There's usually no limit to the number of caesarean sections that you can have. But the more caesareans you have, the longer each operation will take, and the higher your risk of complications becomes. If you've had a caesarean in the past, it's still possible to give birth to your baby vaginally.
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.”
A trial of labor isn't recommended after three or more prior C-sections. Deciding how you will deliver your next baby after a previous C-section can be a complex decision. Talk to your health care provider. He or she can help you weigh the risks of a repeat C-section against your desire for future pregnancies.
“There are some people who have had six or seven C-sections without any issues, and others with only one C-section whose next pregnancy is associated with a very difficult problem such as placenta accreta spectrum disorder, or a horrible adhesions (things stuck together),” he says.
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.
Results: Five or more caesarean sections were associated with a longer operating time as well as an increased rate of severe adhesions. Blood transfusion rate was similar in the two groups but a drop of pre-operative to post-operative haemoglobin was significantly higher in the study group compared with the controls.
Future pregnancies after a caesarean
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.
Conclusion: Women with three or more prior caesareans who attempt VBAC have similar rates of success and risk for maternal morbidity as those with one prior caesarean, and as those delivered by elective repeat caesarean.
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.
But another study from 2020 says the difference isn't so minimal after all: Researchers argue that when a first-time parent has a cesarean section, it does lower their chances of becoming pregnant again.
Uterine rupture is usually when the scar from your previous caesarean section tears open. Though it's uncommon, you should be aware of this risk, particularly if you're thinking about giving birth vaginally next time. It's possible for your scar to gape slightly while you're pregnant (scar dehiscence).
Many health care providers won't offer VBAC if you've had more than two prior C-sections. When did you last give birth? The risk of uterine rupture is higher if you attempt VBAC less than 18 months after your previous delivery.
Getting pregnant after a c-section
It's important to give your body time to recover before you start trying to get pregnant again. 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.
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.
Ana Langer, who leads the Women and Health Initiative at the Harvard T.H. Chan school of public health, one of the most telling findings in the study is that more than 10 percent of women undergoing a C-section died from complications due to anesthesia.
Slow recovery ability: Due to having had 2 previous births by cesarean section, in this 3rd time, the mother's body is much weaker, the ability to recover is slow, and her ability to endure a lot of pain is also worse.
A repeat caesarean section usually takes longer and is more difficult than a first operation because of scar tissue. It carries a possibility of wound infection and blood transfusion.
In some situations, a C-section is not only preferable but mandatory—situations involving conditions like placenta previa, in which going into labor would precipitate life-threatening hemorrhaging, or cord prolapse, which can cause the death of a baby if a C-section is not performed in a manner of minutes.
Answering the question of whether the second cesarean section is more painful, the answer is: Usually no more pain depending on the condition of the old incision with little or no adhesion, and the surgical technique, and pain relief of the doctors.
Types of C-section incisions
The first is through the skin of your lower abdomen, about an inch or two above your pubic hair line. The second is into the uterus, which is where the doctor will reach in to deliver your baby. The type of cut on your abdomen may not be the same as the one on your uterus.
At the beginning of a caesarean section, six separate layers of the abdominal wall and uterus are opened individually. Once the baby is delivered the uterus is closed with a double layer of stitching.
Having a C-section increases the risk of complications in a later pregnancy and in other surgeries. The more C-sections, the higher the risks of placenta previa and a condition in which the placenta becomes attached to the wall of the uterus (placenta accreta).
C-section was associated with a 15% lesser chance of conception than vaginal birth during 3 years of subsequent follow-up, whether or not women were trying to conceive (adjusted hazard ratio 0.85, 95% CI 0.74-0.96), reported Kristen Kjerulff, PhD, of the Penn State College of Medicine in Hershey, and colleagues.
There are far fewer risks to your baby during a C-section. Babies delivered by cesarean are more likely to develop breathing issues, though, especially if your C-section is performed before 39 weeks. That's because labor helps clear your baby's lungs of fluid.