How Many C-Sections Can You Have Safely? Risks And More

Many parents may have a common question during pregnancy: “How many c-sections can you have safely?” This is especially prominent when the obstetrician suggests a c-section delivery, and the parents subsequently plan to have more children. While it is difficult to determine the exact number of c-sections you can have, experts believe that the more caesearn surgeries you have, the riskier the future surgeries become for you and your baby.

However, since each woman’s pregnancy is different, the number of possible risks and complications may vary too, and so does the number of c-section surgeries they can have in a lifetime. Keep reading to know more about the safety, and side effects of a repeat c-section and the factors to consider for subsequent pregnancy after surgery. 

Considerations for Having Another C-Section

There are certain circumstances where you may have to opt for a repeat c-section surgery, including

• Previous uterine rupture
• Placenta previa
• Presence of a classical caesarean scar
• Increased risk of uterine rupture
• Having two prior c-sections
• Any co-existing high-risk pregnancy condition along with a previous c-section (for instance, having twins, preeclampsia)

Some c-section incisions may limit further vaginal birth, which means you may have to opt for a repeat c-section. These include:

• Low-vertical caesarean incisions
• High-vertical caesarean incisions
• J or inverted T-shaped caesarean incisions

How Safe are Repeat C-sections?

According to experts, there is a high risk associated with more than three c-section surgeries. Moreover, the British Journal of Obstetrics and Gynaecology (BJOG) states that five or more caesarean surgeries are associated with increased complications and longer surgery times. 

Possible Side Effects of Repeated C-Sections

In addition to the complications associated with first-time c-section surgery, some additional effects or risks of multiple c-sections include

• Prolonged operation time
• Dense adhesions
• Frequent prenatal medical visits
• Prolonged hospitalisation time
• Intestinal or urinary bladder injuries
• Placenta previa (a condition where the placenta lies in the lower segment of your uterus)
• Previous surgical scars, making it challenging to perform an incision
• Myometrial thinning
• Abnormal placental invasion 
• Severe bleeding that leads to blood transfusion
• Hysterectomy at the time of delivery
• Pain and numbness at the incision site
• Diastasis recti (a condition where the stomach muscles separate and the abdomen protrudes)

Are There Any Advantages of Repeated C-Sections?

Some benefits of repeated c-sections include

• Better planning and scope of preparation to avoid any last-minute rush
• Less anxiety as you are familiar with the procedure
• Lower risk of uterine rupture as compared to vaginal birth after caesarean delivery (VBAC)
• Low risk of fetal morbidity
• No need to go through labour pain

Factors to Consider for a Subsequent Pregnancy After a C-Section

It’s normal to have certain concerns while planning a subsequent pregnancy after a c-section delivery. It is crucial to bring them to your doctor’s notice to get relief from those worries. Some factors that you should consider before planning another pregnancy include

• Wait for your incision scars to heal before planning another pregnancy. It may take up to 18-24 months for your scars to heal completely.
• Maternal age also plays a crucial role in determining a safe delivery. With higher age, the risks associated with caesarean surgeries also increase.
• A longer gap between your pregnancies can help reduce the risk of placenta previa and placental abruption.
• A longer gap can also help you achieve a successful VBAC and avoid complications from multiple c-section surgeries.

Conclusion

It is normal for couples planning to have more kids to be confused about how many c-sections can they have. The truth is that the probability of a repeat c-section completely depends on the safety and condition of the mother and also the health of the baby. Therefore, have a detailed discussion with your ob-gyn about whether you require a repeat c-section or not, and consider all the risks and possible side effects before making an informed decision.

Also read:

What to expect when your water breaks: Learn all about water breaking during pregnancy and our next steps of action during this time.

What to expect during vaginal birth: We have entailed everything you need to know about vaginal birth and what to expect during the labour stages. 

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