Does Caesarean section cause infertility?

The global rise in the rate of Caesarean sections (CS) during the last 20 years has coincided with an increase in the number of couples seeking help for infertility. There have been attempts to examine the link between these two conditions, and available data confirm an association between CS and infertility. The relationship is complex, however, involving more than a simple patho-physiological association. There may be a voluntary component to the causal relationship between CS and infertility, which is best explored using qualitative methods. We argue that CS does cause infertility, but the mechanism could be social/psychological rather than pathological.