Bulletin

Issue: November/December 2005

Research in Action

Unrecognised consequences of caesarean section

A La Trobe University researcher is investigating women's experiences of recovery, and their longer term health, after surgical childbirth. Starting in 2002, the research was conducted against a background of steadily increasing caesareans.

In Australia that year, 27 per cent of the 250,758 women giving birth had a caesarean section. The rate is similar in Victoria, having increased from 16 per cent in 1986.

'There is no doubt that caesarean sections can be life saving, but they are now so common it is clear that many are not being conducted to save lives,' says Ms Michelle Kealy whose research for her doctoral thesis is supervised by Dr Rhonda Small and Adjunct Associate Professor Jeanne Daly, both of La Trobe's Mother & Child Health Research .

'This means that women and their care givers need to weigh up carefully the risks and benefits of performing caesarean section,' Ms Kealy said.

'Given such an increase in their use, surprisingly little is known about women's experiences of recovery and their longer term health after surgical childbirth.'

Ms Kealy interviewed 32 women who had all given birth by caesarean section in Victoria. There were 65 births in the group, including 49 caesarean sections. They were selected from participants in a larger study of women's health after operative birth, including caesarean, forceps and vacuum deliveries.

She identified women who had experienced a caesarean section in the last 12 months, women who had caesarean section before and after labour commenced, as well as women who had more than one caesarean birth. Twelve women experienced vaginal birth as well as caesarean section, so they were able to compare their birth experiences.

Ms Kealy presented findings from her study to the British Sociology Association Medical Sociology Group Annual Conference at York, UK, after receiving the Association's International Student Bursary.

'Lots of previously unreported negative consequences of caesarean section emerged from my interviews,' Ms Kealy said. 'One was that almost all the women were concerned by changes to their body shape, gaining weight or scar problems.'

All but one of the 32 women interviewed talked about body issues. Eighteen expressed negative feelings about their body shape or abdominal muscle tone ('jelly belly'), 17 talked about their caesar scar being numb, painful or itchy, even up to seven years after surgery, and 12 mentioned unwanted weight gain ('caesar pot').

'In a society increasingly concerned with women appearing svelte-like, a scarred and overhanging abdomen may even drive women to consider reconstructive surgery to help repair their damaged bodies,' Ms Kealy said.

'I hope that the findings of this research, based on mothers' own experiences of recovery after caesarean delivery, provide women and their caregivers with more information.

'I also hope the research may contribute to increased caution about caesarean section, especially when considered for non-medical reasons.

'Whilst the surgery may take less than 20 minutes, women live the rest of their lives with the changes it brings. The old adage, “first do no harm” is significant in relation to caesarean section, particularly if undertaken when the risk benefit ratio is uncertain,' Ms Kealy said.

Although many believe the name caesarean comes from Julius Caesar, this is highly unlikely. Different researchers source the term to an ancient Roman law called Lex Regia concerning the burial of pregnant mothers which later became the Lex Cesaria, or from the Latin verb caesaru meaning to cut.