Women whose first child is delivered via Cesarean section (C-section) may have a lower rate of conceiving a second child compared with women who delivered vaginally, according to a study published in April in JAMA Open Network. The findings suggest this effect may last as long as 3 years following the first delivery.
The study, called the The First Baby Study, looked at data gathered from 2,021 women, aged 18 to 35 who were pregnant with one fetus. A total of 712 women in the study gave birth by C-section. The team followed the participants from before they delivered their first child through three years after birth. The researchers said many of the women who had C-sections were older than the average in the group, overweight or obese, shorter than the average, and/or received fertility advice, testing or treatment.
Every six months following birth, the team asked the participants to detail how often they had unprotected intercourse and any resulting conceptions. Nearly 69 percent of the C-section group conceived within three years, while nearly 78 percent in the vaginal delivery group conceived. The researchers said that C-section for the first child not only reduced the chances of getting pregnant again, but that the women also had a higher risk of subsequent stillborn deliveries. The researchers said the effects of C-section remained even after they considered factors like maternal age, time of conception of the first child, pre-pregnancy body mass index, gestational weight gain, past abortions, diabetes, hypertension and hospitalization during pregnancy.
"It’s possible that pelvic or [fallopian] tubal scarring as a result of being exposed to open air and contaminants may affect subsequent attempts at getting pregnant," Richard Legro, MD, study co-author and chair of the obstetrics and gynecology department at Penn State Health Milton Hershey Medical Center, said in a press release. "It is also possible that scar formation from the surgical wound in the uterus, though not in an area where pregnancies implant, may have lingering effects on the process of implantation."
In the recommendations, the team wrote that women under 35 who fail to conceive a year or more after a C-section should see their obstetrician to check their condition. Legro said the findings may also help physicians in guiding women when picking options to give birth.
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