How Many C-Sections Can A Woman Have Safely?

Image: iStock

“How many C-sections can you have?” is a common question many parents may have when the obstetrician suggests a C-section delivery, especially if they would like to have more children.However, it is difficult to say how many C-sections you can have since each woman’s risks and complications vary．一般来说,有一个合并的风险增加cations with subsequent C-sections (1）.

Read through the post to learn about the safety, advantages, and side effects of repeat C-sections.

In This Article

When Is A Repeat C-Section Advisable Over A Vaginal Delivery?

Placenta previa indicates the need for a C-section

Image: Shutterstock

Some of the indicators to go for a repeat cesarean section are (2):

Previous uterine rupture
Presence ofclassical cesarean scar
Placenta previa
Increased risk ofuterine rupture
Any coexisting high risk condition in the pregnancy along with a previous cesarean section (eg: twins,pre-eclampsiaⁱXA severe pregnancy condition of high blood pressure and protein in the urine)
Having two prior C-sections

Related:Preeclampsia: Symptoms, Causes And Treatment

Some incisions from a C-section may limit further vaginal birth and indicate a repeat C-section. They are (3):

‘J’ or Inverted ‘T’ shaped cesarean incisions
Low vertical cesarean incisions
High vertical cesarean incisions

Point to consider

Another potential issue with C-sections is adhesion. Scar tissue that is not ordinarily linked joins tissues and organs to form adhesions (5）.

How Safe Are Repeat C-Sections?

According to the expert advice, there is a high risk associated with more than three C-sections (1）.英国妇产科杂志》和Gynecology (BJOG) says five or more cesarean surgeries are associated with increased complications and longer surgery time (4）.The study also finds that the associated risks of having three to four repeat C-sections are similar to five to nine repeat C-sections(4）.

Related:Getting Pregnant After C Section: How Long To Wait

What Are The Side Effects Of Repeat C-Sections?

In addition to the complications associated with first time C-section, some additional effects of multiple C-sections are (5), (6):

Prolonged hospitalization time
Prolonged operation time
Frequent prenatal medical visits
Dense adhesions
Urinary bladder or intestinal injuries
Placenta previa (the placenta lies in the lower segment of the uterus)
Abnormal placental invasion (the placenta attaches abnormally to the myometrium inAccretaⁱXA pregnancy condition in which the placenta is attached too deeply and firmly to the uterus, invades through the myometrium inIncretaⁱXA pregnancy condition in which the placenta is attached too deeply to the uterine muscle but doesn't pass through the uterine wallor may perforate through the outermost uterine wall of serosa to invade the urinary bladder inPercretaⁱXA pregnancy condition in which the placenta passes through the uterine wall and may impact the bladders or intestine)
Due to previous surgical scars, it might be challenging to perform a surgical incision

It may be difficult to perform an incision on previous C-section scars

Image: Shutterstock

Myometrial thinning

Point to consider

The risk factors for a repeat C-section include bleeding,thrombosis , peripheral organ damage, and frequent blood transfusions.(5）.

Are There Any Advantages Of Repeat C-Sections?

Image: Shutterstock

Some benefits of multiple C-sections include (7) (8):

Less anxietysince you are familiar with the procedure.
Better planningand scope of preparation to avoid a last-minute rush.
Lower risk ofuterine ruptureas compared to vaginal birth after cesarean delivery (VBAC).
No need to go throughlabor pain．
Lower risk of fetal morbidity and mortality

What Are The Factors To Consider For Subsequent Pregnancy After A C-Section?

Some concerns might run in your mind during pregnancy after a C-section. It is important to bring them to your doctor’s notice and get relief from your worries.

Some factors you should consider in consultation with your doctor before a second pregnancy are (9):

Wait for thescars to healbefore attempting another pregnancy. It may take up to 18 to 24 months to heal the scars completely.

Wait for sufficient time for a C-section scar to heal.

Image: Shutterstock

Maternal ageis an essential factor in determining a safe delivery. With a higher age, the risks associated with birth also increase.
A longer gap can reduce the risk associated withplacenta previaandplacental abruptionⁱXA sudden early separation of the placenta (the organ that provides oxygen and nutrients to the baby) from the uterus．
A longer gap can help you achieve aVBAC deliveryⁱXAlso called vaginal birth after cesarean, it refers to vaginal delivery after a previous cesarean deliveryandavoid complicationsfrom multiple C-sections.

Related:Placental Abruption: Symptoms, Causes, Diagnosis & Treatment

According to the national vital statistics report of 2019, 13.8% of births were VBAC (10）.VBAC can be practiced with one previous C-section. However, it is not recommended for everyone to have a VBAC. A committee of doctors will decide if you are fit enough to undertake a vaginal delivery.

Frequently Asked Questions

1. Does C-section pooch go away?

A C-section scar may not go away completely but usually lightens over time. However, fat accumulated under the scar can be shed.

2. How do previous C-sections affect future births?

Previous C-sections may affect future delivery outcomes. In a study published in the National Library of Medicine, C-sections have been associated with future pregnancy complications and fertility issues (14）.

3. What is more painful: C-section or natural birth?

Natural birth may be more painful than a C-section as the latter is performed after administering anesthesia. However, the recovery from C-section could cause more discomfort than a natural birth.

It is common for couples planning to have more kids to be confused about the number of C-sections they can have. However, the condition for a repeat C-section depends on the safety and the condition of the mother and also the health of the baby. Possible complications associated with having multiple C-section deliveries include increased operating time, potential injuries to the bladder and intestines, and the thinning of the myometrium, among others. Therefore, have detailed conversations with your OB-GYN about the associated risks and complications of undergoing multiple C-sections to make an informed decision.

Infographic: Negative Effects Of Repeated Cesarean Deliveries

A doctor may recommend a cesarean delivery due to several causes, including high-risk pregnancy and preterm birth. However, if you plan to have three or more deliveries through cesarean section, it might result in some downside. The infographic below outlines various possible complications of repeated C-sections.

disadvantages of repeated c sections (infographic)

Get high-quality PDF version by clicking below.

Download Infographic

Key Pointers

Some C-section incisions may impede future vaginal births and require a repeat C-section.
Having more than three C-sections poses a significant risk in subsequent births.
A repeat C-section may necessitate additional surgery time and a longer hospital stay.
If you had a C-section, wait for the incision to heal and take a long gap before planning your next pregnancy.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in oureditorial policy．