34 (link),35 (link)]. The participants delivered in 2009 to 2011 at hospitals in Pennsylvania. Investigation of the representativeness of the study sample indicated that the participants in this study were significantly more likely to be white non-Hispanic, married, and to have college degrees and private insurance than women delivering their first child in Pennsylvania as a whole, but were not different in rate of cesarean birth [34 (link)].
Interviews were conducted by telephone by trained interviewers employed by the Penn State Center for Survey Research, using a computer-aided telephone interview system. Participants were interviewed by telephone in their third trimester (baseline) and again at 1, 6, 12, 18, 24, 30 and 36 months postpartum. The birth certificate and hospital discharge data for the births were obtained and linked to the survey data.
FBS participants were recruited through childbirth education classes, hospital tours, targeted mailings, intra-hospital postings, posters, flyers and newspaper ads throughout the state of Pennsylvania. Women were eligible to participate in the FBS if they were pregnant, expecting their first child, aged 18–35 years old, with a singleton pregnancy, English or Spanish speaking, and planning to deliver in a hospital in Pennsylvania. Women were not eligible if they were planning to deliver at home or in a birthing center not affiliated with a hospital, planning for the child to be adopted, planning to have a tubal ligation at the time of birth, or if they had a prior pregnancy of 20 weeks gestation or longer. Women who delivered before 34 weeks gestation were also excluded. These inclusion and exclusion criteria were chosen based on the primary goal of the FBS—to study the association between mode of first birth (vaginal or cesarean) and subsequent childbearing [34 (link),35 (link)]. The participants delivered in 2009 to 2011 at hospitals in Pennsylvania. Investigation of the representativeness of the study sample indicated that the participants in this study were significantly more likely to be white non-Hispanic, married, and to have college degrees and private insurance than women delivering their first child in Pennsylvania as a whole, but were not different in rate of cesarean birth [34 (link)].
Interviews were conducted by telephone by trained interviewers employed by the Penn State Center for Survey Research, using a computer-aided telephone interview system. Participants were interviewed by telephone in their third trimester (baseline) and again at 1, 6, 12, 18, 24, 30 and 36 months postpartum. The birth certificate and hospital discharge data for the births were obtained and linked to the survey data.
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