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Four c sections

(36 Posts)
SleepingInNewYork Sun 18-Feb-18 21:40:17

Has anyone had four sections? Did you need extra monitoring or appointments with a consultant?

WindowsSmindows Sun 18-Feb-18 21:43:25

I had four, same monitoring but all my appointments were with the consultant as I was a private patient and I preferred that.
No problems. Easiest one was the fourth actually.

SleepingInNewYork Sun 18-Feb-18 21:44:30

By same monitoring, what was it that you had? I saw the consultant monthly in my last pregnancy.

WindowsSmindows Sat 24-Feb-18 23:45:37

Sorry I thought others would watch your thread. Yeah monthly scans I think. Nothing extra on the day of the section and to be honest it was the easiest spinal, and the easiest overall recovery.
My friend has has seven sections, never a complication.

mrbob Sun 25-Feb-18 00:11:32

The pregnancy is not normally the problem but the delivery is MUCH higher risk. It is strongly advised against.

Trunkisareshite Sun 25-Feb-18 00:27:58

Is it mrbob? I was told by a consultant that it’s entirely a case by case thing and three was the generic number given out years ago but people still say it like it’s true today. Can you show me some stats as I can’t find any? I’m genuinely interested.

DickTERFin Sun 25-Feb-18 00:36:42

I’ve had four and appointments/monitoring was the same. Recovery from the fourth one was fine. First one was the worst but I think that was because it was a crash section after a long and traumatic labour.

Spangles7 Sun 25-Feb-18 00:39:16

I've had four , the final two in consecutive years, and had normal monitoring. I was warned by the consultant in pre op before that there might be scar tissue etc, but actually she said afterwards there was none, it was as if it was my first ever section (smug smile)

MotherforkingShirtballs Sun 25-Feb-18 00:43:17

I've had three and was strongly advised after the third not to have any further pregnancies due to a weak scar and excessive amount of adhesions. I'd been advised after my second section that my scar was weak (I'd originally wanted a VBAC so made the right decision opting for an ELC instead as the scar would have ruptured). They said I'd need growth scans and a section no later than 38wks in any subsequent pregnancies. This time around it was a very definite "your scar cannot easily support another pregnancy and the number of adhesion made it a very complicated surgery". The surgeon who advised me of this did say as part of the conversation that some people can have 3, 4, 5, or more whereas others can only manage two. It all depends on how you've healed internally on the other sections and they don't know that until they open you up.

elliejjtiny Sun 25-Feb-18 00:43:36

I've had 2 but I'm pretty sure the risk varies from one person to the next and of course elective sections are safer than emergency ones. I know risk of uterine rupture goes up with each section but not sure about the other risks or whether there is any increased risks with pregnancy.

mrbob Sun 25-Feb-18 01:13:53

So risks are: increased operative difficulty because of scar tissue, increased bladder and bowel injury risk due to tissue being stuck down. Increased risk of blood clots. Risk of bleeding is higher too because of the scar tissue but also because the placenta can invade the uterine muscle once the wall has been breached after a first section and getting it out can cause haemorrhage and the risk of hysterectomy is significant (and having a hysterectomy at section carries significant risks too).

So yes it is a "case by case basis" but they don't know exactly which ones are going to be the problem ones (although to be fair they can ultrasound and see if your placenta is invading abornmally) and you can't make any difference to it- it is more luck. And yes as some people have said above you might have 17 c sections and be fine in the same way you can smoke like a chimney and live to 90 but it is about the RISK.

e.g. "Knight et al.11 investigated the number and type of previous deliveries in women subsequently requiring a cesarean hysterectomy. They showed that there was a 1:30,000 chance if undergoing first vaginal delivery, 1:1700 chance if undergoing first cesarean delivery, rising to as much as a 1:220 risk in a woman who had had two or more cesarean deliveries" These are not like normal hysterectomies- these are 10 litre blood loss and risk of death hysterectomies.

I literally was at a conference yesterday where they were talking about this weirdly. The rest of pregnancy is fine as long as you don't go into labour and rupture your scar and the recovery is not necessarily worse but the peri-operative period is high risk. The latest national UK review MBBRACE showed a very slight increase in the risk of haemorrhage as the cause of maternal mortality and they identify abnormal placental implantation (which is due to previous sections) is the reason for this

I am in no way anti c section but I think it is wrong to say they are entirely safe. If you need a c section it is the right thing to do. The risks overall are pretty tiny so your individual chances of a bad thing happening are really small. But the risk gets higher to both of you the more times you have them.

