How many CS can you have?

[wastingmyeducation]

I've had one. But I'd like a big family.
How many CS before it gets too risky?

[TuttiFrutti]

I don't know whether there is a cut-and-dried answer to this, but I know that c-sections get riskier the more you have. I've heard some doctors don't like women to have more than 3.

Having said that, I know women who have had 4 c-sections.

Why did you have your first cs? If you want a big family, maybe a VBAC would be the best option for you?

[wastingmyeducation]

Failure to progress, OP position, then he was getting distressed once I'd had the epidural. Two weeks overdue, obese mother.
I'd like to get fitter/thinner before we try for the next one as I know that would reduce the risks of the same things happening again.
I'd like to go for VBAC next time, but don't want to lose heart if it's not possible.

[georgimama]

Well Victoria Beckham has had 3. I say a birth story in Mother and Baby years ago where the mother was on her fourth C section.

How big a family do you want?

[cmotdibbler]

I have a friend with type 1 diabetes who has had 3 - they certainly weren't told that she couldn't have any more.

[fairygirl3]

have had 3 will be having 4th in august ,no none has mentioned to me that there is a limit to how many i can have.

[Bubbaluv]

After my 1st (em cs) my OB mentioned to me that if I wanted to have 4 or more children I should really consider VBAC as after 3 things are significantly riskier.
I don't want 4 or more, so will be using the sunroof again this time.

[Stayingsunnygirl]

I have a friend who had 5 sections. Each time the consultant would look at the state of the scar on her uterus, and tell her whether or not he thought another pregnancy would be safe for her and the baby.

[wastingmyeducation]

I'd like 4. Don't know if we'll get that far, but I'd like the option. Doesn't sound like it's out of the question though.

[nina99]

Stayingsunnygirl is correct! Every mum heals differently from each CS. The tendency for serious scar tissue meaning the bladder or bowel becomes stuck to the old CS scar increases with each scar. In some women the scar tissue is considerable after just 1 CS although in the majority it becomes more of an issue after 3 or 4 CS's.Most mum's would normally plan for 3 CS's with any further ones depending on how things were at the 3rd!
We occasionally do a 5th CS but by and large the operation is oftne much more difficult and associated with a greater risk of surgical complications (damage to bladder/bowel/increased bleeding). Normally the surgeon should give you and indication after each CS as to how much scar tissue was present at that CS (there will be more at the next one!) and whether on balance it would be reasonable to proceed with another CS.
I would also recommend that if you are thinking for a bigger family to try for a VBAC next time as if you are successful it will minimise the risks substantially for future deliveries.

[morningpaper]

Dh has a chum who has had 6

But the last one she had complete bed rest from about 25 weeks due to risk of rupture

[juuule]

I have read that Ethel Kennedy had 11 children by CS.

[NellyTheElephant]

It is variable and depends entirely on your healing. As others have said, if a VBAC is not an option (wasn't for me) the best thing to do is to ask the consultant at the time they do each subsequent section as they can tell a lot from the state of you when they cut you open each time. After my second secion I was told I was in very good shape re scar tissue and healing etc. I'm due my third section soon. As there is a strong chance we'd like another baby I had a chat with my consultant about it when I saw her to book this section. She said that after 3 sections the risks are greatly increased (5x or something like that?), but that said, as the risk of major complications is tiny in the first place the increased risk level is still very small IYSWIM. My consultant said I should ask at the time of the operation for an opinion on the state of my uterus and scar tissue - it's not a guarantee, but it's a good indicator as to whether problems are likely to arise in the future.

[ShowOfHands]

nina, sounds like you know what you're talking about.

On my notes from dd's birth (em cs) it says at the bottom 'no contraindications to VBAC'. Is this a reference to the amount of scarring then? I always wondered why it was on there ie whether it was a summing up of many things or a comment on my pelvis for example. Can I assume scarring was minimal from this note?

Do you also know why (sorry to bombard) when I lift heavier weights (as in working out and increasing resistance as I get fitter), for the next couple of days around my cs scar I get sharp pains?

