Caesareans Have Drawbacks for Future Pregnancies

Newswise — Outcome of subsequent pregnancy three years after previous operative delivery in the second stage of labour: cohort study

Women who give birth to their first child by caesarean section are far less likely to have a subsequent vaginal delivery than if they have an instrumental delivery, according to new research.

This study will be available on bmj.com on 14 January 2004.

Researchers surveyed 283 women three years after they underwent instrumental vaginal delivery (use of ventouse or forceps) or caesarean section to evaluate the consequences for future pregnancies.

A total of 140 women (49%) achieved a further pregnancy at three years. Women were less likely to report difficulty conceiving and were more likely to have achieved a further pregnancy after an instrumental vaginal delivery than after a caesarean section.

Women were more likely to aim for vaginal delivery and more likely to have a vaginal delivery if they had had a previous instrumental delivery rather than a caesarean section.

In both groups, fear of childbirth was a frequently reported reason for avoiding further pregnancy (51% after instrumental vaginal delivery, 42% after caesarean section).

Instrumental vaginal delivery offers advantages over caesarean section for future pregnancies, say the authors.

The increasing use of caesarean section rather than instrumental vaginal delivery when difficulties arise during labour will have far reaching consequences. Further work is also needed to tackle the psychological impact on women in these circumstances, they conclude.