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gender inequality in medicine
Monday, 1 December 2025 - 10:20

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Thousands of Dutch women per year experience pain during C-section deliveries

Thousands of Dutch women per year experience pain during C-section deliveries

Earlier this year, a large-scale international study showed that approximately 10 to 15 percent of women experience pain during cesarean sections, despite an epidural. In the Netherlands, that translates to thousands of women a year. Yet virtually no women are aware that this could happen beforehand, Nieuwsuur reports.

In the Netherlands, around 30,000 babies are born by cesarean section every year. This usually happens through a horizontal “bikini incision” of approximately 10 to 15 centimeters in the lower abdomen. The gyencologist cuts through several layers of skin, fat, and connective tissue to reach the uterus.

Before the procedure, women usually receive an epidural, which numbs only the lower part of the body. For a planned C-section, an epidural is administered just before the surgery. However, for an emergency cesarean following a stalled vaginal delivery, a slightly shallower epidural is often administered earlier to alleviate the pain of contractions. In these cases, the same epidural is used to provide additional pain relief before the operation. These women are at higher risk of experiencing pain.

It is unclear why so many women still experience pain despite the epidural, Xandra Schyns, an anesthesiologist who specializes in obstetric anesthesia, told the program. But it is clear that it happens. Yet women are still not informed about this. Mostly, they’re told that they may feel “pressure” during the surgery.

In response to questions from Nieuwsuur, the professional associations of gynecologists (NVOG) and anesthesiologists (NVA) said that they would establish joint national agreements on pain management during cesarean sections. No such agreements exist yet.

“We need to prepare women for everything that can happen during childbirth, including a cesarean section. We also need to inform them that some women experience pain during the procedure,” gynecologist Liv Freeman told Nieuwsuur on behalf of the NVOG. "This involves more pain than expected or pain that clearly requires intervention."

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