11/19/2025
So many of my clients have a deep dread of C-section, even if there is nothing in their history or current pregnancy to suggest C-section might be necessary, and rightfully so. C-section rates in the US are at an all-time high, with many studies revealing that neonatal and maternal outcomes are decreasing in this country despite (because of?) all the available modern medicine and procedures.
What is often left out in the labor and delivery room discussions are the many potential complications of C-section. Besides the obvious risks, such as infection, there are some less obvious, such as those listed in the article here.
Women who have C-section (whether they were emergency or scheduled, planned or unplanned) often face significant challenges in health, fertility and future pregnancies. While there are times when C-section are truly life saving, each medical decision, including the decision to cut, should be made with full informed consent. That's why I encourage my clients to take an in depth birth education course, familiarize themselves with common interventions, arrive as far into the labor process as possible, and have a well thought out birth plan.
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)