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Home >Caesarean Section Risks
Caesarean Section Risks
By Nikki Davies
The rising rate of caesarean deliveries in Australia may be putting both mother and newborn at risk of a rare condition that could lead to their deaths.
A caesarean section, as with any surgery, will leave an internal scar. A new embryo can then embed into that scar tissue. This can cause the uterus to rupture and haemorrhage causing certain death unless immediately treated. To add to the problem, the event is not associated with the same pain experienced with a tubal ectopic pregnancy so often a woman is unaware, until it ruptures.
Traditionally the condition has been very rare. However the number of women giving birth by caesarean section in Australia has reached an all-time high and, in line with this, the incidence of caesarean scar pregnancies has also increased.
According to the Australian Institute of Health and Welfare (AIHW) 2002 saw 27% of deliveries being by caesarean section and 2003 (most recent figures) 28.5%, compared with 19.4% in 1994. The Australian Medical Association (AMA) believes that this rate may climb to 35%.
Caesarean section rates tend to be higher among older mothers and those admitted to private hospitals. For women who gave birth in hospitals, 37.4% of those in private hospitals had a caesarean section compared with 25.7% of those in public hospitals.
Among mothers who had given birth previously, 23.1% had previously had a caesarean section. The majority of these mothers (81.4%) had another caesarean section in 2003.
Of the caesarean sections performed in 2003, almost 58% were without labour.
Caesarean section scar pregnancies, which can only be detected through transvaginal ultrasounds, have very significant implications for women and can lead to serious bleeding and surgery, and in some rare cases, hysterectomy. Better ultrasound techniques does allow for earlier diagnoses, but the incidence of caesarean scar pregnancies had been rising in line with the caesarean rate.
A study in the International Journal of Obstetrics and Genecology last year found that most caesarean scar pregnancies were terminated in the first trimester because the growing embryo can rupture the uterus, or the placenta can grow through the lining of the uterus and adhere to the bladder.
Women having a caesarean scar pregnancy have experienced chemotherapy and additional surgery. There are also local incidences of every pregnancy following the initial caesarean to present with this condition. For the mums involved it is heartbreaking, especially if they are forced to decide to have no more children.
In October last year King Edward Memorial hospital in Perth reported that it had handled nine cases in five years, with five women having to undergo chemotherapy and one having an emergency hysterectomy.
Although it is vital that women choose birthing options that are right for them, it is also important to consider that a caesarean section is not minor surgery. It is very painful and invasive – and there can be serious complications that come from it. Women need to be aware of the benefits and risks. It’s always important not just to assume that a caesarean will always be better - they are safe, but they’re not as safe as a vaginal delivery for the mother.
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