Sunday, December 13, 2009

C-Sections Cause Infertility or Emotional Trauma for 1 in 3 Women

by Danelle Frisbie ©2003
statistics updated for 2009


"When doctors and mothers assess the risks of cesareans, they generally only think about what the risks are at that time and ignore the impact they might have five years down the line," says Dr. James Walker, who recently led a study on the long term implications of cesarean section. "Neither the medical profession nor women themselves realize the extent of the long-term problems cesarean sections can cause."

In the study, published in the British Journal of Obstetrics and Gynaecology (1), it was found that 43% of women (almost half!) who have a c-section for their first birth do not have any additional children. Of these women, 20% have chosen not to birth more babies because they report being too traumatized by the first cesarean surgery they had to endure. Women who experienced c-section surgery were six times more likely to have post-traumatic stress disorder as a result of their surgical birth than women who had birthed their babies vaginally. 30% were found unable to become pregnant again due to cesarean-caused infertility complications.

Walker led this study at Leeds University's Department of Pediatric Obstetrics and Gynocology (UK) which followed 500 women throughout their pregnancies and births.

Of the group, 165 mothers who had c-section births (43%) chose not to have any additional children in the years to follow their first cesarean birth. 20% of the women who had a c-section with their first baby reported that they could not handle going through the pain (emotional and physical) of cesarean surgery again. 30% of mothers in the study who had cesarean births were impacted by secondary infertility which prevented them from having any more children without additional means of conception assistance.

In a literature review on cesarean birth research, Walker reports that it is common to find this 1 in 3 infertility rate among women after having a "routine" c-section.

C-section surgery may result in infertility as a result of several things including:

* scarring of the uterus (preventing a hospitable environment in which an embryo can implant)

* hemorrhaging (blood loss) sometimes requiring a hysterectomy

* pelvic infections as a result of the invasive abdominal surgery - which can lead to blocked fallopian tubes (preventing conception)

* scar tissue on and around the ovaries or in the fallopian tubes (preventing ovulation or conception if/when ovulation does occur)

* anesthetic shock or other complications (resulting in additional surgical damage or need for hysterectomy)

* miscarriages due to the placenta being unable to embed securely and grow in the wall of a scarred uterus

* uterine rupture during pregnancy (rupture during pregnancy or birth is very rare, but can occur)

* mothers who are out of shape, stressed, or physically or emotionally weakened at the time of a first c-section can experience infertility due to the physical pain and stress of having major surgery

Walker's findings were validated by another study conducted in Norway between 1967-2003. The Norwegian Institute of Public Health (NIPH) followed 600,000 women after they had their first child during the initial 30 years of this large-scale study. NIPH found that 12% more women did not have a second child if they had experienced c-section with their first baby than women who birthed vaginally.

Walker reminds us, "With other health issues people think about the future, but when they have cesarean sections, which carry an even greater risk of losing a second baby than taking hormone replacement therapy or having cancer, they make the decision without knowing or thinking about the risks involved."

Current (2009) cesarean rates in the UK (where Walker's study was conducted) sit at 25% while c-section rates in the United States have skyrocketed to 37% (up from 32% in 2007). Canada's cesarean rate is at 28%.

35 years ago the U.S. and Canada shared a 5% c-section rate and just 20 years ago the UK still had a low 5% c-section rate. Professional midwives attending homebirths today continue to demonstrate a typical 3-5% cesarean rate for their clients world-wide. Birth research suggests that cesarean surgery is only truly needed in about 3% of all cases of human birth, and should never surpass 10%, or we find that women's and babies' health suffers across the board as a result. Approximately 97% of the time, birth happens perfectly fine on its own when left alone. When babies come gently into this world, the complications (for both mom and baby) do not exist that we currently find due to the major abdominal surgery of unnecessary cesarean section.


Notes:

(1) BJOG: An International Journal of Obstetrics & Gynaecology. Vol 106:3. pp. 227-232




For more information on the statistics and implications of c-section also see:

International Cesarean Awareness Network


Born in the USA by Dr. Marsden Wagner

Pushed by Jennifer Block

The Caesarean by Dr. Michel Odent

Gentle Birth, Gentle Mothering by Dr. Sarah Buckley

Birth & Breastfeeding by Dr. Michel Odent

Ina May's Guide to Childbirth by Ina May Gaskin

The Thinking Woman's Guide to Better Birth by Henci Goer


19 comments:

  1. Excellent post! So many people are unaware of the life long consequences, both physical and emotional, of cesarean sections. It's not just in and out in a hour and here's your new baby.

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  2. What about the women that have no choice on whether or not they got a c-section? My son is 18 months old now and he had to be born via EMERGENCY c-section, my husband and I have been trying to conceive another child (for a year now) with no luck. Could this be the problem??? I am only 22.

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  3. Anonymous -
    Although it is difficult to know in any particular woman's case, it COULD very well be the reason for difficulty in getting pregnant again. Whether c-section is done for elective or necessity reasons, does not make much of a difference on the body of a woman (although it does make a difference for baby -- triggering labor in his/her own time is MUCH more beneficial, less harmful than elective c/s).

    However, it does also take the body 2 full years to completely recover and build back up after a c-section birth, so I would suggest waiting until your child is 2 to even attempt another pregnancy. You want to be fully certain that you are in tip-top shape and have all the nutrients stored that you need to sustain another healthy pregnancy.

    Check out your options for VBAC as well with baby #2 if this interests you. There is no reason to automatically repeat c/s - http://www.drmomma.org/2009/09/vbac-hbac-vbamc-resources.html

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  4. My C Section absolutely caused emotional trauma and kept me from having another child for 21 years! My C Section was completely unecessary and just for the doctor's convenience. It made me fear and distrust hospitals and doctors as a result.

