Very heavy bleeding after childbirth does not usually affect a woman’s fertility, researchers reported yesterday.
But women who experience complications of caesarean section may be less likely than others to become pregnant again, according to a Scottish study.
The rate of postpartum haemorrhage – blood loss greater than 500ml – has risen in the UK alongside a rise in its risk factors, including caesarean section.
Dr Gail Fullerton of Aberdeen Maternity Hospital, UK, and her team looked at the impact on the mother’s future fertility. They used information from a local database on 34,334 first pregnancies, gathered over two decades.
Overall, one in ten women experienced the problem. The chance of bleeding was higher with caesarean than vaginal deliveries (59% versus 21%). It was also higher among older women, those with a higher body mass index, and smokers. Risk was also raised nearly three-fold for the subsequent pregnancy.
There were no significant differences between women with and without the problem in the rate of conceiving a second pregnancy, in the gap between pregnancies, or in early/late pregnancy loss.
But women who had a caesarean section and subsequent heavy bleeding went on to have a lower rate of subsequent pregnancy – 41.5% versus 36.8% for women who had a caesarean section without the problem.
The study was published in BJOG: An International Journal of Obstetrics and Gynaecology.
"While experiencing post-partum haemorrhage in an initial pregnancy increases the risk of recurrence in subsequent pregnancies, it should not be cause for concern in relation to future fertility," said Dr Fullerton.
"The women in our study showed no adverse affects to the likelihood or timing of future pregnancies after an initial complication."
Fullerton, G. et al. Outcomes of pregnancy following post partum haemorrhage. BJOG 23 January 2013 doi:1111/1471-0528.12120.
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