The Risks of Having More Than 2 C-Sections


If you have had more than 2 C-Sections and want more children, there are risks.  The more C-Sections you have the more at risk you are for things like surgical adhesions, uterine rupture etc.

It hardly seems fair to the women who really want large  families, but surgery takes its toll on your body.

For the woman who has had only one C-Section this isn’t quite as critical because, unlike years past, having a VBAC or Vaginal Birth after a C-Section is more commonly practiced today and has proven successful for many women.  But for women who have had more than 2 C-Sections, the less likely you are to have a successful VBAC.

But what what about the women who have had several C-Sections, for instance 8 or more successful C-Sections with no problems?  

True, there are women who have had many more than 2 C-Sections without any problems, however they are the exception and not the rule.  These women are fortunate that they have not experienced any risks because of so many surgeries, however I wouldn’t encourage any woman to take that risk.

Multiple C-Sections carry the risk of …

Uterine Rupture.  Each time a C-Section is performed the scar tissue from the last C-Section is weakened. This puts your uterus at risk.  In fact, hysterectomies are almost five times higher for women having a forth c-section than for women having their second.   Also the risk of uterine rupture increases the closer your pregnancies are.  That’s why doctors want you to wait at least 18 months between births.

Uterine rupture is fairly rare, however infant death is about 10 times higher for women who experience a rupture.

Blood Transfusions.  The risk of blood transfusions increase after 6 c-sections or more.

Adhesions and Scar Tissue.  Any time you have abdominal surgery you will incur scar tissue or adhesions, and C-Section are no different.  Adhesions don’t always cause a problems or present risk but each C-Section creates more adhesions, and multiple C-Sections can create an excessive amount of adhesions which can be problematic.

Adhesions are risky because they can attach or adhere to other organs causing pulling and other complications. For example, adhesions are often the cause of bowel obstruction.  In addition adhesions can cause pain and discomfort that may not become a problem until several years later.

Adhesions are not typically life threatening but they can  cause extreme discomfort, pain and complications if you experience too many abdominal surgeries.

Placenta Previa.  Having multiple c-sections has been known to increase the risk of Placenta previa, which is where the placenta covers or lies very near the cervix.  This can be a problem because as the cervix opens up, it cuts off the placenta at the top causing heavy bleeding.

Very few women with placenta previa ever experience fatal complications but placent previa is capable of  causing dangerous levels of heavy bleeding which can lead to anemia and blood transfusions.

Placenta Accreta

Placenta accreta is where the placenta attaches too deeply into the uterine wall. Placenta accreta is often associated with placenta previa, particularly if the patient has had a previous C-Section.   It’s the scar tissue from previous c-sections that increases this risk.

Risks may involve damage to the uterus or other organs as well as possible hemorrhaging when trying to remove the uterus.

Note:  The risk of placenta accreta is much less for women having 2-3 c-sections than it is for women having four or more c-sections.

If you’ve already had 2 or more C-Sections and want more children, think carefully about the dangers and risks of having multiple C-Sections.  Especially if you have several children already.  As a mom, longer hospital stays and significant risks and health problems for you wouldn’t be in their best interest, not to mention yours.

14 comments

  1. Catherine Potter says:

    Do you know if this information exists in Spanish somewhere? I am trying to find it for a Spanish-speaking patient who has had 4 previous c-secions and is pregnant with her 5th child. She is Spanish-speaking only.

  2. Elizabeth says:

    Hi Catherine, This information is not in Spanish at this time, however I’m looking into a way that it can be viewed in Spanish, however until then I don’t have a translation for you, I’m so sorry :-(

  3. Brenda says:

    Hi iam33 and iam pregant and this is my 5 child but I have 3with c-section my youngt is Almost 10 years old is that a hight risk

  4. Elizabeth says:

    Hi Brenda, if your overall health is good and you’re last C-Section was almost 10 years ago, you should not be at a high risk for another C-Section. You may have some adhesions that will make the C-Section procedure take a little longer, but overall it should be OK. Have you spoken to your doctor about this yet?

