three c/s limit? - Mothering Forums

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Old 01-26-2007, 09:22 PM - Thread Starter
 
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I hear alot of people here having more than three c/s and i'm a little confused. I've heard that after three they basicaly force you to tie your tubes. That's the way it is in my area so i just took it as normal procedure everywhere.

That's the way i get anti-vbac people to back off, i just tell them i want more than 3 kids. It seems to work around here but now i'm concerned that i'm not saying the right thing to get them off my back. (i do have alot more info than that know, but sometimes you run into a pretty rude one and you just don't want to get into it with them, so a nice one liner works best)

Just want ya'lls thoughts

In love with the Hubs (6-03) & : Kookie Pookie Girl (c/s 5-05) & Bouncy Big Boy (vbac 2-07) & : Miss Cheeky Cheeks (hbac 11-08) 100*90* 100lbs = Las Vegas : Almost there!
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Old 01-26-2007, 10:12 PM
 
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My OB said it depends on the person and she'd have to evaluate me after each previous section, but that I'd probably be safe for at least four. I think three is the point where doctors start to question whether it's safe anymore (maybe they're just paranoid in your area?). A lot of people around here have pointed out that Ethel Kennedy had 11 c-sections, so obviously it's possible!

On the other hand, I think it's a perfectly reasonable thing to say to people, if it makes them stop bugging you.
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Old 01-27-2007, 12:44 AM
 
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If you know someone who was forced to have tubal ligation, I'd ask if a lawsuit is in order. It is illegal and against medical ethics to force a person to have any kind of unwanted surgery, esp. one with permanent results.
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Old 01-27-2007, 02:24 AM
 
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One of my friends moms had 4 c/s and that was in a time when they really wanted to limit that. Also a friend has had 2 c/s because both breech and her md said his will let his patients *try* for a VBAC up to 4 c/s.

Angie wife to Joe and Mom to Lucas(10) and Alex (7), Elizabeth (4), Joey (2), and #5 due May 29
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Old 01-27-2007, 02:28 AM
 
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My mom had 5 c/s's and one VBA3Cs (all classical incisions). They did get on to her after the 5th section (6th child) and convinced her to get her tubes tied.
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Old 01-27-2007, 01:06 PM
 
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They start pushing tubals because the more c/s you have the more dangerous it is for the mom and baby if she gets pregnant again. But this aspect of c/s is left out when they cut you the first time or refuse to let you VBAC the second time.
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Old 01-27-2007, 01:38 PM
 
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Ditto to Tanya.
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Old 01-28-2007, 01:41 AM
 
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Each woman is different in how she heals after each section, so it's really something that simply cannot be determined with certainty in advance.

That said, *most* OB's are comfortable with 3 sections barring unusual complications in any particular woman. I'd actually venture to say it would be *almost all* OB's who are ok with three.

When you get to the fourth, you could have trouble getting an OB to take you on as a patient, though I've honestly not heard of this happening a whole lot.

What I *have* heard is OB's talking mom into a tubal 'if things don't look good' during the c-section, usually this is on the third or more.

That said, I had my third section 8 weeks ago and my doc (who is very much pro vaginal birth, pro VBAC, and has an astonishingly low primary section rate) said he'd have no problems whatsoever if we wanted to have another baby and resulting fourth section. He said my uterus looked great with minimal scar tissue, so I would likely be one that could have a 4th, 5th, even 6th section without problems IF I continued to heal as I have with the first three.

We're done having babies, so it's a non-issue, but I know several other women who have had four sections with no problems or issues (either with the surgery OR having their doc agree to take them on). I think you're just really not very likely to find many women wanting 4, 5, or more kids these days, plus it'd have to be a woman who had sections for every single baby, so it's just not that common.
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Old 01-28-2007, 01:45 AM
 
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This may be the Catholic school version of an urban legend, but one of my grade-school nuns swore Ethel Kennedy had all eleven of her kids by section. Classical, one would assume. Yikes.

The main risks associated with increased number of sections are placental: previa and accreta.

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
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Old 01-28-2007, 02:06 AM
 
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Somewhere...there is a site about a woman who had 8 c-sections. She tried vaginal for all. I think the oldest is in his/her teens, so it's pretty recent.
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Old 01-28-2007, 05:07 AM
 
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Quote:
Originally Posted by PookieMom
I hear alot of people here having more than three c/s and i'm a little confused. I've heard that after three they basicaly force you to tie your tubes. That's the way it is in my area so i just took it as normal procedure everywhere.
Ummm....no one can force you to have your tubes tied. That doesn't mean that they won't try to coerce you into it or won't make up some bogus reason for why you should have it done (any look at the number of c/s done per year and it's clear that surgeons are very good at making up reasons for doing surgeries).

