Can a C-Section Lead to an Ectopic Pregnancy or Stillbirth?

Why you should take a new study with a grain of salt.

woman holding her pregnant belly Piotr Marcinski/Shutterstock

A new study is warning about the adverse side effects of C-sections, and this one sounds super scary. That is, until you read the fine print.

Researchers in Denmark conducted one of the largest studies to date using data from almost 833,000 mothers. The mothers were divided into two groups: those who had previous vaginal births and those who had previous C-sections. After combing the data, researchers discovered that a small but significantly higher number of women who had C-sections with their first deliveries went on to suffer stillbirths and ectopic pregnancies in a subsequent pregnancy. (An ectopic pregnancy is a serious and potentially life-threatening complication that occurs when a fertilized egg grows in the fallopian tube instead of implanting in the uterus.)

The Fine Print

The numbers are startling on first read: according to the study, women who had C-sections with their first live birth had a 14 percent increased rate of stillbirth and 9 percent increased rate of ectopic pregnancy compared with women who had a vaginal delivery.

This does not mean your risk increases by 14 percent and 9 percent. Researchers found that the absolute risk increase for stillbirth was 0.03 percent (or one stillbirth for every 3,000 C-sections) and 0.1 percent for ectopics. That means 2,999 births did not result in stillbirth, and 99.9 percent of subsequent pregnancies were not ectopic.

Why Any Risk?

This study was not specific about what exactly causes these tragic complications but here's what we know about C-sections in general:

C-sections involve cutting through the abdominal muscles and the uterus to deliver the baby. Then, the placenta is removed and the uterus and abdomen are stitched back up. A scar forms on the skin, abdominal muscles and the uterus during the healing process.

It's that scar that sometimes causes problems with the next pregnancy, since the inside of the uterus is no longer a smooth surface, like it is after a vaginal birth. When the new placenta grows with the next pregnancy and adheres to the uterine lining of a scarred uterus, it may not grow or attach properly. It might attach to the scarred area, grow too deep into the uterine lining or all the way into the uterine muscle. Blood vessels that were severed during the first C-section might not heal in a way that allows for adequate circulation. These potential complications can cause severe bleeding and circulation problems for mother and baby.

That's why it's important to only have a C-section if you really, truly need it. When done for the right reasons, C-sections are absolute lifesavers. Too often, however, C-sections are performed for reasons that don't really require surgical intervention. Instead they require patience, a clear understanding of normal physiologic birth and the willingness to let Mother Nature and a woman's body do their thing, the way they're intended to.

I recommend women read studies like this with the understanding that the study results don't predict what will happen to them. Most studies are intended to help professionals learn more about how they should (and shouldn't) approach pregnancy and birth. In fact, when you flip the statistics, they really show that the chances of you and your baby being perfectly fine are excellent, whether or not you had a C-section in a previous birth.