New concerns about the risks of Caesarean births emerged today with research looking at the consequences for future pregnancies.
The researchers found that women who had their first child by Caesarean were more likely to report having problems conceiving again compared to women who had a vaginal delivery using instruments such as forceps.
They were also far less likely to go on to have a normal delivery if they had the major operation during their first pregnancy.
The researchers, from the University of Dundee, said the increased use of Caesareans rather than instrumental vaginal delivery when problems arose during labour would have far reaching consequences for women.
The number of Caesareans carried out has increased rapidly in recent years, with around a quarter of the 600,000 babies born in the UK each year now delivered by this method.
This well above the 10% rate recommended by the World Health Organisation. The National Institute of Clinical Excellence is considering tightening up the rules to prevent women from having the operation for non-medical reasons - often requested by those classed as "too posh to push".
The latest research, published on bmj.com, looked a 283 women three years after they had either an instrumental vaginal delivery or a Caesarean. Of these women, almost half (140) had been pregnant again after three years. Those who had a vaginal delivery using either ventouse or forceps were less likely to say they had difficulty becoming pregnant again.
Out of the 192 who had planned to get pregnant again, only 5% of women who had a vaginal delivery reported difficulty conceiving compared with 19% of those who had a Caesarean.
The researchers said their study supported past research which had shown that Caesarean births can have a long-term consequences for fertility, leading to women having fewer children and more difficulty conceiving.
Of the 91 women who said they did not plan another pregnancy, about half (42) said they "could not go through childbirth again", with no significant difference between the two delivery groups.
The researchers, led by Professor Deirdre Murphy, said more research was needed on the psychological impact on women having a Caesarean or instrumental birth due to the long-lasting effects it could have on them.
They said to cut down on Caesarean births wherever possible women should have their first child by vaginal delivery using instruments if necessary
"Women who have had an instrumental vaginal delivery should be reassured by the very high rate of spontaneous vaginal delivery that can be achieved in a subsequent pregnancy," the team added.
By Jenny Marra, Head of Press 01382 344910, out of hours: 07968298585, j.m.marra@dundee.ac.uk