How many c-sections??

seximami2011

Since we don't have a C-Section board I guess the next best is this board. My question is how many c-sections can a woman have in their lifetime???? I want 5-7 children and I'm on my 2nd right now. I'm hoping for a VBAC but if I don't go into labor on my own before my scheduled csection on the 29th then that will be my second csection.

iris427

There isn't a set number and different doctors may give you different answers.  Personally I wouldn't feel comfortable going past 3-4 cesareans.  The more cesareans you have, the more risk you have.  By a 7th cesarean I'd be worried about major risks like placenta accreta and postpartum hemorrhage.

To give you an idea of how risk accumulates with each c/s, look at the numbers from one study:

Placenta accreta was present in 15 (0.24%), 49 (0.31%), 36 (0.57%), 31 (2.13%), 6 (2.33%), and 6 (6.74%) women undergoing their first, second, third, fourth, fifth, and sixth or more cesarean deliveries, respectively. Hysterectomy was required in 40 (0.65%) first, 67 (0.42%) second, 57 (0.90%) third, 35 (2.41%) fourth, 9 (3.49%) fifth, and 8 (8.99%) sixth or more cesarean deliveries. In the 723 women with previa, the risk for placenta accreta was 3%, 11%, 40%, 61%, and 67% for first, second, third, fourth, and fifth or more repeat cesarean deliveries, respectively. 

https://www.ncbi.nlm.nih.gov/pubmed/16738145 

MAprincess

The above stats are really good.  It will depend on what your doctor is comfortable with and what they see each time they go in there- people heal differently.  My SIL had 4 c/s and had c/s related complications with the last two that resulted in NICU stays for the babies.  Both are fine now but she will definitely not be having a #5.

pinkmoonlight

iris427:

There isn't a set number and different doctors may give you different answers.  Personally I wouldn't feel comfortable going past 3-4 cesareans.  The more cesareans you have, the more risk you have.  By a 7th cesarean I'd be worried about major risks like placenta accreta and postpartum hemorrhage.

To give you an idea of how risk accumulates with each c/s, look at the numbers from one study:

Placenta accreta was present in 15 (0.24%), 49 (0.31%), 36 (0.57%), 31 (2.13%), 6 (2.33%), and 6 (6.74%) women undergoing their first, second, third, fourth, fifth, and sixth or more cesarean deliveries, respectively. Hysterectomy was required in 40 (0.65%) first, 67 (0.42%) second, 57 (0.90%) third, 35 (2.41%) fourth, 9 (3.49%) fifth, and 8 (8.99%) sixth or more cesarean deliveries. In the 723 women with previa, the risk for placenta accreta was 3%, 11%, 40%, 61%, and 67% for first, second, third, fourth, and fifth or more repeat cesarean deliveries, respectively. 

https://www.ncbi.nlm.nih.gov/pubmed/16738145 

I agree with this. There is really no set number, but personally I would not go with any more then 4. However that being said- there are plenty of woman out there who have had 5,6,7,8,9,10 and even 11 c-sections. Ethel Kennedy had 11 children via cesarean delivery. I have also read countless stories of woman who have had 5-9 sections.

Brownie_222

I would not feel comfortable having more than 3. If I may, can I ask why your OB has you scheduled so early?

holly321

I don't think I would feel comfortable having more than three.  But like pp said, there are many people who have had more.

novilise

Yes, I agree...there really isn't a set limit...it depends on the person and the situation.

I would like to have 3 or 4 children, which I know may be by c-section, if I am not able to VBAC. 

I heard of people haveing 9 to 10 children by c-section without many complications at all, but it's probably rare. But, then, I guess anytime you have that many children, it is rare not to have some kind of complication! But it is no doubt more common with many c-sections.

I think Ethel Kennedy actually 'only' had 5 c-sections. Maybe 6? Not all of her kids, but still a lot of them. And I'm guessing that must have been with the old, classical uterine incision. 

lorryfach

Ethel Kennedy had 5. And I have not personally read any stories from anyone having more than six. The ONE that I read having 6, she had placenta percretia and it was affecting neighboring organs and it was a pretty huge deal. I'm curious where so many of you are reading countless stories of this?! Not many people have more than five kids via any kind of delivery anymore.

lkf041

I agree that it depends on the doctor.  My cousin is on her 5th csection, which will be her 5th in 6.5 years!  That would scare the crap out of me.

Also, keep in mind the ACOG revised their guidelines and have made vba2c considered just as safe as a vbac.  I've already had 2 csections and am trying to vba2c this time.  I do realize that this may not happen and another c is in the future for me.  If so that will mean I've had 3 csections in 3 years exactly.  I'd like 4 children, but if this results in another c we will be taking a bigger break in between next time. 

novilise

lorryfach:

Ethel Kennedy had 5. And I have not personally read any stories from anyone having more than six. The ONE that I read having 6, she had placenta percretia and it was affecting neighboring organs and it was a pretty huge deal. I'm curious where so many of you are reading countless stories of this?! Not many people have more than five kids via any kind of delivery anymore.

Yeah, that's what I thought, too, because I heard once that she had 11 so I went searching and apparently there are some old news articles saying that she just had her fifth section with her last child when she was around 40. 

Usually, the most that I read about are 4 to 5 c-sections. But I have seen a good many 6 to 7 c-sections. Not nearly as many after that, but ...yeah, not many people have more kids than that anyway. 

