Are women’s experiences of different modes of birth related to interventions during the previous birth? Results from the nested Lifelines ROAHD cohort

Background
Childbirth experience profoundly influences maternal postpartum wellbeing, yet the impact of various modes of birth, and interventions during the index birth, on subsequent childbirth experiences remains unclear. This study aimed to explore associations between subsequent modes of birth and childbirth experiences, while adjusting for any interventions during the index birth.
Methods
Data were obtained from the Lifelines Reproductive Origins of Adult Health and Disease cohort, a nested cohort within the Lifelines cohort. Women’s childbirth experiences were measured using the Childbirth Experience Questionnaire 2.0 (CEQ2.0). Participants included women who had given birth twice, at 25 weeks gestation or later, and had fully completed the CEQ2.0. Linear regression models assessed associations between subsequent modes of birth and CEQ2.0 scores (total and domain specific), adjusting for any interventions during the index birth. 
Results
Of the 805 included women, 58.1% had a spontaneous vaginal birth at their index birth, increasing to 83.2% at their subsequent birth. Compared with spontaneous vaginal birth, assisted vaginal birth and emergency caesarean section had a negative association with CEQ2.0 scores. After adjustment for intervention in the index birth, the strength of the negative association between assisted vaginal birth and CEQ2.0 scores slightly increased, whereas the strength of the negative association between emergency caesarean section and CEQ2.0 scores slightly decreased.
Conclusions
Understanding that interventions during the index birth may influence subsequent childbirth experiences could help to provide tailored care for women to minimize the risk of a negative childbirth experience, and ensure support if intervention becomes necessary in subsequent births.