To quote PP:

Quote:
Is it legal to sterilize anyone who doesn't want it?
No. Sterilization is legal for mentally competent, adult women and men in all 50 states only if it is voluntary. No mentally competent person can be forced to have the operation.
In fact, last year around this time a woman in CT won a lawsuit against the OB who sterilized her w/out her consent during her c/s.
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Old 01-28-2007, 05:18 AM
 
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Originally Posted by TanyaS View Post
They start pushing tubals because the more c/s you have the more dangerous it is for the mom and baby if she gets pregnant again. But this aspect of c/s is left out when they cut you the first time or refuse to let you VBAC the second time.
EXACTLY. Funny how the o.b. wrote that she had obtained my consent by telling me of "risk of infection and bleeding". She left out the part about possible death, emotional trauma, loss of fertility, future problems with placenta etc, not to mention possible inability to secure a care provider within one's insurance network...

Mama to my spirited J, and L, my homebirth: baby especially DTaP, MMR (family vax injuries)
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Old 01-28-2007, 05:26 AM
 
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I'm about to have my 4th c-section and I was asked briefly if I was interested in a tubal but when I said no I wasn't pressured or questioned at all.

I'm not sure if we are done having children but I will definitely ask my OB's opinion after this baby is born as to whether or not I seem like a good candidate for 5-6 sections.

ribboncesarean.gif cesareans happen.
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Old 01-28-2007, 12:27 PM
 
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Some OBs still go with the three csection rule and I am not sure why. For one there is no significant difference in risk between a third csectoin and a fourth or even a fifth, it is after the fifth that it increases. This is of course with 3 bikini cut type csections, if you are cut vertically, the risks are different or if you have two scars on your uterus (vertical and horizontal)

I will be having my fourth csection in the next ten weeks. My uterus is deformed and my doctor said she would be willing to do at least five. However I am calling it quits after this for sure.

We do have a OB group who refuses to do more than three csections and they bully their patients into tubals. Absolutely makes me sick, because they also do not do VBACs and they start to induce patients at 37 weeks.
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Old 01-28-2007, 04:13 PM
 
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We do have a OB group who refuses to do more than three csections and they bully their patients into tubals. Absolutely makes me sick, because they also do not do VBACs and they start to induce patients at 37 weeks.
So what do they do when a woman comes in pregnant after 3 c/s? Tell her she's too high risk and she'll have to see a midwife? Then the midwife says she's too high risk, she'll have to deliver her own baby? I'm liking this parallel universe.
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Old 01-28-2007, 10:53 PM
 
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Most reproductive Dr.'s will tell you the 3c rule is ridiculous. I trust their opinion because they do a lot more testing on a non pregnant woman and make sure that her body IS capable of carrying out a pregnancy again.

I am on probably my 4th c-section and my ob knows I will have one more pregnancy which will be another c-section so that is 5 total (unless I can convince someone to vbac this time, but the last will STILL be a c-section) Anyway, long story short, my OB said that my uterus looks so great that there is NO reason not to keep going as long as the rest of my body can handle it.

Each woman is an individual and the Dr.'s need to assess each person.

I know a woman who basically was told she WILL die if she has another pg, and that was after only 3 pregnancies and 1 c-section.
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Old 01-29-2007, 12:48 AM - Thread Starter
 
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wow! Thanks for all the responses. It is really sad around here, how people just go along with what they are told. There is a woman that lives in the next town over that had 5 sections and her youngest is now 25 and people still roll their eyes and whisper about how terrible she is for it to this day! Makes me sick!:

In love with the Hubs (6-03) & : Kookie Pookie Girl (c/s 5-05) & Bouncy Big Boy (vbac 2-07) & : Miss Cheeky Cheeks (hbac 11-08) 100*90* 100lbs = Las Vegas : Almost there!
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Old 01-29-2007, 02:59 AM
 
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Originally Posted by Shawnee View Post
So what do they do when a woman comes in pregnant after 3 c/s? Tell her she's too high risk and she'll have to see a midwife? Then the midwife says she's too high risk, she'll have to deliver her own baby? I'm liking this parallel universe.
Well the group I go to will do more than three that is right down the hall. I imagine they either 1)see the patient anyway because they want the money or 2)refer them out. There are CNM here but I am not sure they do VBA3C, I know one that has done VBA2C however.
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Old 01-30-2007, 01:56 AM
 
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I never asked what my practice's policy is on # of c-sections but they deliver at a Catholic hospital so no tubals - thank heavens!!! Quite frankly, I think that should also mean no saying no to vbac.

