C-section may avert later pelvic surgery

Women with a first pregnancy who deliver by Cesarean section seem to be protected against pelvic surgery later in life, according to results of a study conducted in the UK.

pregnancy itself puts a strain on certain pelvic structures and increases the risk of urinary incontinence and other problems, said Dr. Deirdre J. Murphy. "Cesarean section may reduce the risk of additional trauma at the time of delivery, but this needs to be balanced with the significant benefits to mother and infant of achieving a normal vaginal birth."

Murphy and colleagues from Ninewells Hospital and Medical School, Dundee, conducted a study involving 7,556 women who delivered their first infant between 1952 and 1966.

Included in the study were 352 women who subsequently required pelvic surgery. The comparison group comprised 1,403 women who delivered a baby during the same time period and did not require surgery.

As reported in the British Journal of Obstetrics and Gynecology, women who had a Cesarean section had an 84 percent lower risk of needing pelvic surgery by compared with those who underwent vaginal delivery.

Of those who had Cesarean sections, 47 percent were elective and 53 percent were emergency procedures. Both elective and emergency Cesarean sections were protective against pelvic surgery compared with vaginal delivery.

"There are many risks and benefits with cesarean birth that should be discussed prior to making decisions about delivery," Murphy commented. "When counseling women, it's reasonable to advise that delivery by Cesarean section protects" against pelvic surgery later in life.

SOURCE: British Journal of Obstetrics and Gynecology, August 2005.