Pregnant after three caesareans and hernia repair, why extra monitoring?

[271091N]

Hi this may sound like ramblings but I will get as much info in as possible. I have 3 children with my previous partner and I am currently 10+2 with my 4th with a different dad. My previous pregnancies were all consultant led, first 2 were emergency sections and the 3rd was a planned section. The last one didn’t heal and I was left with a 5cm incisional hernia which took 8 hours and 9 incisions to repair. I haven’t had a period in over a year so I went for a scan yesterday to check how far along I was, after the scan I got a call from the hospital from the consultants receptionist saying they need to see me before my next scan (12 week scan in 2 weeks) and that I need to start taking aspirin and that I will need to start growth scans pretty much straight away. I am a bit older than when I had my last child I was 29 and this time will be 35. My children were what could be considered on the smaller side at birth, first 2 both weighed 6lb2 and the 3rd was 6lb. Obviously I haven’t actually seen the consultant yet and they could answer all my questions but I’m concerned why this pregnancy is so different even though I know all pregnancies are different I feel like this is a higher risk pregnancy than my others and I can’t help but panic. I took 15 pregnancy tests as I genuinely didn’t think it was real and now I have seen nugget I know it’s happy and wriggly and heart is beating away nicely and I’m already insanely in love it’s made me panic even more.

Is it to do with the internal scar tissue?

I had three c- sections and was warned not to get pregnant again. They said that the lining of the womb becomes thinned out? This together with scar tissue can make it difficult for the uterus to support a pregnancy. That's what I was told but that was a few years ago. They will probably want to monitor you very closely.

The very best of luck with your pregnancy.

surely it's a combination of things - why your previous pregnancies were consultant led/the number of sections and reasons for the emergencies/ how they repaired the hernia if it was related to the section scar (it might make doing another section more complex).

Sounds like your babies may have been <10th centile for weight, depending on their gestation, so that would be an indication for additional scans just to make sure they're growing to their full genetic potential, and not being limited by the placenta (which is what the aspirin helps prevent problems with)

I’ve only got 2 dc. Both were emcs. In my second labour I had a uterine rupture from the scar tissue from the first CS, and then massive haemorrhage. They may be concerned about the strength and stability of your uterus after 3 previous CS. Some hospitals consider you to be high risk once you are 35, regardless of past history too. Or maybe it’s a combination of several factors.

Well I’d think because of all the past c sections but I was also told to take aspirin and given multiple growth scans with my second pregnancy. My first pregnancy having no issues, vaginal birth but baby weighing 6 and a half pounds was apparently too small

The medical recommendation is that more than 3 c sections requires a lot more monitoring and your last one didn’t heal properly …. a quick google search will confirm this

TBH, I'm surprised you'd even need to ask why they are concerned!

-All 3 pregnancies consultant led previously
-Now age 35
-Underweight babies
-Wound not healing then a hernia
-2x emergency sections then a planned one. As others have said, many woman are advised not to try for a 4th after 3 sections due to the risk of rupture

Take a list of questions with you when you do see the consultant, but its seems pretty clear why you are high risk.

There's no need to be quite so surprised, perhaps give her a bit of a break? Previous CSs and a non wound healing isn't an indication for growth scans, although yes she'd be under consultant care. Sounds like baby's weights are marginal anyway and even as a midwife I can't remember the exact centiles my babies were born on!