Not all births are equal: Delivery type and fertility intentions by age at first childbirth

As maternal age at first birth continues to rise in Italy, this study investigates whether and how the mode of delivery at first birth is associated with subsequent fertility intentions, with a specific focus on differences by maternal age at childbirth. Using weighted data from the Fertility Over Forties survey (2024) on 2375 Italian mothers with one child, we estimate predicted fertility intentions by age at first childbirth (under and over age 35), accounting for delivery type and other characteristics of the delivery. Results show that the mode of delivery at first birth is significantly associated with fertility intentions, with more medicalised or interventional deliveries generally linked to lower intended fertility. At the same time, a strong age gradient emerges: mothers aged 35 and older report consistently lower fertility intentions across all delivery types. Differences across delivery modes within age groups are comparatively modest, and we do not find clear evidence that the association between delivery type and fertility intentions varies substantially by maternal age or healthcare setting. We discuss the implications of these results in light of the recent literature on reproductive careers and maternal age and call for greater attention to mothers’ birth experiences and well-being in demographic research.