    I am glad to say that I had a VBAC (despite being rushed to the hospital for fetal distress) thanks to a tenacious and caring midwife on my side.

    For those interested, my VBAC story is here:
    http://parentingbythelightofthemoon.blogspot.com/2010/04/copied-from-my-previous-blog-original.html

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  5. I have very serious PTSD about my first birth, via emergency c-section. It took me 11 months to get pregnant when we started trying after my son was 18 months old. We finally did get pregnant, and I am education myself as much as I can to have this baby naturally. We are having our VBAC at a birth center and are currently taking Bradley classes.

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  6. This is a great post! My first was a natural, term birth (with a posterior baby, ouch! lol) and home hours later. It was a 2 day labour but only 5 hours in the hospital and just lovely. My second was an emergency (classical) caesarean at only 25 weeks (after losing one of our twins in the pregnancy). That was just awful... I'm now pregnant with our third and despite being told I am not a candidate to VBAC given my scar type, I have every intention of trying with this baby! We have researched the statistics thoroughly and we know that an attempt at a VBAC (with precautions in place for a caesarean birth) is the safest method to birth this baby.

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  7. Do you happen to have the title of the journal study?

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  8. I think part of the problem is that there is no real counseling or something of the like available to women when it a c-section is nessassary. I had a c- section when I had my daughter (now 4yrs) and was completely at piece with the idea. My water broke but I never actually started labor. I went in to the situation knowing what to expect after talking to my counselor, and many family members over time before the day arrived, leaving me prepared for the days possibilities. I dont have other kids but that is my choice beacause of birth control

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  9. This is an excellent post! My first was a normal, phrase beginning (with a rear infant, ouch! lol) and house a long time later. It was a 2 day manual work but only 5 a long time in the medical and just attractive. My second was an crisis (classical) cesarean at only 25 months (after dropping one of our twin babies in the pregnancy). That was just horrible... I'm now expecting with our third and despite being informed I am not an applicant to VBAC given my scratch form, I have every objective of trying with this baby! We have investigated the data thoroughly and we know that an effort at a VBAC (with safety measures in location for a cesarean birth) is the most secure strategy to beginning this infant.

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  10. I had one child 12 yrs ago C-section and now unable to have another child. I always wondered why. Good info. I regret it.

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  11. me and my partner have been trien for nearly to years so this study is a 100% accurate and what should i do is there any options for me i want to give my twin girls a little brother or sister one day and the waits killing me my c section was an a emergency one

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  12. Melinda GallupMay 11, 2013 4:32 AM

    I had no choice. My son was stuck and I had to have a c-section or we both would have died. He turned 10 years old this past March, and we have been trying for another baby for 9 years and 3 months. It's HEARTBREAKING that we cannot have another baby without fertility treatments. We can't afford them without mortgaging our home, so we simply cannot do treatments. The anger and sadness of infertility has worn me down.
    My c-section itself almost killed me because my doctor was an idiot and left my uterine artery open. I was bleeding internally for 16 hours before they even noticed that I was as white as a ghost, with gray lips and no blood pressure.

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    Replies
    1. I know what your going through I had a c-section as well 5 years ago and we have been ttc for 2 1/2 years and we were told we had unexplained secondary infertility and we would probably only be able to concieve with treatments which we cannot afford either. I wish you all the best.

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    2. Same here... Emergency C-section 4 years ago. Have been trying to conceive for 3 years... I am already well into my 30s and it is heartbreaking every month. My doctor, the same one who performed the section wont tell me that there is anything wrong... but I know that there is. Best wishes for all.

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    3. I am having the same issue I had my first child vaginal when I was 19, then 11 months later I got pregnant with my second child and she had to be delivered emergency c section. It has been 3 years since she was delivered by c section and now me and my husband have been ttc since November and still no luck. Now I know that this could very well be our problem. Hope everyone the best of luck in ttc

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    4. My son is nearly three, - emergency c section as well. I went into the ER after my water broke just under 36 weeks, and even after the induced me, I never dialated. I cried from the time the doctor told me it was necessary until I finally made it out of surgery with my baby boy. Now, I have had three miscarriages up to date and doctors won't even take me serious and investigate. No one has confirmed infertility, saying that I'm still young to be diagnosed as infertile. It would make me feel remarkably better, I feel like it would anyway, if I just knew. . . If everyone would stop telling me I was crazy. :/

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  13. I had a c-section 5 years ago... When my son turned 2 1/2 my husband and I started trying to have another with no luck...... I have had all the things listed above checked and was told that none of those was my problem the only thing I got was that I now have unexplained secondary infertility and my chances of ever concieveing again are slim to none..... Its HEARTBREAKING.... I have had many test done and I still have no answers and I cannot afford IVF because its to expensive so I will never be able to get pregnant again.... My scare from my c-section isn't straight and goes up farther on one side then the other.... My doctor doesnt even care that I am struggling now to get pregnant I have a miscarriage in 2011 and the only thing my doctor said was she didnt see anything wrong and sent me to home....
    my advice if you can prevent a c-section then BEG until you dont have to have one if you have no choice like others then remember that you might only have one child :(

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  14. My daughter went thru the same thing, she went to a specialist and her uterus is way too high due to the scar tissue she is having surgery to remove it all so that she can have another child, wish her luck

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  15. I had to have an emergency c-section on aug. 31, 2012 which resulted in losing my second daughter... me and my husband have been having unprotected intercourse since about 10 months after that and still nothing. do you think that it is possible that i will not be able to have another child as well???....

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