If you've had a c-section before, you can have a vaginal birth after a c-section (VBAC) or an elective repeat c-section (ERCS). If you are fit and healthy, both are safe choices with very small risks.
Each repeat C-section is generally more complicated than the last. However, research hasn't established the exact number of repeat C-sections considered safe. Women who have multiple repeat cesarean deliveries are at increased risk of: Problems with the placenta.
There's also no set rule when it comes to the number of C-sections you can have. "I have performed a woman's sixth C-section with virtually no complications or difficulties, and I have performed second cesarean sections with many adhesions and potential complications," says Jason S.
Most women who have had a caesarean section can safely have a vaginal delivery for their next baby, known as vaginal birth after caesarean (VBAC). But you may need some extra monitoring during labour just to make sure everything is progressing well.
The success rate for women who attempted a VBAC after 2 c-sections was found to exceed 71%, while the uterine rupture rate was around 1.3%. The risk of complications was similar to those of a repeat c-section.
The risk of rupture is higher (over 1 percent) after ≥2 prior cesareans, with induction of labor, or after a short interdelivery interval.
“So, every patient is different and every case is unique. However, from the current medical evidence, most medical authorities do state that if multiple C-sections are planned, the expert recommendation is to adhere to the maximum number of three.”
Can c-section scarring cause infertility? Yes, c-section scarring sometimes causes infertility. But with treatment, many people go on to have healthy pregnancies.
Compared with primary cesarean delivery, repeat cesarean delivery could be associated with additional risks. Uterine rupture is one of the most catastrophic complications of pregnancy and can also present as an asymptomatic scar dehiscence.
A vaginal birth after a caesarean section (VBAC) is an option for women who have had one previous caesarean. After two previous caesarean sections, the risks of a labour and vaginal delivery increase. Most experts recommend against a VBAC for women who have had 2 previous caesareans.
There's usually no limit to the number of caesarean sections you can have. But the more caesareans you have, the longer each operation will take and the higher your risk of serious complications becomes. You will have scar tissue where your wounds have healed after each operation.
Kristina House (USA) has given birth to 11 children (six girls and five boys) all by Caesarean section between 15 May 1979 and 20 November 1998.
'Spice Girl' turned fashion designer Victoria Beckham has four children and delivered them all via c-sections. Brooklyn (1999), Romeo (2002), Cruz (2005) and Harper (2011) were all born by elective caesareans.
You will need to wait at least 6 months but your doctor or midwife may advise you to wait for 12–18 months. The longer you leave your scar to heal, the stronger it will be. It's particularly important to make sure your scar has completely healed if you want to try for a vaginal birth next time.
"Waiting until 39 weeks increases maternal risk," said Laura Hart, MD, a fellow in the division of maternal fetal medicine at the University of Texas Health Science Center in Houston. "The optimal time of delivery is 38 weeks for women with 2 previous cesarean deliveries and 37 weeks for those with 3 or more."
Ideally, your doctor will cut through the same scar so that you don't have multiple scars on your abdomen and uterus. Sometimes scar tissue can be difficult to cut through but your doctor should be able to cut through it.
Getting Pregnant After C-Sections
The good news: If you've had multiple C-sections you're just as likely to conceive as women who gave birth vaginally. Doctors recommend you wait at least six weeks after a C-section before having sex and generally encourage using birth control until six to 18 months postpartum.
If you've already had a cesarean birth (also called c-section), you may be able to have your next baby vaginally. This is called a vaginal birth after cesarean (also called VBAC). Cesarean birth is surgery in which your baby is born through a cut that your health care provider makes in your belly and uterus.
C-sections and scarring
As with any surgery that involves an incision, it is normal for scar tissue to develop after a Caesarean section. However, sometimes this scarring can cause severe inflammation or obstructions that will make future pregnancies difficult.
This study shows that CS scar myometrial thickness is not static and changes throughout pregnancy in the study population. Our data also suggest that in a women's group with a CS niche in the first trimester, the CS scar myometrial LUS thickness reduces more rapidly between the second and third trimesters.
8-16 Weeks: Pulling on scar tissue from a previous cesarean section. This pain can feel like sharp pinching or burning pain and is often located in the belly wall, under the skin, right or left, to the side of and slightly above the skin scar from a previous cesarean section.
“It's very common for cesarean scars to itch or hurt years later, but that doesn't mean that it's normal,” says Dr. Ashley Rawlins, PT, DPT. Normal implies healthy and functioning well. If you're bothered by your scar, all is not well — and you can definitely do something about it.