Late c-sections increase risk of future premature births

A growing body of evidence shows that having a c-section in the second stage of labour increases the risk of premature birth in a future pregnancy.

Thre doctors performing a c-section

Tommy’s news, 09/01/2019

Professor Andrew Shennan, Director of the Tommy’s Research Centre in St Thomas’s Hospital, London, is calling for new guidelines for obstetric doctors about the use of c-sections in late labour. This comes after his research showed the increased risk of preterm birth in pregnancies after c-sections.

He found that 14% of women who have a late stage c-section (in the second phase of labour) go on to have a premature birth in a future pregnancy. He compared this to women who did not have a late stage c-section, where only 2% of women went on to have a preterm birth.

Professor Shennan said, ‘Caesarean sections performed late in labour have been linked to a risk of preterm birth in the next pregnancy. When done at full dilatation (in the second stage of labour) the risk is increased 6 fold from 2% to around 15%. The risk appears to continue in future pregnancies. Through our work in the Tommy’s centre, we are looking at how to manage this problem as sometimes late caesareans are necessary in an emergency. For example, women can have cerclage (a cervical stitch) to help reduce future risks.’

As part of the long-term plan, the NHS is committed to reducing the preterm birth rate, and is working with Professor Shennan at the Tommy’s centre to  to achieve this.

‘These research findings will help obstetricians provide best practice care when a caesarean section at full dilatation is required.’ Matthew Jolly, national clinical director for maternity and women's health

C-section benefits and risks

While most women who have a c-section will go on to have healthy future pregnancies, as with any major surgery, there are future benefits and risks with c-sections. In some cases, it will be the safest option for mother and baby but as well as the risk of premature birth in future, other c-section risks can include:

Benefits of having a c-section

Women may be offered a planned c-section for many reasons, including problems with the placenta or if a baby is in a difficult position. The benefits of a ceasarean for women who have not had one before include a reduced risk of injury to the vagina and greater bladder control after birth, among others.

An obstetrician should explain the benefits and risks of having a c-section to women, and informed consent should always be given.

Premature birth research

Tommy’s conducts research to find out what puts women at risk of premature birth in order to prevent it.

Each year in the UK, around 60,000 babies are born too soon. The earlier a baby is born the higher the risk of health and development problems, which is why it is so important to find out the cause and take steps to stop it from happening.

Read about Tommy’s current premature birth research.

More about premature birth

Read more Tommy' news and views

  • A nurse taking a patients blood pressure in a hospital room


    Pregnancy is a unique chance to predict health risks to mums

    A recently published article, co-authored by Professor Catherine Williamson from Tommy’s Research Centre at King’s College London, suggests that certain pregnancy complications can indicate future health issues for women.

  • Rising demand for Tommy's midwives in coronavirus lockdown


    Tommy’s awarded grant to help meet rising demand for support during coronavirus lockdown

    Tommy’s has received a grant from the UK Government’s Department for Health and Social Care to support the costs of its PregnancyHub information and support services throughout the summer, due to rising demand in the wake of coronavirus.

  • Tommy's researchers latest findings


    Tommy’s Research Centres continue vital work on pregnancy complications

    Although recruitment to some clinical trials had to be paused when coronavirus hit the UK, scientists at Tommy’s Research Centres across the UK are still hard at work, supporting women and families in our specialist clinics and sharing their latest studies with academic journals.

  • Blog

    Miscarriage during lockdown

    The day before Mother’s Day, and two days before the UK officially went into coronavirus lockdown, Zara Dawson found out she was having a miscarriage. Her third consecutive miscarriage in less than a year, and fourth consecutive loss, after losing her second son Jesse in 2018 to termination for medical reasons.

    Was this information useful?

    Yes No