From the study: “It is also important to recognize that this study focused on nulliparous women with no prior uterine scar. If a nulliparous woman chose to have an elective CS, morbidity with subsequent pregnancies could be higher because of reported increases of abnormal placentation with the presence of a uterine scar.”
IMO it is also necessary to consider the impact of multiple abdominal surgeries on maternal health. Risk for excessive scar tissue causing surgical complications, risk of hysterectomy, risk of requiring transfusion, etc., all go up with each cesarean delivery.
I have no doubt this study will be widely used to encourage women to believe cesarean delivery is the selfless way to safely birth your baby. It makes me angry that so many experts seem to look at each birth in a vacuum and completely disregard the impact on a woman’s reproductive life as a whole.
Coincidentally, I received the following e-mail from a reader last night:
I was born by C-section due to a legitimate emergency. Because it was done in a hurry in the 1970s, it involved a vertical cut and thus my younger brother “had to” be delivered the same way; in an effort to minimize scarring the OB went in through the existing incision.
Twenty or so years later, I had to rush my mother to the emergency room, and then consent to surgery (she was already comatose) to address what turned out to be a direct result of her two C-sections. The scar had opened up on the inside and her small intestine got tangled into the incision, causing a blockage severe enough that she nearly died.
A year later, it happened again with a different part of the incision. At that point, the surgeon elected to go ahead and open the entire incision back up and then re-sew it with a reinforcing plastic-type mesh to prevent it from opening again.
So my mother’s two major surgeries for having children ultimately resulted in two *more* major surgeries, when she was twenty years older and thus less able to bounce back. It was the beginning of a downhill spiral in her overall health.
My point is that a Ceasarean can lead to complications decades after it’s done, as it did with my mother. So a non-emergency Caesarean is opening up a lot more possibilities for problems down the road, than it may seem at the time, for *no good reason*. I wish more women knew that.
Of the 4,317,119 babies born in the United States in 2007, 1,372,844 were delivered via Cesarean section. Are we ready for the long-term effects of that many surgeries?