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The research, published in the British Journal of Obstetrics and Gynaecology, lends weight to concerns that Caesareans can reduce a woman’s fertility. The procedure has become increasingly popular, with one in five deliveries in Britain now carried out by Caesarean.
Many women, particularly busy professionals and celebrity mothers such as Victoria Beckham and Liz Hurley, elect to have the operation, which enables them to pick a precise date of birth. The rising rates of Caesarean have caused experts to urge for more natural births, with less risk of complications and a quicker recovery.
The study, carried out at the University of Aberdeen, shows that the average time between births was longer for those who had a Caesarean compared with other types of delivery. Caesarean mothers were more likely to suffer other complications in future pregnancies.
The authors concluded that the incidence of conception after a Caesarean is “significantly reduced”. Instrumental vaginal delivery — using forceps to extract the baby — did not appear to have an effect. The findings come after research which suggested that women who have a Caesarean double the risk of a subsequent stillbirth.
The Aberdeen researchers studied 25,371 women who had their babies at the city’s maternity hospital between 1980 and 1997. They found that 66.9 per cent who had a Caesarean went on to have another baby. This compared with 71.6 per cent of those who had an instrumental vaginal birth and 73.9 per cent of those who had a spontaneous vaginal delivery.
The researchers said that whether the Caesarean was planned or an emergency made no difference to the rate of future pregnancies.
The average length of time before the next pregnancy after a Caesarean was 36.3 months. This compared with 31.8 months after an instrumental vaginal delivery and 30.4 months after a spontaneous vaginal delivery.
Women who had a Caesarean were also more likely to have an ectopic pregnancy — where the fertilised egg becomes implanted outside of the womb, such as in the Fallopian tube. There were 9.5 ectopic cases per 1,000 women in those who had had a Caesarean, compared with 5.7 per 1,000 for women who delivered spontaneously.
Statistics from the Department of Health show that the Caesarean rate in England increased from 22 per cent in 2002-03 to 22.7 per cent in 2003-04. Almost one in ten in NHS hospitals is for the mother’s convenience. The rate is higher at private hospitals.
Reasons cited for the rise include better detection of foetal distress, more older women having babies, the desire for a pain-free labour and the potential impact of a vaginal birth on a woman’s sex life.
Jill Mollison, of the Department of Public Health at the University of Aberdeen, said: “This study highlights an association between mode of delivery and subsequent pregnancy. This is an important finding against the background of rising Caesarean section rates.”
Peter Bowen-Simpkins, from the Royal College of Obstetricians and Gynaecologists, added: “Those involved in the delivery of obstetric care should be aware of the association and consider its implications when deciding to perform a Caesarean.”
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