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
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
* scar tissue on and around the ovaries or in the fallopian
tubes (preventing ovulation or conception if/when ovulation does
* 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
* 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
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
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
(1) BJOG: An International
Journal of Obstetrics & Gynaecology.
Vol 106:3. pp.