MotherforkingShirtballs Sun 25-Feb-18 01:26:12

Just to add that my third section was wonderful, I had a gentle caesarean with the curtain lowered at delivery and my baby delivered onto my chest just like in a VB, they let the cord stop pulsing before they cut it, I had skin to skin while they stitched me up, and they waited until we got to recovery before they did any weighing and measuring. But recovery from there on in was horrendous. I had afterpains like you wouldn't believe, pain in my wound so bad that I needed oramorph before I could get out of bed, on day five post-section I developed sepsis due to retained tissue and my uterus hadn't shrank down at all so my bleeding had stopped due to it not contracting, then the retained tissue came away alongside a secondary PPH. It was not the postnatal recovery that I envisioned!

MotherforkingShirtballs Sun 25-Feb-18 01:28:22

What you could do, if you're planning another, is to make an appointment with the birth reflections service at the hospital where you had your last delivery. They'll go over your delivery notes with you and will be able to discuss any issues the surgeon found such as adhesions. It might help you assess whether you want to risk a fourth section?

elephanttrunks Sun 25-Feb-18 01:44:47

I've had more than 4...have a thread atm which I don't want to be outed on so wouldn't say the exact number but it's a few more. Pregnancies were not treated differently but I was always first on the list for my sections after number 4 and they never let me go too near due date. Had steroid injections at the end of the last one as I only went to 38 weeks. Feel free to pm if you want more info

SleepingInNewYork Sun 25-Feb-18 03:43:51

Thank you for all of the information.

Do you know if the impact on your body is less if your pregnancies did not all go to full term or is the whole issue with the surgery itself rather than pressure on the scar?

SleepingInNewYork Sun 25-Feb-18 03:46:05

MotherforkingShirtballs I have already asked and the consultant said he was happy to support me in another pregnancy but I feel he was more agreeable than perhaps he would normally be as my last baby didn’t survive.

branstonbaby Sun 25-Feb-18 04:29:46

I had four c sections in six years. Was put on bedrest for the last six weeks of the pregnancy.

No extra treatment and the delivery / recovery was fine.


branstonbaby Sun 25-Feb-18 04:33:42

And just saw last note about your baby.

I'm so sorry for your loss. thanks

I think it is important to talk more to your doctor in RL.

LivingInTheSeventies Sun 25-Feb-18 04:39:42

I had 4, the last after losing a baby (5 births). I was told my placenta was very thin and another pregnancy was a risk but they were fine with supporting it. Funny enough, my placenta was completely fine for the last one and they said they would support as many more dcs as I wanted.

Hedgehog80 Sun 25-Feb-18 04:48:19

Sorry for your loss OP 💐

I’ve had 5 c sections plus other surgeries ( emcs, elcsx3, sterilised, ivf procedures, reversal and another elcs)
C sections 2 and 4 had complications due to placenta accreta but number 5 was fine! Ds3 is 6 wks now it was all uncomplicated. They were all delivered a bit early after first one so last 4 sections were at 39,38,36,38 weeks. My 36 weeker was in NICU for just over a week and a his time I had steroids just in case
My consultant and surgeon told me it’s up to me if I have any more, they had a good look at time of surgery and scar tissue was minimal they did say they never recommended more than 3 but in my case having another wasn’t totally contraindicated but that I HAD to wait at least a year preferably 2 if I did.
Currently I don’t think I would but I feel better that I have the option again now and can decide in a couple of years if I’m done or not

BikeRunSki Sun 25-Feb-18 05:44:18

I had a uterine rupture I. Labour prior to my second CS ( crash CS) and was advised not to have any more babies.

Hedgehog80 Sun 25-Feb-18 10:53:16

Forgot to add I had a few extra scans and c section was scheduled before the preferred 39 weeks but it wasn’t overly intensive monitoring. Tbh I had more done the first few weeks as they wanted to make sure the pregnancy was many ectopic and then were very interested to see where the placenta was once they knew it was posterior the extra checks were scaled back till 28 weeks

Hedgehog80 Sun 25-Feb-18 10:53:39

Wasn’t ectopic

MotherforkingShirtballs Sun 25-Feb-18 11:02:27

I'm so sorry for your loss flowers

I think surgeons, and other medics, are taught to be very pragmatic about these things and even with the sad outcome of your last pregnancy if the surgeon didn't think your body could stand up to another caesarean he would be duty bound to tell you so.

In my last pregnancy I had growth scans every four weeks, was admitted at 36wks due to transverse positioning, had steroids for her lungs, and then eventually delivered at 38wks.

SleepingInNewYork Sun 25-Feb-18 19:04:38

Thank you everyone.

I have found the email address of my last consultant’s secretary, from when I had the autopsy results. I will ask whether it is possible to discuss the condition of my womb regarding another pregnancy. Would the surgeon who carried out my last operation have made notes about it or would it be a case of waiting to see if/when I became pregnant again?

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