One in four British babies is born by Caesarean section

A study in Scotland has confirmed that women who have Caesareans may have problems getting pregnant again.

It also backs up other studies which suggest those who manage to conceive may go on to have difficult births.

Writing in the British Medical Journal, doctors said women should be encouraged to have natural births wherever this was possible.

High rates

The number of women giving birth by Caesarean section in the UK has increased steadily in recent years.

There is anecdotal evidence to suggest this rise is down to women opting for Caesareans for non-medical reasons - "too posh to push" mothers.

A Caesarean section in one pregnancy may cause problems in a subsequent pregnancy Dr Maggie Blott

The latest estimates suggest that one in four babies born in the UK is delivery by Caesarean section.

This is well above the 10% rate recommended by the World Health Organization.

The government's NHS watchdog, the National Institute for Clinical Excellence, has published guidelines aimed at cutting the number of Caesarean births.

Caesareans are much more expensive for hospitals than normal deliveries. They also have risks for mothers and babies.

As part of this latest study, researchers from the University of Dundee questioned 283 women who gave birth to children in 1999.

Of these, almost half had given birth again three years later.

However, the study found that women who had a Caesarean were much more likely to report having problems conceiving again compared to those who had a vaginal delivery using ventouse or forceps.

Just 5% of women who had a vaginal delivery said they had experienced difficulty getting pregnant compared to 19% of those who had Caesareans.

The study also found that women who had a Caesarean first time around were more likely to have surgery for the birth of their second baby.

The researchers also questioned the 91 women who said they had no plans to get pregnant again.

Some 42 said they simply "could not go through childbirth again". There was no difference between those who had a natural delivery and those who had a Caesarean.

The doctors called for further research to identify the psychological effects of giving birth and what help if any can be given to women who find the experience too traumatic.

Dr Maggie Blott of the Royal College of Obstetricians and Gynaecologists urged women to take notice of the findings.

"The perception among women is that Caesarean section is better and safer," she told BBC News Online. "We are starting to see that it's not the case.

"Actually its more difficult and dangerous for the first baby and a Caesarean section in one pregnancy may cause problems in a subsequent pregnancy.