11/21/2025
The standard method for closing the uterus after cesarean delivery, used for over 50 years, may be causing a host of long-term health issues for millions of women.
According to Dr. Emmanuel Bujold and Dr. Roberto Romero, leaders in obstetrics and gynecology, current closure practices—where sutures join the uterine lining with surrounding muscle—fail to restore the uterus’s natural structure, leading to serious complications.
Their exhaustive review reveals the risks: abnormal placenta attachment affects up to 6% of women, uterine rupture up to 3%, and premature births up to 28%. Many suffer pelvic pain (up to 35%), excessive bleeding (up to 33%), and endometriosis or adenomyosis (up to 43%). Such complications are linked directly to the scarring produced by the conventional closure method.
Bujold and Romero propose a nuanced technique: suturing tissues only of the same type, carefully reconstructing the muscle layer while leaving the uterine lining untouched for natural regeneration. Although this new method takes 5–8 minutes—twice as long as the traditional approach—the additional blood loss is minimal and outweighed by better outcomes for future reproductive health.
With cesarean rates rising globally, especially in countries like Canada where 27% of births are by C-section, prioritizing meticulous uterine repair is a critical public health concern. This shift in surgical thinking may help millions experience safer subsequent pregnancies and better long-term well-being.
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📄 RESEARCH PAPER
📌 Emmanuel Bujold et al, "Uterine closure after cesarean delivery: surgical principles, biological rationale, and clinical implications", American Journal of Obstetrics and Gynecology (2025)
