Pregnant after 3 csections....advice

[Mummyto3GBG]

Hi all, I have 3 kids age 7, 2 and 10 months....I’ve just today found out I’m pregnant (not planned)...had 3 sections. 1 emergency, 2 electives. I was told at my last section they wouldn’t really recommend me having another baby due to the scar tissue and risk of adesions and that if I did decide I wanted another that I should wait a lot longer than I did last time. I had thought we might have one more in a few years but I would have spoken to a consultant about it before trying...anyway now I’m pregnant and my baby is only 10 months...Has anyone been in a similar situation to me, I don’t know what to do?! I’ve asked the doctor to call me but won’t be till tomorrow, not told my partner yet he didn’t even want anymore 🙈

Snap OP! I'm 28 weeks pregnancy with my fourth, after 3 sections. I had the same advice as you, although mine was just a straight 'we don't recommend you getting pregnant again', with no mention of waiting. My youngest was about 20 months when I conceived though.

I was very worried, but the subsequent advice I received was that it is quite a generic thing they say, and that people sometimes do have four or even five sections. Additionally, my consultant said that a fourth can be slightly easier than the third, because they have often cleared away a lot of scar tissue during the third. She did say that this was entirely anecdotal though and not grounded in research. Just observations made by herselfvand her colleagues.

I’m so glad I’m not the only one! I wasn’t planning on even thinking of having another for at least 2 years then I’d planned on discussing it with a consultant first to weigh up the risks before me and my partner decide to try. Have they been more concerned about you this time or said things are more risky or anything will be different in terms of surgery? Im probably mega overthinking at the moment as I’m still in shock but I’m worried they’ll say I might die and leave my kids without a mother

My mum had 4 Csections (no vaginal birth) and she’s perfectly healthy.
I’m 31 (eldest) and the youngest is 17 x

I've had all the same thoughts going round my head as you! Especially after the shock of finding out, in the first few weeks. I'm seeing my own consultant on Thursday so will let you know anything she says. However, I have seen a different consultant and I felt quite reassured after that appointment. She was the one who said that herself and her colleagues had noticed 4th sections often being easier than thirds! She said that it's a more challenging op, as they need to carefully pick through the adhesions, but that the top consultants do these type and are very experienced. She said it'll just take longer, particularly the sewing up afterwards. I think the risks tend to be more related to possible bladder or bowel damage, but obviously they are very careful. The bigger, more scary risks don't tend to be related to the amount of sections you've had, necessarily... But the amount of previous sections can increase the chances of placenta accreta or the placenta embedding in scar tissue. If these happen, it increases the possibility of needing blood transfusions or even a hysterectomy. But if these don't happen, the risks of a fourth section aren't hugely different from a second or third. Also, those things I've mentioned can be diagnosed through scans etc, so if they did happen, they'd have prior knowledge and would be prepared. So don't panic! Many more women these days are having multiple sections, because the rates are so high.

Thank you so much I needed to hear this! Yes it’s the placenta accreta / placenta embedding in scar tissue I’m most worried about I think, I’ve been googling all afternoon...I’m scared i’ll have it and die! I’ve been googling all afternoon. Aw yes please keep me updated! I’m hopeful my GP will be able to get me an appointment with a consultant at the hospital who can read back through my notes and weigh up how risky the 4th section would be too but with Covid I’m not sure how likely that’ll be.

I think that the biggest risks from placenta accreta occur when it goes undiagnosed. So, if a woman were to have a vaginal birth and had this issue, the bleeding would be profuse and unexpected. In the case of a planned section, particularly after having had several already, this will be something they are on the lookout for, and if you are at risk, will be diagnosed with scans etc. If this did occur, there would be a specialist team on standby, blood at the ready and the option to do a hysterectomy if bleeding were not controllable. Placenta accreta is becoming more common these days and so is something that medical staff are used to dealing with. I've had all these thoughts already too, and so have done lots of research! Anyway, your chances of the placenta embedding in scar tissue are very low! Do you have a midwife who knows you well from previous pregnancies? I called mine and she contacted my consultant straightaway, as soon as I discovered my pregnancy and they looked at my notes and were able to have a chat quite early on.

Thanks so much for all this advice, I really feel so alone. I should tell my other half but as he doesn’t realise all the complications that come the more sections you have so I think he’ll just be shocked and thinking about the logistics of having 4 kids and the expense/ house/ car etc and worry about that more which to me seems irrelevant at the moment when I’m more concerned about being alive to look after them. Yeah I rang the GP today and asked the receptionist If she’d ask the midwife to ring me back as I’d thought maybe she could get me in to see/ a phone call at least with a consultant but she didn’t ring me back, she maybe thought I don’t have her on my books at the moment so won’t bother. The GP is due to ring me in the morning though so hopefully I get somewhere with that. Did the consultant reassure u in the beginning that the chances of any of these complications still remained low in a 4th section?

