In recent decades, the global rates of c-sections have escalated.
Every year, more than 23 million women globally have their babies via c-section.
This makes c-section by far the most common surgery in the world.
What Are The Long-Term Risks Of C-Sections?
To date, there has been a lack of research into the influence of c-section surgery on women’s long-term health.
A new study has revealed women who have c-sections face an increased risk of undergoing a hysterectomy later in life. They also face a greater risk of complications after a hysterectomy.
Here’s what you need to know about this new research on hysterectomy complications after previous c-sections.
What Did This Study Look At?
The short-term risks of c-section surgery have been well established for some time.
This new research is the first population-wide analysis of the long-term complications for women who have had c-sections.
Researchers from Aalborg University in Denmark and Ariadne Labs in Boston looked at a database of almost 7,700 women in Denmark who gave birth for the first time between 1993 and 2012.
These women later underwent a hysterectomy, between 1996 and 2012, for various reasons, excluding cancer.
The researchers wanted to investigate whether previous c-section surgery increased the risk of complications, blood transfusions and the need for further surgery, in women who had a hysterectomy later in life.
What Did The Study Find?
The researchers found women who had given birth at least once, and who later had a hysterectomy were 50% more likely than the general population to have previously had a baby by c-section.
This suggests that having a c-section puts women at increased risk of needing a hysterectomy later in life.
Women who had a c-section and a later hysterectomy were more than 16% more likely to experience complications such as post operative bleeding and infection than those who had given birth vaginally. They were also 30% more likely to require re-operation.
Those women who had two or more c-sections were 96% more likely to need blood transfusions during a later hysterectomy.
C-Sections And Future Surgery Complications
Hysterectomy surgery doesn’t usually require re-operation. If it does, it means something went wrong during the first surgery, such as infection or organ damage.
However, when a woman has had a c-section, scar tissue from the surgery can cause difficulties in any future procedure in the same area, such as a hysterectomy.
Obstetrician and study co-author Dr. Neel Shah, who leads the Delivery Decisions Initiative at Ariadne Labs, said in a statement:
“Because women often have more than one baby, we are the only surgeons that routinely cut on the same scar over and over again, and that makes surgery technically harder each time.
“The internal tissue starts to fuse together and can look like a melted box of crayons. C-sections and hysterectomies are two of the most common surgeries performed on women, and those who require both are at significantly higher risk of complications”.
It has long been suggested over half of c-sections performed in high income countries such as the United States are unnecessary and the result of too many interventions during pregnancy and labour.
The long-term risks of c-sections are more apparent when women decide to have more children. Women who have previously had c-sections are at higher risk of having uncontrolled bleeding (haemorrhage), a ruptured uterus, and an unplanned hysterectomy. These risks are increased even further if they have had a second c-section.
How Can You Reduce The Risk Of C-Section?
While some women need c-sections for medical reasons, we know most women prefer to avoid surgery.
It is also becoming apparent the reason c-section rates are skyrocketing has little to do with women, and far more to do with where they give birth. Dr Shah has been working hard to find out the driving forces behind increasing rates of c-section surgery.
The Denmark research shows how incredibly important it is for women to avoid a medically unnecessary c-section.
Although this can seem incredibly difficult, given that the vast majority of c-sections are unplanned and seem to be necessary at the time, you can, in fact, do a lot to ensure you avoid the surgery.
When choosing an obstetrician and a hospital, find out what their c-section rate is. If they have a moderate or high rate, then look elsewhere. Choosing a care provider and a setting with low c-section rates is a major step towards avoiding having one yourself.
Consider primary midwifery care, if it’s available. Research shows women who use this option have better birth outcomes compared with those who give birth in obstetric settings.
You can read more about this in Midwives Getting Better Results For Birthing Women and Hospital Birth – Is It The Safest Option For Healthy Women?
Ask about the hospital’s policies on induction and other interventions. Quite a few procedures seem to have become a normal part of giving birth in hospital, even though they aren’t based on current evidence, and offer little benefit to mothers and babies.
Find out more in 8 Procedures You Might Want To Reject During Labour.
Talk to your care providers and find out their attitude to normal physiological birth and c-section. If you feel you won’t be supported in trying to avoid a c-section, consider finding a new care provider.
Read more in How Do I Choose A Care Provider? to ensure you have the right person caring for you.
Make sure you are well prepared for birth before you go to hospital in labour.
C-Section Prevention – 8 Ways To Avoid An Unnecessary Caesarean is packed with tips for the best way to make sure you’re empowered to have a positive birth experience.