Effect Of Second-child Intent On Delivery Mode After Chinese Two-child Policy Implementation

Objectives:To assess the influence of second-child intent on nulliparous women’s delivery preferences and final delivery modes,particularly caesarean delivery on maternal request(CDMR),after the implementation of China’s two-child policy.Materials and Methods:It’s a cross-sectional and prospective observational study conducted in a tertiary teaching hospital in Chongqing,China.1,000 low-risk nulliparous women were initially involved,and they were divided into two groups based on the intent to have a second child.Finally,814 women who completed all interviews remained for analyses.Their Preferred mode of delivery in second trimester and at admission and their final delivery mode,especially CDMR were obtained.Results:814 women who completed all interviews remained for analyses,in which 51.2%of women intended to have a second child.The preference for CD at the second trimester between the intent and no-intent group was 6.2%vs.17.9%(aRR:0.35,95%CI:0.20-0.63)and increased to 24.2%vs.37.3%(aRR:0.65,95%CI:0.45-0.94)at admission,respectively.Finally,the overall CD rates between the two groups were 41.0%vs.50.4%(aRR:0.84,95%CI:0.60-1.18),and the CDMR rates were 16.7%vs.29.0%(aRR:0.56,95%Cl:0.37-0.86),respectively.Conclusions:Women who intend to have a second child are less likely to request a CD,and high rates of CD and CDMR in nulliparous women may be decreased after the implementation of China’s two-child policy.