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C-section is done to deliver your baby safely, and many mothers get it done every day. A recent medical article written by two leading experts has sparked an important conversation about how the uterus is closed after a C-section. Their findings suggest that the most commonly used closure technique may be linked to several long-term complications. This can feel concerning, especially if you already had a C-section or are preparing for one.
Understanding what a C-section is, the closure techniques used and what new research suggests can help you prepare better to speak about your concerns with your doctor.
What is a C-section?
A C-section (caesarean birth) is a surgery done to safely deliver the baby through incisions made in the abdomen and uterus. Doctors perform C-sections when:
- A vaginal birth is not safe
- Labour is not progressing
- The baby is in a position that makes vaginal delivery risky
- You or your baby needs urgent help in an emergency
- Previous C-section
- Placenta previa
- Breech or transverse lie
- Multiple babies
- Certain medical conditions
- Cephalopelvic disproportion (baby cannot pass safely through the pelvis)
Emergency or unplanned C-sections may happen during labour if new complications arise. Remember, caesarean births are very common.
Why are Experts Questioning the Way the Uterus is Usually Closed?
According to Dr Emmanuel Bujold and Dr Roberto Romero, the most widely used uterine closure technique may be causing preventable long-term health issues. Their review, published in a special issue of the American Journal of Obstetrics & Gynecology, suggests it may be time to rethink this approach.
Why?
Because this commonly used method stitches together different types of tissues. The common stitching method stitches the uterine lining and the muscle layer. Although this technique is simple and fast, it may not restore the uterus to its natural structure.
The result, according to the experts, can be abnormal scar formation. And that scar may lead to complications in future pregnancies or affect a woman’s health over time.
What Complications Did the Study Highlight?
The review has viewed many research studies and identified several issues that may occur post this type of uterine closure.
Some possible long-term complications and their reported rates include:
- Prematurity in future pregnancies (up to 28%)
- Pelvic pain (up to 35%)
- Placenta attaching abnormally to the uterus (up to 6%)
- Endometriosis or adenomyosis (up to 43%)
- Postmenstrual bleeding (up to 33%)
- Uterine rupture in a future pregnancy (up to 3%)
Why Does the Current Uterus Closure Technique Cause Concern?
The traditional method has been used for more than 50 years. This method is widely used for various reasons, such as:
- It’s quick
- It reduces immediate blood loss
- It is simpler to perform
If someone has a cut on their cheek, you wouldn’t stitch the skin, muscle, and inner lining of the mouth all together. That wouldn’t heal naturally. The same principle applies to the uterus.
Because the method doesn’t follow the uterus’s natural layers, healing may not be optimal.
What is the New Technique Being Recommended?
The technique proposed by Drs. Bujold and Romero focus on the uterus’s natural anatomy. It involves:
- Suturing the muscle layer in two parts
- Closing the outer covering of the uterus with a separate stitch
- Not touching the uterine lining, allowing it to regenerate naturally
The downside of this technique is that it takes a little longer.
- Standard technique: 2–3 minutes
- Proposed technique: 5–8 minutes
Why Does Uterine Closure Matter So Much?
The uterus isn’t just any organ. It changes dramatically during pregnancy and must withstand the pressure of future pregnancies. If the scar is poorly aligned, it may weaken or heal unevenly. This is where the closure technique matters.
A healthy uterine scar should:
- Stretch well
- Heal in layers
- Allow the placenta to attach normally
- Stay strong during labour
- Reduce long-term pain and bleeding
C-section deliveries happen daily. This surgery has been used for years to bring babies into this world. However, this study sheds light on how the uterus is repaired afterwards and how this may influence a woman’s long-term health. While it is good to know about newer studies, you must always trust your healthcare team. If you have any questions about C-section and your long-term health, do not hesitate to ask your doctor.
Whether you’re pregnant, a new mom, or navigating postpartum, you don’t have to do it alone. Join our support group to connect, share, and support one another.
FAQs on C-Section and Standard Uterine Closure Technique: Is it Safe?
- Will a C-section affect future fertility?
No, a C-section does not always affect future fertility. Many women who undergo C-sections can conceive normally again. However, multiple C-sections may increase the risk of placenta problems. - Can I request a specific uterine closure technique during my C-section?
You can speak to your doctor about your preferences, or if there are any doubts you may have. Your doctor will decide what is safest and most suitable to deliver your baby safely.
