Can caesareans harm future fertility?

New research shows that women who give birth to their first child by Caesarean section may have problems conceiving future children. The study shows that women who did not have a surgical delivery for their first birth later found it easier to conceive and to have a second child naturally than those who had given birth by Caesarean.

The researchers, based at Dundee University, Scotland, and the Ninewells Hospital Medical School, also in Dundee, published their findings in the online version of the British Medical Journal. The results lead them to conclude that as many women as possible should be encouraged to have natural births. Currently, estimates suggest that one in four babies in the UK is surgically delivered.

The research team surveyed 283 women three years after they had their first child, and found that just under half of them had since become pregnant again. Of the women who had had Caesarean births, 19 per cent reported that they had experienced difficulty conceiving. Just five per cent of women whose first child was delivered naturally said that they later had problems getting pregnant. Deirdre Murphy, leader of the research team, said that the trend towards using Caesarean sections rather than instrumental deliveries when there is 'poor progress' during labour may have long term consequences. 'It is worrying', she said, adding that if women choose to have a Caesarean for 'no other reason than personal preference', they should be informed that 'it may take a long time to get pregnant later'.

The UK's National Institute of Clinical Excellence (NICE) is currently considering new guidelines for health services on the provision of Caesarean sections 'on demand'.