How Many C Sections Are Safe to Have?

To have a C-section is not a light decision that is taken by the doctors or women who are in labor. Fortunately, in the USA, C-section surgeries are performed by professionals who are highly qualified, thereby putting the laboring mothers and their babies in good hands so as to help decrease any risks associated with the surgery. It is usual for a mother to have repeat C-sections if she has given birth to one baby by cesarean. But how many C sections are safe?

How Many C Sections Are Safe to Have?

Recovery rate in each female is different following subsequent C sections. Some may recover easily at a similar rate after every surgery, while some may have a longer, more difficult recovery period after subsequent cesareans. Usually, having one or two C-sections do not increase the risk significantly to both the mother and the baby.

According to studies having three or more C sections significantly increases the risk of developing complications and it is not recommended to have vaginal delivery after third C-section. However, it has not been established in research as to exactly how many C sections are safe to have because different women have different health conditions. Therefore, you should work closely with your doctor to figure out whether or not it’s safe for you to have another C section.

There are risks and benefits involved with both vaginal and cesarean births. After one cesarean, it can be a complex decision for any female to decide whether to have next delivery by vaginal delivery or C-section. You should discuss this issue with your healthcare provider. They are the best judge to decide about the risks of a repeat C-section. There are multiple factors that are taken into account while deciding the method of delivery including your age, weight, medical history, and reasons for previous cesareans.

What Are Possible Complications of Multiple C Sections?

The risk of the following conditions is increased in women having multiple repeat C-sections:

1.       Formation of Scar Tissue

After each surgery, scar tissue called adhesions may develop on the uterus and organs nearby. A repeat C-section becomes more difficult due to dense adhesions, thereby prolonging the time to deliver a baby. Pain could develop be caused by adhesions as the movement of internal organs is limited. Occasionally fertility problems may develop due to adhesions as they can block or put pressure on fallopian tubes. A lot of scar tissue or adhesions can make it trickier for your doctor to make an opening in the uterus, if a repeat cesarean is performed. This increases the time of the surgery and also increases the risk of your doctor making a cut into your bowel or bladder accidently.

2.       Heavy Bleeding

The chances of heavy bleeding are increased after every cesarean, thereby increasing the risk with multiple cesareans. Heavy bleeding might require treatment with removal of uterus or hysterectomy. A blood transfusion may be needed in cases of heavy bleeding. According to one study the risk of removal of uterus increased from 0.65% after initial C-section to 2.41% after the 4th C-section.

3.       Injury to Bladder and Bowels

Injury to bladder is more likely to happen with repeat C-sections. The adhesions or scar tissue developed during initial cesareans that bind the uterus to the bladder increase the risk. Small bowel obstruction can also occur due to adhesions.

4.       Placental Problems

The risk of developing placental problems increases with the number of C-sections. The problems could be placenta accreta-implantation of the placenta too deeply into the wall of the uterus, or placenta previa-when the placenta implants partially or completely on the cervical opening. It is difficult to remove the placenta following birth of the baby in such cases, and can increase the risk of heavy bleeding, thereby increasing your risk of hysterectomy.

According to one study the risk of developing placenta accreta was increased from 0.24% after the initial C-section to 2.13% after the 4th C-section.

What Others Say

One of my family members is about to deliver her third child this November. She had Cesareans performed with all of her previous children and will have another cesarean with this child. It has been advised by her doctor that she could deliver no more than one child with a scheduled cesarean because it is not healthy to cut her again and again.

I already had 3 children by cesarean and am scheduled to have my 4th baby by cesarean. It is my true belief that there is no hard and fast limit as to how many C sections are safe to have. All females heal in a different way and this decision should be best evaluated following individual considerations. You should also seek second opinion if you are advised against further C section which would indicate that you could not have more children.

I have developed much scar tissue from my third cesarean; therefore, my doctor has advised that I do not try again to have a baby. We have considered following his recommendation. My third child died due to malformed kidneys. My heart still longs for him; however, we have two more children and we have seen through it all by the grace of God. 

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