I am not sure where to post this, so if this is in the wrong place, I apologize.
To make a long story short, I have had four cesareans and am pregnant with my fifth child. I was told after my last cesarean that I should consider not having any more children. The reasoning is (from the OB's perspective) that if I were to have another cesarean, there could be some major complications. I have a lot of adhesions. It is just in my body's nature to create a lot of scar tissue in general from what I have seen. Apparently, the OB had a hard time finding my uterus because the adhesions make my bladder, bowel, and other organs appear like my uterus, as well as fusing everything together to some extent. He was not able to lift my uterus out of my abdomen for the surgery, and it certainly took longer to complete than any of my others. I went to this particular OB because I no longer wanted to fight the system for a trial of labor last time and he was a high risk OB, so I figured he would be able to handle whatever my adhesions would throw at him.
His fears are that he may accidentally nick my bladder or bowel in another cesarean and if this goes unnoticed there is a large chance for infection. He would then have to go back in to repair any damage. Also, this makes the surgery a lot longer. My fear is that if there were any real emergencies with the baby, that the cesarean would take too long to get to the baby.
He did say that he assisted in a cesarean where another organ was accidentally nicked but they caught it and the repair was made right then. He is a really sweet OB, not pushy at all and said he would not tell me not to have more children, but he wanted me to know the complications I may get into with another cesarean. He said he is concerned about the recovery time as well if there were some sort of additional damage done.
So, folks...I am wondering what you would do in my shoes. I am scared with all the negative possibilities for future children and harm that may come to them or me. I thought I would try for a VBAC this time, but all homebirth midwifes in state are not taking on patients with this many cesareans after a newborn died from a rupture in a homebirth recently. There are no hospitals in my state that take on VBAC patients after 3 cesareans. I would like to leave the door open to more children, but wonder if maybe I should think more for the children I have here on this Earth and seek some permanent BC after this.
Sorry this is so long! I need some girlfriends to chat with me over this ;)
You may not find anyone to help you with a VBAC. If you cant, I would enlist in some help for after the c-section just in case there are some complications. Complications are not necessarily the end of the world, but you are going to need more recovery time/help around the house. I would also consider this one being the last one, because like you said, you dont want to take unnecessary risks when you have 5 children that need you. If you do have another section, you can get a tubal done at the same time. So there's that to consider as well. Good luck!
My sister has had four and was told the same thing after her third. Her OB (delivered all three) told her he didn't think a fourth child was a good idea but that if she choose to do it than she should plan on making it her last. He told her she should plan on permanant birth control at that time and that he was the only doctor in the area that would even consider delivering a fourth. When she questioned about a fifth, he said he wouldn't do it under any circumstances and wouldn't even have someone to refer her to.
He was actually quite kind about it and encouraged them to expand their families in other ways if they felt called to have more children. He said the human body was simply not created to have multiple pregnancies and uterine surguries. That modern gyn practices were actually fairly "unnatural" and alien to how the body was supposed to function and heal.