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Childbirth

Share experiences and get support around labour, birth and recovery.

a 4th csection.bad idea?remind me of risks.

71 replies

moljam · 02/02/2008 09:43

im not pregnant but would love a 4th but would be 4th csection.gp not impressed,consultant fine,gp said wait 3 years.im trying to wait-ds will be 3 in dec this year.so plenty of time to keep changing our minds!i did have bladder damage with 3rd due to scar tissue but is all ok now.

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moljam · 02/02/2008 14:22

?

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Scotia · 02/02/2008 14:24

Sorry I don't know anything about c-sections really, but my friend had 4. There's five years between her third and fourth though.

lutonlass · 02/02/2008 14:44

Dont want to scare you but my friend has just had her 4th c-section and she ended up bleeding out and the baby had to go into the SCBU. She had the go ahead from her docs etc and it had been almost 8 years since her last section but she still had complications, this may not be the case for you at all (she is slighlty overweight aswell so that could possibly have been something to do with it) and you could go onto being fine. I think as long as you know all about the complications are are confortable going through it all again...recovery period and all....then why notand i think if i did want another one then nothing could really deter me from my goal.
Im due my 2nd section this tuesday!

chipmonkey · 02/02/2008 14:56

I'm having my 4th section next April. There is an increased risk of placenta praevia, which I had on my third baby but this time my placenta is apparently nice and high. I'm in Ireland and as a general rule we tend to have more children than in the UK and 4 CS's would not be that uncommon. And I have hardly heard any bad stories at all.

Lulumama · 02/02/2008 15:01

think lisalisa has had 4 or possibly 5 sections.

i think that the op could take longer due to scar tissue and adhesions, and there are higher risks of placental issues, but your consultant will advise.

can you see someone before TTC? a doctor cannot give you the specialised info you need, an obs/gynae can

everyone i know who has had c.s has had 3 at the most. there are risks to all c.s and all births, it is finding out exactly how much bigger the risk is and making an informed decision

moljam · 03/02/2008 20:39

thanks.i saw consultant and he said it was fine and nothing in my notes to suggest not too.it was gp who wasnt happy with consultants view.but i suppose its the consultant who does the op.
consultant said so long as aware of risks.

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maxbear · 03/02/2008 20:53

The more sections a woman has the riskier they get, they take longer to do and there is a higher risk of losing quite a lot of blood, bladder damage etc. The worst case scenario would be a placenta praevia which would carry a significant risk of severe haemorrhage and hysterectomy. Having said all of this, if you have no other complications you might well be fine. I would strongly suggest that you get a gynae appointment with someone at the hospital which did your last section, they are the only ones who can give you accurate advice. As for the three year thing, sounds like a figure your gp has just picked out of no where. Good luck.

moljam · 03/02/2008 20:57

can you explain more what placenta praevia is?sorry to sound dumb-i probably should know this!
also the consultant i spoke to was one of the team that did all 3 sections.wasnt 'the' actual person but on their team with my notes in front of him.maybe gp said 3 years as hes hoping i'll go off idea by then!

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moljam · 03/02/2008 20:58

just remembered.gp wasnt happy consultant decribed the no more than 3 csection rule as old school

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Lulumama · 03/02/2008 21:01

placenta previa is where the placenta is either near, touching or completely covering the internal cervical os. there are 4 grades, with 3 and 4 bringing the most risk of blood loss and complications. so if the placenta was covering the os almost completely or completely , as labour started and the cervix starts to dilate, there would be big blood loss..grades 1 and 2 are less of an issue and often the placenta previa has moved as the uterus has grown as the pregnancy progressess.

even if you are not going for vaginal delivery, it is an issue, as dilation before a planned c.s can cause blood loss, sometimes sex can cause bleeding, so it would need monitoring. sometime severe cases need hospital monitoring and bed rest

moljam · 03/02/2008 21:02

what would signs be?when would this most likely happen?

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Lulumama · 03/02/2008 21:14

it is usually picked up at the 12 wk scan IIRC, and then at the 20 wk you would be rechekced, if there was an issue , then you would be rescanned.

