Objective: To determine the risk of cesarean delivery for women who th
emselves were born via operative delivery. Methods: A linked data base
was constructed between the birth certificates of individuals born in
Utah during 1947-1957 (parental cohort) and who subsequently became a
parent of offspring born in Utah between 1970-1991 (offspring cohort)
. Parental cohort women (cases) who had been delivered operatively (ce
sarean delivery, mid- or high forceps) as well as women who had a sibl
ing delivered by an operative procedure were matched (1:2) with parent
al-cohort women born by spontaneous vaginal delivery (controls). Both
cases and controls were selected based on having a record of at least
one delivery in Utah during 1970-1991. Results: Women who were deliver
ed by cesarean were at increased risk of subsequently delivering their
children by cesarean (odds ratio [OR] 1.41, 95% confidence interval [
CI] 1.18-1.70; P < .001). Progressive risk was associated with parenta
l delivery by mid- or high forceps (OR 1.72, 95% CI 1.20-2.47; P = .00
4), parental cesarean because of cephalopelvic disproportion alone (OR
1.83, 95% CI 1.16-2.88; P = .01), or parental cesarean for dysfunctio
nal labor (OR 5.97, 95% CI 1.5-23.6; P < .001). The attributable risk
for cesarean delivery to the contemporary population is 3.5%.