more then one c section

[aishi666]

Hello im Aisha im a proud mummy of 6 boys 4 of which where c sections im now pregnant again 3 month with baby 7 and 5th section has anyone else had more then 4 c sections and been fine with it?

[JudiAU]

By "fine with it" do you mean physically?

I have no experience with a c-section but my sister has had four, all with the same OB. After her third, he told her she could probably do one more if she really wanted but that he didn't think more than four was was safe and he wouldn't deliver it. (They had planned on five.)  He wanted them to commit to some form of permanant birth control before they resumed "activitiy." I don't know if that was his general opinion or if it was based on her inciscion site(s) but it is probably worth discussing how multiple surgeries effect your risk.

I do have one cousin with a very large family (no birth control for religous reasons) and she has given birth various ways. They were told something similar but because of their beliefs, continued to have children. They have eight kids now but I don't know how many c-sections.

Good luck with your pregnancy and birth.

[starrlamia]

I know that your risk of morbidity raises with each c-section, as does your risk of placenta previa, placenta accreta and hysterectomy. But I dont know anyone who has had that many.

[thencamehenry]

I came across this article awhile back.  I warn you it is written in such a way that it would be scary for a pregnant mom to read, but when I read it I learned some things I didn't know about exactly why it's risky to have multiple c-sections. Ugh, I almost hesitate to post this, but I really think it's important to share it because the risks of c-sections are so minimalized in our country right now.

http://abcnews.go.com/Health/caesarian-rates-placenta-accreta-contributing-rise-maternal-death/story?id=13399308

If I were in your shoes I would be pretty curious to know where the placenta is located in relation to previous scars.  They can tell at your 20 week ultrasound.  Hopefully it will be well clear and that will alleviate some worry.

[Storm Bride]

I've had five c-sections. Physically...I have fairly extensive nerve damage in my pelvis and lower abdomen, dating back to my third one (in 2005). Other than that, I'm fine. I'm not even a little bit okay with it, emotionally. But, I don't think that's what you're asking about, is it?

There are several risks that go up with multiple c-sections. I dodged all of them, but there are definite concerns.

Judi: That's one of the things I truly hate about OBs. He won't deliver it? So, if she gets pregnant again (which is, after all, her choice, not the OB's!), he's so concerned about the dangers that he'd leave her without a surgeon? That makes soooo much sense. This is a trigger of mine, because the OB badgered me about a tubal all through my third pregnancy, even though I'd been very, very clear that I wanted another baby after ds2. He was relentless. (He also didn't seem to see any contradiction between his stance of "you have to have a c-section, because you've already had two, and we want a healthy mom and healthy baby" and "once you have this one, you shouldn't have any more, because more than three c-sections is soooo dangerous". Apparently, his definition of "healthy" and mine are...divergent.)

[miriam]

I

Edited by miriam - Yesterday at 5:26 pm

[Storm Bride]

Originally Posted by miriam 

I am sorry, Storm Bride. I remember your ordeals.  

As I understand it, doctors are seeing more placenta previas and accreta than ever before in mothers, possibly because of the scar tissue.  

It's almost certainly about the scar tissue. I remember an OB (can't remember his name, and I should - my brain is just not functioning right now - lack of sleep, combined with heat) presenting at the 2007 ICAN Conference. He had some statson the rates of previa and accreta with multiple c-sections, and the numbers were astonishing. The absolute risk was still fairly low, even after 4-5 c-sections, but the increase in risk with increasing c-sections was clearly noticeable, and there was significant jump after...think it was four. I remember that was the one thing I was really worried about when I was pregnant with dd2, especially after we determined that I had an anterior placenta.

It is my understanding that Mrs. Ethel Skakel Kennedy, wife of Robert F. Kennedy and mother of Robert F. Kennedy, Junior, had all of her eleven children by caesarean section.  I do not know if she ever had a hysterectomy, but I do know she liked to play tennis.

Nobody seems to know exactly how many c-sections she had. I've heard several different numbers. But, she definitely had a lot.

OP: There are risks (eg. previa, accreta) that clearly go up with each subsequent c-section. The other issue, I think, is just the whole "lightning strike" thing. If Complication A happens very rarely during a c-section, then any one c-section is unlikely to result in Complication A. But, if a woman continues to have c-sections, then her chances of having Complication A occur go up a little, simply because there have been more chances. (I have no idea if I expressed that clearly or not. My brain really isn't working right now.)

[dlm194]

Just an fyi.....  that article states that NJ saw 40 maternal deaths last year due to placenta accreta.  That statistic is incorrect; I verified that with the NJ Center for Health Statistics who takes the NJ c-section rate very seriously.
 

Originally Posted by thencamehenry 

I came across this article awhile back.  I warn you it is written in such a way that it would be scary for a pregnant mom to read, but when I read it I learned some things I didn't know about exactly why it's risky to have multiple c-sections. Ugh, I almost hesitate to post this, but I really think it's important to share it because the risks of c-sections are so minimalized in our country right now.

http://abcnews.go.com/Health/caesarian-rates-placenta-accreta-contributing-rise-maternal-death/story?id=13399308

If I were in your shoes I would be pretty curious to know where the placenta is located in relation to previous scars.  They can tell at your 20 week ultrasound.  Hopefully it will be well clear and that will alleviate some worry.

[nononose]

Are those numbers right?  25% chance of accreta  if the placenta is on top of the scar after 1 c/s, 50% after 2, 75% after 3 and 100% after 4.  Can't be!
 

Originally Posted by thencamehenry 

http://abcnews.go.com/Health/caesarian-rates-placenta-accreta-contributing-rise-maternal-death/story?id=13399308

[Storm Bride]

Originally Posted by nononose 

Are those numbers right?  25% chance of accreta  if the placenta is on top of the scar after 1 c/s, 50% after 2, 75% after 3 and 100% after 4.  Can't be!
 

The article said "approaching 100%" after four c-sections. Those numbers are slightly higher than I'd seen before. The quote did say those numbers were a rule of thumb, not solid stats, though.  I don't have the numbers I had before in front of me (and don't know where they are), but the biggest study I saw wasn't such a steady increase. The risk of an accreta, if the mom had a previa (the study I'm talking about didn't directly address the placenta being on the scar itself) went up steadily with each c-section, and then took an abrupt jump after the 4th or 5th (can't remember which - but I think it was the 4th). The odds of developing a previa at all also went up with subsequent c-sections. It's scary stuff.