Resumen:ObjectiveThis study aimed to explore the association betweensexual violence and mode of delivery.DesignNational cohort study.SettingWomen presenting for routine ultrasound examinationswere recruited to the Norwegian Mother and Child Cohort Studybetween 1999 and 2008.PopulationA total of 74 059 pregnant women.MethodsSexual violence was self-reported during pregnancy usingpostal questionnaires. Mode of delivery, other maternal birthoutcomes and covariates were retrieved from the Medical BirthRegistry of Norway. Risk estimations were performed usingmultivariable logistic regression analysis.Main outcome measuresMode of delivery and selected maternalbirth outcomes.ResultsOf 74 059 women, 18.4% reported a history of sexualviolence. A total of 10% had an operative vaginal birth, 4.9% hadelective caesarean section and 8.6% had an emergency caesareansection. Severe sexual violence (rape) was associated with electivecaesarean section, adjusted odds ratio (AOR) 1.56 (95% CI 1.18–2.05) for nulliparous women and 1.37 (1.06–1.76) for multiparouswomen. Those exposed to moderate sexual violence had a higherrisk of emergency caesarean section, AOR 1.31 (1.07–1.60) and1.41 (1.08–1.84) for nulliparous and multiparous women,respectively. No association was found between sexual violenceand operative vaginal birth, except for a lower risk amongmultiparous women reporting mild sexual violence, AOR 0.73(0.60–0.89). Analysis of other maternal outcomes showed areduced risk of episiotomy for women reporting rape and a higherfrequency of induced labour.ConclusionsWomen with a history of rape had higher odds ofelective caesarean section and induction and significantly fewer episiotomies