MrsRecycle · 03/02/2008 21:22

I had 3 sections and am very small and not overweight. At my last section, I was told I could not have anymore due to adverse scar tissue and that was with 6 years between sections. The surgeon didn't have to use a scalple to open up my scar, he just pushed his finger through - he said that if it had been a few hours later, both ds and I would not have survived. I'd love another one but am listening to my consultant on this one and want to be around for my other 3 kids.

LadyVictorianSqualor · 03/02/2008 21:34

If a third or fourth section is so dangerous its begs the question why are they so often against VBA2C, especially when the risks of uterine rupture are hardly increased from a VBAC to a VBA2C....

What is it they say about CS's? They just pass all the risks onto the next pregnancy?

moljam · 03/02/2008 21:34

MrsRecycle-bloody hell!thats scary!if consultant said that im sure that would be enough to stop you ever thinking shall i shant i thoughts ever again!do you think you being very small was factor?im also very small.did they not warn you before 3rd?did you know during pregnancy this was problem or just when they did section?
i think same as you when you say you want to be here for your other 3 children.theyre more important to me than any others i may have.

lulu-thanks.ifit were to happen what action would they take?

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moljam · 03/02/2008 21:35

LadyVictorianSqualor .sorry im tired and not understanding.what does that mean?

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Lulumama · 03/02/2008 21:37

if you did have placenta previa, then your c.s might be a bit more complex , if you had a lot of bleeding, you might be asked to stay in hospital towards the end of pregnancy. all this would be explained to you if it happens, so try not to worry too much now, especially as you are not pregnant yet, there is every chance the placenta could implant normally.

moljam · 03/02/2008 21:42

thanks lulu- i just want to think seriously before even ttc as although wed love another baby.we dont want to do anything stupid.

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Lulumama · 03/02/2008 21:44

look, you can drive yourself mad with the what ifs and worst case scenarios, can't you? if your consultant does not thikn there is a problem, then i guess that is your starting point, but it is great to look into it properly, and make an informed choice.

moljam · 03/02/2008 21:47

i think the thing that worried me was that although consultant was fine-he even laughed as i sat crying in his officewhen i visited gp to say what consultant had said and ask about what his opinions were(dont know why i done it as i already knew)he said he thought it was big risk and if i was his wife or daughter hed advice againgst it.

i will go mad panicking i think

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LadyVictorianSqualor · 03/02/2008 21:48

Sorry moljam, basically a VBAC (vaginal birth after caesarian) is sometimes not exaclty supported in the maternity services, some cons think if youve had one CS you should always have one (whether or not you could physically have a vaginal birth), with a VBA2C (vaginal birth after 2 cs) it is even less likely to get a cons to agree to 'allowing' you to try to labour naturally, even though the only real increased risk compared to a first natural labour after 0cs's is uterine rupture (after one CS the irsk is about 0.5% and after two it doesnt really increase).

Hope I explained that a bit better.

My last comment was about how a lot of CS's are done and they arent necessary per se, but the patients are not warned that each CS increases risks to their next pregnancy.

WendyWeber · 03/02/2008 21:50

I had 4, moljam - deliveries got earlier and earlier to avoid any possible risks, so dc3 was delivered at about 38 weeks and dc4 at 37; they were very sleepy and rubbish feeders but that seemed to be a family trait anyway. (dc1 was delivered at about 41+3 and even she was dopey. I have a feeling that if all had been well and all could have been left until cooked they'd have gone to 42 weeks or even longer, which means they were actually even earlier than they seemed. dc4 was very jaundiced and seemed quite prem)

I had no problems with scars or adhesions or bladder damage or bleeding, but then mine were all electives for one thing, and I am v tall with relatively small babies for another.

If your consultant is OK with it I think you should def consider it, really (I think GPs sometimes have their own axes to grind )

Lulumama · 03/02/2008 21:51

mol, your GP is not an expert in obstetrics, by all means listen to him, but a conusltant obstetrician will know a thing or two about multiple c,sections!

WendyWeber · 03/02/2008 21:52

There is an occasional poster on here called zipper (lol) who has had 6 or 7

LadyVictorianSqualor · 03/02/2008 21:53

I'd say that if your cons is ok with it, go for it, they tend to err on the side of caution so if s/he thoguht there was a real problem with it you'd be the first to know.