Caesareans linked to risk of infertility
Posted on June 4th, 2019

Courtesy The Guardian (UK)

One in three women cannot have a second baby after emergency operation, study claims

Almost half of all women who give birth to their first baby by emergency Caesarean section do not have another child – with nearly one in three suffering long-term infertility problems and one in five too traumatised to go through childbirth a second time.

In the first study of its kind, one of Britain’s most eminent obstetric experts found that three times more women had long-term infertility problems after undergoing a Caesarean section than those who had experienced a natural birth.

It also found that six times more first-time mothers who had a Caesarean section suffered trauma sufficient to prevent them having another child, than those who gave birth normally.

Caesarean birth has celebrity advocates including Victoria Beckham and Liz Hurley. Obstetricians admit it has become a lifestyle choice for those ‘too posh to push’.Advertisement

The research paper, published in the British Journal of Obstetrics and Gynaecology , followed 500 women who had given birth, some naturally and some by Caesarean, for five years after the delivery of their first child.

‘Neither the medical profession nor women themselves realise the extent of the long-term problems Caesarean sections can cause,’ said Professor James Walker, head of the academic unit of paediatric obstetrics and gynaecology at Leeds University and co-author of the study.

‘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,’ he said.

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

Of the 165 women in the study who had a Caesarean section, 42.4 per cent did not have any more children- 30 per cent for reasons of infertility and 19 per cent because they could not bear to go through childbirth again. In contrast, just 29.1 per cent of the 148 women who underwent a normal birth failed to have further children. Serious injury as a result of Caesarean section is rare but damage can include major abdominal surgery, infections, haemorrhage, injury to other organs and anaesthesia complications.

Long-term complications in subsequent pregnancies include the risk of a ruptured womb and placental problems that can lead to infertility and increased respiratory problems in the baby.

According to the Royal College of Obstetricians and Gynaecologists, there has been a fall in the number of senior obstetricians in labour wards, resulting in increased reliance on unsupervised junior doctors.

‘Junior obstetricians simply do not know how to respond to complex labours except by performing Caesarean sections,’ said Dr Maggie Blott, a consultant obstetrician at King’s College Hospital, London. ‘The result is too many Caesareans are taking place, too many of which are performed by doctors who don’t necessarily have enough experience to guarantee their patients’ safety.’

Anna-Marie Bennett won damages from her local hospital last year after an emergency Caesarean by a junior obstetrician in 1997 left her in a coma for seven days. ‘I did not want a Caesarean and, if there had been a senior obstetrician on hand to advise, the hospital has admitted I would not have been given one,’ she said.

Ms Bennett lost 28 units of blood, an ovary and a fallopian tube, and suffered such extreme internal and external scarring that when she became pregnant a second time and underwent another Caesarean, the doctors perforated her bowel.

The findings have, however, been dismissed by Nicholas Fisk, professor of obstetrics and gynaecology at London’s Imperial College. ‘This survey is based on unreliable statistics taken from a group of women who were given emergency Caesareans,’ he said. ‘It is certainly true that the rates of Caesareans are going up but that is because doctors are now allowing women to choose, which is to be warmly welcomed.’

Over the past 20 years, the proportion of Caesareans has increased from 5 per cent to 21.5 per cent. This makes the UK the country with third-highest rate of Caesarean sections in the world.

Almost half of all obstetricians questioned in a recent Royal College of Obstetricians and Gynaecologists survey thought the rate too high and admitted that many operations were unnecessary. The college was so alarmed by its findings that it called for a clampdown – but already in many private hospitals the proportion of women opting for Caesarean births is estimated to be as high as 60 per cent.The rise in rates has continued despite the recent deaths of Tracey Sampson, 36, and Laura Touche, 31, at the Portland Hospital in London.

‘A Caesarean is an operation very similar in seriousness to a hysterectomy,’ said Dr Sharon Oates, a consultant in obstetrics and gynaecology at the Royal Shrewsbury Hospital which, at 10.4 per cent, has the lowest rate of Caesareans in the country.

‘The normalising of the operation throughout society has lulled women into a false sense of security. It’s only a matter of time before we have a sharp increase in maternal mortality because of Caesarean sections. We are beginning to see it happen already.’

https://www.theguardian.com/uk/2002/apr/21/medicalscience.research

C-Section May Affect Future Fertility

By Salynn Boyles Courtesy WebMed

Surveyed Women Had Harder Time Getting Pregnant After Surgery

Jan. 14, 2004 — Women who deliver their first child by C-section may have more trouble getting pregnant again, a new report from Scotland suggests.

When compared with moms who had difficult deliveries ending in vaginal birth, women in the study who had cesarean deliveries said they had more problems getting pregnant after the birth of their first child. Roughly 20% of the cesarean mothers reported difficulty conceiving a second child, compared with 5% of women who had vaginal deliveries aided by instruments like forceps.

But a childbirth expert who commented on the study for WebMD says fertility issues are way down the list of concerns regarding cesarean section.

“If there is an effect on fertility, it is certainly a very small one,” says California ob-gyn Bruce Flamm, MD, who has written two books on cesarean deliveries. “My concern is that this will divert attention from the much more significant issues surrounding C-section. Most women will not have any trouble getting pregnant again after having this operation, but there are other big risks they need to consider.”

One Response to “Caesareans linked to risk of infertility”

  1. aloy Says:

    All that is fine. But how come this particular doctor was at the same place donkey years while others go on transfer?. And what about the wealth accumulated?.

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