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You may have heard the claim\u2014especially from the \u201cnatural birth<\/a>\u201d enthusiast crowd\u2014that spontaneous, uninduced labor and vaginal delivery is ideal, both for the health of the baby and the mother. Research also indicates<\/a> that the vast majority of women desire to give birth vaginally [1]. In fact, the desire for a VBAC (vaginal birth after Cesarean)<\/a> indicates that there are many women who have had a prior Cesarean who hope to have at least one vaginal birth experience. <\/p>\n\n\n\n So how does a first birth impact a second birth? Is there a causal relationship between your first labor and the next one? In other words\u2014are you destined (or, if you had a traumatic first birth<\/a>, doomed) to repeat your first experience?<\/p>\n\n\n\n A 2000 study<\/a> published in the British Journal of Obstetrics and Gynecology<\/em> tabulated birth data over 17 years to answer the questions above. The results were both surprising and reassuring [2]. <\/p>\n\n\n\n The short answer is that there is<\/em> a correlation between the first and second births, but that relationship is not as neat and tidy as we may want to believe.<\/p>\n\n\n\n Researchers S. D. Mawdsley and T. F. Baskett evaluated data from Grace Maternity Hospital in Halifax, Nova Scotia, to find the 13,813 women who had a vaginal delivery at term of a single baby in a head down position, and also delivered a second, single head down baby at the same hospital (twins and complex positions were excluded in this study). <\/p>\n\n\n\n Mawdsley and Baskett then investigated two questions: <\/p>\n\n\n\n For the vast majority of women in their first pregnancy, spontaneous labor that concludes in a vaginal delivery has a very high correlation with a second spontaneous labor and vaginal delivery (94.6%). The chances slightly diminish with labor induction<\/a> (any artificial method to initiate labor) or augmentation (medication to continue a stalled labor). While those who were induced<\/a> for a first pregnancy had a 91% chance of spontaneous delivery for their second, women whose labor stalled and received augmented labor support had an 89% chance for their second.<\/p>\n\n\n\n So, if your first pregnancy ended in a vaginal delivery, the good news is that you have a very high chance of a second pregnancy unfolding in the same way. And even if labor stalled, or if you were induced for your first pregnancy, you still have an extremely high likelihood of a spontaneous delivery for your second baby.<\/p>\n\n\n\n And yet, this study reveals a lot more than meets the eye. For women who had various kinds of interventions in their first delivery, the chances of a repeat of those interventions and of a C-section delivery increased with the second birth. For example, women whose first babies were delivered via vacuum, had a 2.5% chance of repeat vacuum delivery for their second baby. Whereas women who had a spontaneous first delivery had a mere 0.4% chance of vacuum delivery for their second. <\/p>\n\n\n\n Women whose first baby was delivered via forceps had an increased occurrence of C-section deliveries for their second (2.9%), compared to women who had spontaneous first deliveries (1.4%). They also had a much higher likelihood of a repeat forceps delivery for their second baby (10.6%) compared to a slim occurrence (2.6%) for women whose first delivery was spontaneous.<\/p>\n\n\n\n But even more surprising, the method of managing a second labor<\/em> had the greatest impact on the second delivery than any other factor. Among all of the women in the study (13,831), those who received augmented labor support (1,034) had a significantly higher rate of C-section for their second birth (7.6%) compared to women who received no labor augmentation and were not induced (1.1%). Women who were induced for their second baby had a 3.3% rate of C-section delivery. <\/p>\n\n\n\n When the second labor unfolded on its own, without induction or augmentation, the vast majority of babies were born without interventions (94.6%). But if the second labor was started via induction, only 88.9% were born without interventions, and if the mother received augmentation, that number dropped to 76.8%. <\/p>\n\n\n\n When the second labor unfolded on its own, without induction or augmentation, the vast majority of babies were born without interventions (94.6%). But if the second labor was started via induction, only 88.9% were born without interventions, and if the mother received augmentation, that number dropped to 76.8%. <\/p><\/blockquote><\/figure>\n\n\n\n In addition, women whose labor was augmented had a 14.1% occurrence of delivery via forceps, compared to just 4% of women whose labor progressed without intervention. Delivery via forceps is also much higher among women who were induced for their second baby at a high 8.2%.<\/p>\n\n\n\n Below is a table that shows the full results of the study\u2014highlighting the relationships between how a second labor was managed, and how the second baby was delivered.<\/p>\n\n\n\nWhat the research says<\/span><\/h2>\n\n\n\n
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The good news: one vaginal birth often yields another<\/span><\/h2>\n\n\n\n
<\/td> Spontaneous Labor, 2nd Delivery <\/strong><\/td><\/tr> Spontaneous Labor, 1st Delivery<\/strong><\/td> 94.6%<\/td><\/tr> Induced Labor, 1st Delivery<\/strong><\/td> 91%<\/td><\/tr> Augmented Labor, 1st Delivery<\/strong><\/td> 89%<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n The role of birth interventions in delivery outcomes<\/span><\/h2>\n\n\n\n
The management of labor is the most important factor determining delivery outcomes <\/span><\/h2>\n\n\n\n