The two largest cases of lots of c-sections that stick out in my own head:

I know one lady personally who had all 9 of her children by c-section. The complication that she did end up having eventually was ectopic pregnancy, though, but I think that may have been the last child- the 10th- and she was in her 40's by then.

Another case that comes right to mind is this lady- she had all 9 by c-section:

https://manymcdaniels.com/birthstories.html

 

seximami2011

He says that by looking at my ultrasounds and the fact that I am 37 weeks and measuring 32 weeks he feels that my stomach is not growing fast enough for my babys growth. I'm not growing but he still is...my doctor doesn't want him to get too big or it might complicate delivery. He also said that contractions could began to effect his breathing and heart rate the bigger he gets.

JillianNov8

I had 4. The 4th one, I started to bleed out. Almost had to go back into the OR. LOST A LOT of blood, needed a transfusion. 3 doctors were pounding (that's what it felt like) on my stomach. One was reaching in me (yes in me, whole hand) and massaging my uterus, After that doctors said absolutely no more. It got pretty scary. They actually had me in the OR ready for surgury, I was so drugged up. Hughhhhh, it was bad! I was on iron for 6 months to try to help replace the blood loss. Even with a transfusion.

iris427

There was a state representative in Missouri that had 7 cesareans--she was a huge advocate of getting CPMs legalized so she would talk about it.  I'm not sure if she ever had any serious complications.

And there is this article about a woman having her 9th cesarean and has serious complications.  It's scary.  

https://articles.philly.com/2010-05-31/news/25216929_1_cesarean-c-section-vaginal-births 

novilise

I read that detailed article about a 9th c-section before and it is pretty insightful. But one thing I've wondered...maybe I missed it....what kind of initial incision did that lady have? Did they ever say? I know they talked about how doctors will do a low uterine incision, etc, but I don't know that it ever said for sure that this was her case, too?

The lady I mentioned in my previous post had the old, classic scar. The second lady I mentioned.....in the website link....I don't know what kind she had. I was suspecting she had the newer low uterine incision, though. 

And I do guess that Ethel Kennedy must have had her five c-section babies with the old, classic incision. That's pretty impressive and scary, I guess. I know I wouldn't be able to do that unless I was deeply convicted to do it! 

 Mummyofsix, that is good to know. That is how I feel, too. If I do need a c-section this time, I will just take it time by time and see what the doctors think. I am only planning on 4 at the most, though. (But I know there could still be time for surprises after that!)

iris427

novilise:

I read that detailed article about a 9th c-section before and it is pretty insightful. But one thing I've wondered...maybe I missed it....what kind of initial incision did that lady have? Did they ever say? I know they talked about how doctors will do a low uterine incision, etc, but I don't know that it ever said for sure that this was her case, too?

The lady I mentioned in my previous post had the old, classic scar. The second lady I mentioned.....in the website link....I don't know what kind she had. I was suspecting she had the newer low uterine incision, though. 

And I do guess that Ethel Kennedy must have had her five c-section babies with the old, classic incision. That's pretty impressive and scary, I guess. I know I wouldn't be able to do that unless I was deeply convicted to do it! 

 Mummyofsix, that is good to know. That is how I feel, too. If I do need a c-section this time, I will just take it time by time and see what the doctors think. I am only planning on 4 at the most, though. (But I know there could still be time for surprises after that!)

I'm not sure whether cesarean scar type would affect the risk or severity of placenta accreta, which is what happened to the mother in the link having a 9th cesarean.

 

novilise

I'm not sure either. I know it's more common in the classical, vertical incision because the placenta tends to implant high up, though.I guess there is just potential for many more problems with that type of incision, which makes sense.

I can't imagine having that type of scar. Even if it was just the outward layer of skin! It would be so weird for that to stretch out so much!

iris427

mummyofsix:

iris427:

I'm not sure whether cesarean scar type would affect the risk or severity of placenta accreta, which is what happened to the mother in the link having a 9th cesarean.

 

 It makes a big difference. Where the incision is on a lower transverse section is normally far too low for an embryo to implant, which is obviously not the case when your incision runs from the top to bottom of your whole uterus. Accreta risks are from the placenta moving into/ through the scar as it grows. Interestingly, I have had 5 anterior placentas, but with DC6 it grew backwards behind the baby (like parallel to my spine). My OB's both commented that with a lot of pregnancies after multiple c/s's they notice that the placenta will move away from the scar. 

 I am not saying its not an issue, because it definitely is. Just giving my experience.   

Thanks, that is interesting.  

There seems to be a pretty high correlation between placenta previa and placenta accreta so in that case, I wonder if the low transverse incision makes a difference.

lorryfach

novilise:

I can't imagine having that type of scar. Even if it was just the outward layer of skin! It would be so weird for that to stretch out so much!

You know, I never even thought of that! My MIL was cut vertically, so I guess she must know what that looks like. She had TWINS after a primary c/s, so lots of stretching!

luvbeingmom

as other posters have said, it totally depends on your individual situation.

some people can't have more than 2 cs because their uterus was stretched so thin and it wouldn't be safe to have any more pregnancies.

i just had my 4th cs and the doc came out of surgery and told me that my uterus is actually in great condition considering i've had 3 previous cs and that it looks like it would be safe for me to have another baby. we're not sure if we will yet, but at least we know that we can. 

if we do have another, i think that's it for us... even though everything went well with this cs, i was extremely nervous about it

wendy25

My mom had 5 c-sections (6 kids - one set of twins). Her last c-section was in 1983. They joked after the 4th they were going to install a zipper. Just wanted to say that it can be done.