The Centers for Disease Control and Prevention notes that Cesarean sections accounted for nearly one in three of all births in 2012. While cesareans are potentially lifesaving surgical procedures, in some cases complications can affect fertility. Fallopian tube damage or uterine adhesions may make conceiving another baby challenging.
Snags conceiving after a cesarean aren't the norm, but aren't exactly rare either. A meta-analysis published in 2013 in the journal “Human Reproduction” found a subsequent rate of pregnancy 9 percent lower following a cesarean compared with women who delivered vaginally. The studies analyzed also showed a birth rate 11 percent lower for women who had undergone cesareans. The authors note that maternal age, a history of infertility and voluntary decisions not to have more children may have affected results.
While a cesarean is generally a safe procedure, it does come with a list of potential complications. These include infection, hemorrhage, injury to organs, adhesions or scarring, or reactions to anesthesia. Certain of these complications may result in decreased fertility. For example, post-surgical infection may cause Fallopian tube damage, which in turn can cause infertility.
Scars and Struggles
While the outward mark from your surgery is a visual reminder of your cesarean, the internal scarring can impact your ability to conceive again. Pelvic adhesions -- abnormal fibrous connections between two anatomically different surfaces -- can cause an inability to conceive and the risk of ectopic pregnancies, as well as pelvic pain. Adhesions don't necessarily render a woman completely infertile, though -- they may make getting pregnant again just take longer than it would otherwise.
If your conception struggles come from endometriosis that was caused by your cesarean, your doctor may suggest surgically removing the abnormally growing cells or tissue. This may also help to reduce severe pain or regulate any between-period bleeding. While endometriosis is a post-surgical result for some women, it doesn't affect the majority of mothers. The estimated rate of cesarean-related endometriosis according to a meta-analysis published in the "Journal of Human Reproduction" is around eight cases per 100 women.