  5. arabia says:

    Hi Elizabeth I’m 22 and 24 weeks having my third child by c section my youngest is 16 months old. Am I at risk for serious complications?

  6. Elizabeth says:

    Hi Arabia, When thinking about serious complications it helps to think about your history. How did your last C-Section and recovery go? It’s impossible for me to know if serious complications could occur because I’m not your doctor and I don’t know your history. Having a third c-section there will be more adhesions, but you also may never have any problems with those adhesions. Your c-section procedure may take a little longer but that’s generally not a problem. My biggest concern for you is that if you are feeling worry or concern you should discuss this with your doctor. I’m sure s(he) can put your mind at ease.

  7. melissa says:

    Hi I am 38 have had 4 c-sections and a tubalization, I am wanting to get it reversed to have another baby, can you tell me the risks of this, my youngest is 3

  8. Elizabeth says:

    Hi Melissa, A tubal ligation can be reversed but it’s expensive and not guaranteed. However you’ll need to talk to your doctor because you may have adhesions and more surgery to reverse your tubal ligation could produce still more adhesions. Those things can make conceiving difficult, not to mention, you’ll probably have yet another C-section meaning even more adhesions.

  9. Meghan says:

    I am stressing! Im trying not to but never knew the risks tell I decided to look them up. I am having my 4th c section in less than 3 months. My last c section was a year ago. I got preg about 6-7 months after that c section. I am also plus sized. I had no idea about the risks with having a 4th. I have been having a lot more pain with this one and braxton hicks like crazy! I also have a history with pre term labor with my last 2 kids. I was given shots and pills to stop labor a numberous amount of times and was placed on bedrest around 7 months. I did manage to make it to 37 weeks tho with both of them. (my 1st baby was over due and an emergency c section) Is there anything specific my dr should be keeping an eye on? Is there stuff i can do to prevent any complications? Any insight would be great!!! Thank you.

  10. Elizabeth says:

    Hey Meghan,

    My best advice is DON’T STRESS. Easy for me to say right? But stress complicates things. There’s nothing you can really do to ‘prevent’ complications. There are risks the more C/S you have but as long as you keep your appts. and your doctor is aware of your history, you should have nothing to worry about. Keep in touch, let me know how things go :-)

  11. Adikini Veronica says:

    hi Elizabeth,i have had two c-sections and discovered i was pregnant when my second child was ten (10) months old.I am about 3 months now preg.now.i was still feeling pain in the scar and could feel something like a lump right beneath the naval.During the second c-section,the Dr had to remove some fibroids (3) from my womb.I am so worried about this pregnancy.Do you think i will carry though?Am i in the high risk bracket?I am currently experiencing some pains and sometimes cramps.

  12. Elizabeth says:

    Hi Adikini,

    Some pain and cramping can be normal but how severe is it? Severe cramping and pain is not normal and you should check with your doctor. Chances are you can carry to term and since you had the fibroids removed you should be at less risk but you should ask your doctor.

    Elizabeth :-)

  13. Charmaine says:

    Hi I have had 5 previous c sections last one 10 years ago I am 43 and would love to have another baby I am fit and healthy and active after births had no problems with all the births doctors did say tissue is very thin could be dangerous which I believe doctors say that quiet often. Would I be ok?bit worried after some reassurance and advice.

  14. Elizabeth McGee says:

    Hi Charmaine,

    No one can say whether or not having another C-Section at 43 would be OK, however the risks are much greater, in fact the risks increase each time you have a c-section so I would think very carefully. Being older is also a risk. You could be fine or you could have problems, that’s why they call them risks, there’s no certainty either way. All we have to go by is statistics and the likelihood of certain problems based on similar circumstances.

    Sorry I can’t be more certain for you but that’s not something anyone can effectively predict.

    One thing I’d suggest is talking with your doctor at length about this. What does s(he) think and what things are you especially at risk for. You doctor has your medical history on file a candid discussion can help not only with your decision but with feeling comfortable with that decision, whatever it is.

    My very best to you :-)
    Elizabeth
    Elizabeth McGee invites you to read Cpanty Vs. Abdomend – Abdominal Support After C-Section

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