With the rise in the number of cesarean deliveries, experts (and hopeful moms-to-be) have worried that having a c-section might negatively impact future fertility. Happily, a new study finds that a surgical delivery doesn't hurt a woman's chances of becoming pregnant with a second (or third...) bundle of joy.
Having a cesarean delivery comes with great reward (your beautiful baby!) but also, it has long been suspected, the possibility that it might make it harder to become pregnant again. In fact, previous studies have shown that women who deliver via c-sections generally end up having fewer babies compared to women who give birth vaginally. This has understandably caused concern, particularly since more and more women are having c-sections these days. But new research puts the concerns about fertility after a cesarean delivery to rest, finding that having a c-section doesn't cause problems with future fertility.
For their study published in the journal Human Reproduction, researchers in the UK looked at data from over one million first time mothers who all had healthy pregnancies and gave birth to singleton babies between 2000 and 2012. They found that 21 percent of the moms-to-be ended up needing c-sections. Only 4 percent of those cesarean deliveries were elective.
When comparing the number of subsequent births in those moms who delivered their first baby vaginally versus those who gave birth via c-section, the researchers found only a marginal difference in the rates of future fertility — not big enough to be concerned that having a c-section negatively impacts future fertility.
But when they dug a little deeper, the researchers noticed that the future fertility rate among women who had c-sections differed depending on the reason for their surgical delivery. For example, those moms who had an elective c-section because their babies were breech had the lowest reduction in future fertility. In contrast, women who delivered via cesarean because of a medical indication (placenta previa, for instance) or in an emergency situation (say because baby's heart rate became dangerously low) had the largest reduction in subsequent births.
What this shows, say the researchers, is that it's not the procedure itself that leads to an apparent reduction in fertility, but rather it's the medical and social circumstances that make the operation necessary in the first place that could explain the apparent decrease in fertility after having a c-section.
"By carefully distinguishing between different complications of pregnancy, we have found that having a caesarean section as a first-time mother leads to only a very small effect on subsequent fertility," said the study's co-author. "The circumstances behind the procedure may have a bigger impact and may explain the reduction in fertility apparent in previous studies."
The fact that the effects of a c-section on fertility are minimal should go a long way to reassure those moms who end up needing a cesarean delivery and still want more children in the future. Of course, even though there is less effect on fertility than was assumed, it's still important to recognize that giving birth via cesarean comes with some risk, so be sure to learn all about c-sections and talk to your practitioner if there's a possibility there's a c-section is in your future.