[MrsRecycle]

For me, it's 3 - my scar tissue is so bad that during my 3rd cs my consultant told me I would die if I had another baby. Would have loved a 4th but that's the way it goes -am grateful for the 3 I have.

[rempy]

Have replied about this before but lost the reference. In essence, the risk of placenta praevia and accreta increase with each section, so that by the 4th the risk has increased to enough to worry us anaesthetists enough to get 4 units of blood crossmatched and the rapid infuser ready before we start the op.

Placenta praevia and accreta are where the placenta implants into the scar, and doesnt come away, so mother bleeds. There are degrees of severity, some are not too bad, some dreadful and would require hysterectomy and other surgery to sort out.

However, if your placenta on scan is away from the scar, it is probably ok, and you are not at risk of that particular complication.

There are other risks, as nina pointed out increasing surgical difficulty, and of course each time you have a section you run the risks of wound infection, and DVT/PE, particularly if overweight.

[nina99]

Yes it is wise to take the advice of the surgeon who was there doing the operation at the time, he/she will have a good indication of how things would be the next time! Don't hold onto any regrets in this matter, I am sure you are enjoying the 3 healthy DD/DS's you have.

[BlackLetterDay]

When I worked at the hospital there was a lady who had just had her 7th section, she did rupture with that one though.

[georgiemum]

She should have had a zip put in. My sis had 3 and says that her tummy is really saggy and nasty (she is quite skinny).

[pinkmagic1]

I have always been led to believe that 3 is the safely recommended max. A women I know of got pregnant with a 4th after 3 sections and the doctor wasn't impressed and said she was putting herself and the baby in danger and suggested sterilization after the baby was born.

[MrsRecycle]

There was a mnetter called zipper that had 6 (or maybe more). I am certainly enjoying the 3 we have as I never thought I'd have 1 let alone 3.

[wastingmyeducation]

7! I just searched on her posts out of interest.

[cikecaka]

I had 4 cs, had tubes tied during last one though

[smallorange]

I'm having my third section in June and will have to have a scan at 32 weeks to check position of the placenta.

The doc told me they are fine with 3 sections but start to get nervous at 4.

That's fine by me as DP will be marched to the same hospital for the snip as soon as I am recovered from the section!

[nina99]

Hi ShowOfHands,
The comment regarding "no contra-indication to VBAC" is likely to be an overall comment on your suitability for a vaginal birth rather than a comment on the degree of scar tissue. With only one previous CS they will not know how much or how little scar tissue formed after the last CS (they will only be able to comment on this at the time of surgery were you to need another CS). Occasionally VBAC is not recommended when a mum has had a single previous CS as the risks of scar complications or the likelihood of an emergency CS would be deemed to be 'unacceptably' high- for example if you had a 'Classical' CS where the incision on the uterus itself was a vertical one (a weaker uterine scar and higher rate of scar rupture)rather than the horizontal one used in most routine CS's or if there were signficant tears extending from the uterine incision caused at the time of the last delivery which would again lead to an increased risk of scar complications were labour to occur.

Most mums who get CS scar related pain have this as a result of stretching or tension on the more rigid skin or subcutaneous tissue scarring as opposed to the actual scar on uterus itself. This is usually not a problem for mother and baby. However uterine scar complications when they rarely occur can also manifest with intense constant severe scar pain which may or may not be associated with vaginal bleeding. The majority of such scar 'ruptures' happen during labour when the uterine scar is being 'pulled' by the uterine muscles as they contract or as a result of direct trauma to the abdomen. It is extremely rare to have a spontaneous uterine scar rupture before labour. If you have any such concerns the safest thing to do is to go into the day assessment unit or labour ward where they can assess you and put you onto a fetal heart monitor to assess the baby's heart rate. With scar rupture there are nearly always abnormalfetal heart rate abnormalities.

Having said this it sounds like your discomfort is more likely to be caused by superficial tissue related stretching rather than uterine scar problems.

Hope this helps

[fairygirl3]

im a bit worried now,tried for vbac with my last 2 but as would not induce & labour didnt start i had the sections,as i said no one said anything to me after my 3rd about anymore being risky,but this is definatly the last !