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Originally Posted by Aliviasmom View Post
Somewhere...there is a site about a woman who had 8 c-sections. She tried vaginal for all. I think the oldest is in his/her teens, so it's pretty recent.
Right here: http://www.manymcdaniels.com/birthstories.html

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Old 01-30-2007, 09:34 PM
 
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There is a multiple c-sections yahoo group and there are many women on there with 6, 7, 8, 9 cesareans.

The doctor who did my first cesarean said he had done 7 on one woman.

Mama to 3 kids. We live in a yurt!
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Old 01-31-2007, 04:14 PM
 
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Originally Posted by Shawnee View Post
So what do they do when a woman comes in pregnant after 3 c/s? Tell her she's too high risk and she'll have to see a midwife? Then the midwife says she's too high risk, she'll have to deliver her own baby? I'm liking this parallel universe.

Well, according to federal law, if a woman comes to the hospital in active labor, they are required to treat her and are not allowed to force medical intervention like c/s. I can't remember the name of the act, though.

I think it's ridiculous that doctors will push repeat c/s but balk at VBACs. :/ I understand that it's mostly due to liability, but it's just...absurd. VBACs in general are much safer than repeat c/s.
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Old 01-31-2007, 04:34 PM
 
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Well, according to federal law, if a woman comes to the hospital in active labor, they are required to treat her and are not allowed to force medical intervention like c/s. I can't remember the name of the act, though.
EMTALA. But EMTALA has nothing to do with right to refuse treatment, and women can be sectioned under court order (in theory); it applies only to hospitals' inability to street the active labor patient.

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Old 01-31-2007, 04:37 PM
 
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I have a friend being induced tomorrow for c/s #5. She's been on bedrest for almost her entire pg.
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Old 01-31-2007, 04:50 PM
 
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Actually, maxmama, that's not entirely true.

Quote:
The federal Emergency Medical Treatment and Active Labor Act (EMTALA) requires hospitals to admit women in active labor and to abide by their treatment decisions until after the baby and placenta are delivered. The act was originally designed to prevent hospitals from “dumping” patients who couldn’t pay but has since been widely used to hold hospitals accountable for violating other patient rights, including the right to refuse treatment. If your hospital threatens to perform a cesarean despite your refusal, notify them that they are in violation of your rights under EMTALA and that you plan to file a complaint.
Also, as to the court order thing, it should be noted that:
Quote:
As a result of these rulings, both the AMA and ACOG have revised their ethical guidelines to state that court-ordered cesareans are rarely, if ever, justified, and are most definitely not justified in instances where the proposed treatment poses any risks to the mother.
This comes from a document about what to do if your hospital has "banned" VBAC, but certainly applicable to this discussion.

If they start threatening you with a court ordered cesarean - remind them of Angela Carder or Ayesha Madyun. It's always a good idea to know your legal rights!

Other useful sites:
http://advocatesforpregnantwomen.org...interventions/
http://www.childbirthconnection.org/...Link=0&area=27
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Old 01-31-2007, 05:01 PM
 
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I have a friend who had 5 c/s the fifth baby is only a few years old so this was recent. My mom's fourth baby was an emergency section (you know the true kind where the mom has no blood pressure and they can't find the baby's heartbeat in the ambulance and she needed two pints of blood afterwards) due to massive hemmorhaging from placenta previa and so she had the vertical incision. Despite the fact that we were all big babies and so her uterus was still pretty stretched out and she had the vertical incision she was still allowed to try for a VBAC with her fifth. Now this was in the 80s where I think maybe they were more VBAC friendly but they did allow her to try until things weren't looking good. Not sure exactly what caused that determination but I do know when they went in her uterus was pulling apart at the incision (my sister was another good sized baby-10lbs). I haven't really heard much about them being limited. As someone else said what are they going to if you show up pg again for a 4th or 5th time?
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Old 02-06-2007, 01:28 PM
 
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I had 4 C/s and was never told that. The last baby the uterus was really thin and the OB said I shouldn't get pg again. But 2 specialists thats just not right and I could have as many babies as I wanted. I'll be having a HVBA4C any time now
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Old 02-06-2007, 04:49 PM
 
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I had four cesareans, hopefully no more!! The witch OB that was on call when I transported from my HBA3C attempt actually said not to get a tubal because the risk of damaging my bladder. Whatever. She was an idiot anyway. She told me if I was induced two weeks earlier, I would of VBAC'ed. Whatever again. I plan on having at least two more. Hopefully, they will be VBAC's.

 

  

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