Mode of delivery and subsequent fertility

STUDY QUESTION When compared with vaginal delivery, is Cesarean delivery associated with reduced childbearing, a prolonged inter-birth interval or infertility? SUMMARY ANSWER Women whose first delivery was by Cesarean section were not significantly different from those who delivered vaginally with respect to subsequent deliveries, inter-birth interval or infertility after delivery. WHAT IS ALREADY KNOWN Some studies have suggested that delivery by Cesarean section reduces subsequent fertility, while others have reported no association. STUDY DESIGN, SIZE, DURATION This was a planned secondary analysis of the Mothers' Outcomes After Delivery study, a longitudinal cohort study. This analysis included 956 women with 1835 deliveries, who completed a study questionnaire at 6-11 years (median [interquartile range]: 8.1 [7.1, 9.8]) after their first delivery. PARTICIPANTS/MATERIALS, SETTING, METHODS Exclusion criteria regarding the first birth were: maternal age 50 years, delivery at