Most C-Sections Don’t Impact Future Fertility.
Past studies have shown that women who have cesarean sections are less likely to give birth again, raising questions about whether C-sections may impact fertility.
But a new study led by researchers from the School of Public Health and Aarhus University Hospital in Denmark suggests that C-sections do not impact future fertility, and that underlying medical conditions that were indications for the C-sections confounded the results.
SPH researchers accounted for maternal medical conditions and fetal presentation in the first birth, and found that fertility was not reduced following the most common situation for C-section, an emergency procedure for an infant positioned head-first. In contrast, subsequent fertility was found to be reduced for less common indications for C-section—a breech birth or a planned C-section.
Breech births can stem from maternal conditions that distort the uterine cavity, such as uterine fibroids. Meanwhile, the most common indication for emergency cesareans is fetal distress, the research team noted.
The researchers studied more than 900 Danish women, ages 18 to 40, who were trying to conceive spontaneously during 2007–2012.
Lead study author Rose Radin, who earned her PhD in epidemiology at SPH in 2014 and is a postdoctoral fellow at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, said past studies could not determine whether the lack of subsequent births was actually due to the C-section or other factors. Those studies did not address the indication for the C-section or the mother’s desire for more children, she noted.
The new study was part of an ongoing follow-up study called Snart-Gravid that enrolled Danish women attempting pregnancy. Participants completed a baseline questionnaire at enrollment and follow-up questionnaires every two months for up to 12 months.
The research team also is at work on another North American-based study of pregnancy planners, PRESTO.
Co-authors included Elizabeth Hatch and Lauren Wise, professors of epidemiology; Kenneth Rothman, professor of epidemiology and vice president of epidemiology research at RTI Health Solutions; and Wendy Kuohung, associate professor of obstetrics and gynecology at the School of Medicine.