How Many C-Sections Is Too Many?
A good friend of mine dreams of expanding her family by just one more; she longs to hold another baby in her arms and watch her children grow up together in a fulfilled, happy brood.
But there's just one problem—her doctor doesn't want her to have another c-section.
According to the Center for Disease Control and Prevention, 32.8% of all births since 2011 have been via cesarean section—a number that is fast on the rise again, after reaching an all-time high of 60% in 2009. Following that unprecedented surge in the surgical mode of delivery, the American College of Obstetricians & Gynecologists (ACOG) cracked down on the rules and guidelines for c-sections in an attempt to lower the rate.
However, the c-section continues to be a popular form of delivery, especially as women are delaying childbearing until older ages, which brings with it increased complications during pregnancy and a higher likelihood of necessitating a c-section delivery.
Additionally, some women and doctors are simply advocating for c-sections on demand for those who choose it.
“The medical field now acknowledges a patient’s right to actively participate in her choice of medical treatments, including [the] method of delivery. We have accepted that a patient is entitled to cosmetic surgery, assuming that she is providing informed consent. We should follow the same principle for cesarean section on demand,” writes Dr. Louise Duperron.
But knowing the risks that come along with a c-section, is there a cut-off for women giving birth surgically? Is there such a thing as too many c-sections?
Because a c-section slices directly into a woman's uterus, the surgery itself inherently weakens the uterine muscle, and the scar tissue that will grow over the incision can simply never be as strong as whole tissue. In fact, the weakening of the uterus muscle places a laboring mother who has already had a c-section at a higher risk for her uterus literally ripping open—a condition called uterine rupture. The risk for uterine rupture after one c-section is relatively rare, about 1 in 100 for mothers who had a low transverse incision (most doctors do those routinely now), according to the Mayo Clinic.
The experts at the Mayo Clinic also explain that, in general, most doctors set the “limit” of c-sections to three. After three subsequent c-sections, the risks just get to be too high for the mother. The risks include the weakened uterine wall, of course, but multiple sections can also cause problems with the pregnancy itself, as allowing the placenta and embryo limited space to land on the damaged walls of the uterus. Furthermore, bladder and bleeding problems are common as the number of c-sections goes up.
Additionally, doctors advise that women who wish to have more children and have had a c-section wait at least 18-24 months after their c-section before becoming pregnant again in order to allow the uterine tissue ample time to heal. A pregnancy too soon may further weaken the uterus and place the mother at a higher risk for rupture as well.
Have you had multiple c-sections? Has your doctor discussed these risks with you?