One in Three Women Infertile After Caesarean
Even More are Too Traumatized to Give Birth Again
Jul 11, 2009
A study in the British Journal of Obstetrics and Gynaecology has found that almost half of all women who have a caesarean section birth for their first child, don't have any more children. Of these, one in five have chosen not to have more children because they are too traumatized by the surgery and one in three are physically unable to because of caesarean-caused infertility problems.
The rate of post-traumatic stress disorder was six times higher than in first time mothers who had given birth vaginally.
Caesareans Can Cause Long Term Problems
Professor Walker from Leeds University Department of Pediatric Obstetrics and Gynaecology in the UK, followed 500 women through their pregnancy and delivery. Some of these women had vaginal births and some had caesarean sections.
In the group of 165 caesarean mothers, a rather alarming 42.4% did not have any subsequent children and of these, 19% said they could not bear to go through the pain of surgery again and 30% were affected by secondary infertility, preventing them from having more children without assisted conception.
Professor Walker, lead author of the study, said
"When doctors and mothers assess the risks of Caesareans, they generally only think about what the risks are at that time and ignore the impact they might have five years down the line."
Why Can Caesareans Damage Fertility?
There are several complications which can cause infertility. These include:
- Excessive scarring of the uterus, preventing an embryo from implanting
- Severe blood loss which requires the surgeon to remove the woman's uterus in order to save her life
- Pelvic infections resulting from surgery, which can block the fallopian tubes and prevent conception
- Scar tissue can grow over the ovaries, preventing ovulation, and in the fallopian tubes
- Miscarriages caused by the placenta being unable to embed in the wall of the womb securely
- Uterine rupture during pregnancy, causing loss of the baby and a life threatening danger to the mother
- Older age of the mother at the time of her caesarean can push her into subfertility, possibly due to the physical strain of surgery.
A Norwegian study supported Professor Walker's findings on trauma following caesarean but rejected that the lower childbirth rates were related to surgical risks. The Norwegian Institute of Public Health followed 600,000 women having their first children between the years 1967-1996, and subsequent births up to 2003 and they found that 12% more women failed to have a second child if they had had a caesarean, compared with mothers who gave birth normally.
Caesarean rates in the UK are around 25% and are a staggering 36% in the USA. 20 years ago the rate was only 5% and real life threatening emergencies only occur in around 5% of cases. Health professionals should work at reducing these spiralling rates to preserve the emotional health and fertility of women.
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