I’ve had four c sections and they were within four years. I’ve not had any problems. Hope all goes well for you.

I've had 4 sections. I had the same consultant for DC3 and 4 and he was very much of the view that risks associated with multiple c-sections could be assessed and overcome by a competent surgeon BUT if the placenta implanted into the scar tissue from previous sections that can cause massive complications. His honest opinion was that thought should be given as to whether to continue the pregnancy in those circumstances. Luckily that wasn't the case for me and all my pregnancies and deliveries were straight forward.

I understand that, this is where my worry comes though as when does it become too late to decide/see that? I really don’t want to discontinue the pregnancy unless I would be seriously risking my current children being without a mother but how far down the line does it become too late to decide that? Like when would they find out if the placenta has attached to the uterus? Surely by then it’s too late?

I had lots of scans in my last pregnancy and I’m sure they checked where the placenta was attached right from the beginning. I was offered sterilisation last time but it wasn’t at any stage suggested that I don’t have anymore children (not that I will be).

I’m just so confused, I don’t even know whether they will give me a straight answer as they didn’t in recovery after my 3rd section. The consultant who did it said she wouldn’t really recommend another due to her having to cut through a lot of scar tissue and my uterus being thin and the increased risk of complications the more sections you have. She didn’t say I absolutely shouldn’t have another though as when I’d said I had wanted one more she just said I should definitely wait longer than I did last time....which I obviously haven’t. I was being sick at the time so planning for another baby was not really top priority at the time, i was fine if it was my last. I’d then spoke to my gp and she’d agreed if in a couple of years I wanted another we could organise me seeing a consultant before trying to get more clarification on this but obvs too late now.

I think it comes down to our individual uterus health more than anything else. My pregnancies were planned and my last one was a two belt encouraged by my consultant who told me of other patients who were on their fifth or sixth c section.

Actively not a two belt!

@Mummyto3GBG

I understand that, this is where my worry comes though as when does it become too late to decide/see that? I really don’t want to discontinue the pregnancy unless I would be seriously risking my current children being without a mother but how far down the line does it become too late to decide that? Like when would they find out if the placenta has attached to the uterus? Surely by then it’s too late?

My consultant told me that they could ascertain placenta position by the 12 week scan. I do get how hard a decision it is, my fourth pregnancy was not planned and i probably would have stopped at 3 otherwise because of the worry about leaving my 3 young children without a mother if there were complications.

Hi op, can highly recommend the Facebook group C-Section Support UK. Loads of women on there who've had multiple sections and some with short gaps between. I've not been in your position personally but head over there if you aren't on it already for some good advice. All the best.

Thank you, I just feel like I’ve been so lucky with my 3 previous babies / pregnancies / csections / recovery that surely my luck has to run out at some point when I keep pushing my body. Don’t get me wrong I was worried about my 3rd csection but that was planned so you weigh up the risks and the consultant had said I was absolutely fine to have another after my 2nd...this time that wasn’t the advice I was given. How close together did you have your 4 sections?

Thank you freeacorns I’ll have a look on there!

I think maybe you need to talk to whoever did your last section as they will have the knowledge of what your uterus actually looked/felt like, especially with such a small gap.

Yeah I’m hoping I’ll be able to speak to her and soon 😩 GP is ringing me this morning so I’ll let you know where it goes from there...I’m not very hopeful I’ll get anywhere fast tho

Spoke to the GP she’s going to try and push a referral through to the consultant but said it might take her a few days to get back to me to let me know how successful she’s been with it

I know a friend who has had her 4th c section and is totally fine (baby healthy too).

Thank you seriouslynotserious how close did she have the 4 sections? I’ve just made a referral to the hospital only I didn’t know my last period so guessed and I also put on the form about needing to speak to a consultant re risks with carrying on with pregnancy. Rang to check they’d received it and got a rude woman on the phone who said you won’t be able to discuss any of this till 16 weeks. Anyone any advice how I can get seen quicker?

There was 14 months between my third and fourth c section. As I said further up, my consultant was very positive and encouraging to me getting pregnant although she did say she would have recommended waiting longer if I’d been planning on having a vaginal delivery rather than a c section. All four of my c sections were within four years.

Were you advised not to have any more ever?