Lower fertility may follow C-section for first baby – Futurity: Research News

Those who deliver their first child by cesarean section are less likely to conceive a second child than those who deliver vaginally, despite being just as likely to plan a subsequent pregnancy, researchers report.
The researchers followed more than 2,000 women for three years after they delivered their first child.
Although previous studies showed that women who delivered by cesarean section (C-section) were less likely to bear subsequent children, it was unclear to researchers whether this was due to maternal choice or a lower rate of conception, says Kristen Kjerulff, professor of public health sciences at the Penn State College of Medicine.
Conception after C-section
The researchers followed women from before the birth of their first child and interviewed them every six months until three years after their first delivery. During each interview, they asked women to report how often they had unprotected intercourse in each of the previous six months.
The researchers analyzed data from 2,021 women between the ages of 18 and 35 who provided data on unprotected intercourse and resulting conceptions for three years after their first birth. Nearly 600 of those women delivered their first child by C-section and those women were more likely to be older, overweight and obese, shorter, and more likely to have sought fertility advice, testing, or treatment.
Approximately 69% of women who delivered by C-section conceived after unprotected intercourse compared to approximately 78% of women who delivered vaginally. Women who delivered by C-section also had a reduced likelihood of a live birth. The association remained after researchers accounted for maternal age, pre-pregnancy body mass index, time to conception of the first child, gestational weight gain, prior induced abortions, diabetes, hypertension, hospitalization during pregnancy, and other factors.
Could scarring be the reason?
Controlling for intercourse was a key strength of the study and allowed the researchers to rule out trauma or lingering pain from C-section, says coauthor Richard Legro, chair of the obstetrics and gynecology department at Penn State Health Milton S. Hershey Medical Center. Although the study didn’t investigate the reasons for the decreased conception rate, he suspects there may be some physiological reasons.
“It’s possible that pelvic or

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