Women's preferences for mode of second birth—A prospective study of two Israeli birth cohorts

Heidi Preis*, Pnina Mor, Sorina Grisaru-Granovsky, Arnon Samueloff, Rinat Gabbay-Benziv, Rony Chen, Michal Eisner, Joseph Pardo, Yoav Peled, Arnon Wiznitzer, Yael Benyamini

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Introduction: Various biopsychosocial factors affect women's preferences with respect to mode of birth, but they are usually not examined simultaneously and prospectively. In the current study, we assessed the contribution of personal characteristics of first-time mothers, their prior prenatal perceptions, events during birth, and subjective birth experiences, on their preference about mode of second birth. Methods: This was a secondary analysis of two prospective birth cohort studies. Participants included 832 primiparous women recruited mostly from women's health centers in Israel, and through natural birth communities and cesarean birth websites. Women completed questionnaires prenatally and were followed up at 6-8 weeks postpartum to understand their preferences for a second birth. Results: Regression models indicated that after vaginal first birth, being less religious, believing that birth is a medical process, and having a negative experience increased the odds of preferring primary cesarean for the second birth. After cesarean birth, being more religious, having higher education, conceiving spontaneously, having a more negative birth experience, and perceiving better treatment from the staff during birth contributed to preferring vaginal birth for the second birth. Conclusions: Religiosity is central to women's preferences, probably because of its association with the desire to have many children. Modifiable factors, such as women's beliefs about the nature of birth, their overall birth experience, and their perceived treatment from the staff, could influence the uptake of having vaginal births. Intrapartum care that is empathic and encouraging, along with education about modes of birth, could help decrease cesarean birth rates.

Original languageEnglish
Pages (from-to)237-245
Number of pages9
Issue number2
StatePublished - 1 Jun 2020


FundersFunder number
Israel National Institute for Health Policy Research165R‐2011
Israel Science Foundation351/16
Tel Aviv University


    • beliefs about birth
    • biopsychosocial
    • birth experience
    • mode of birth
    • religiosity


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