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what are the risks of Multiple C-Sections?

Posted by on Sep. 14, 2011 at 12:12 AM
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I have had 3 beautiful little girls all  by c- section...my oldest is three then i have a 2 year old and an almost 6 month old...me and my husband were wanting to try for one more...see if we can have a boy...but im terrified because i've heard of a lot of women dying giving birth to their fourth child via c-section...was wondering if there are any mothers of 4 by c-section on here can tell me their story of how their fourth went and how far apart their children are...im really scared...because for one thing..i am not on birth control right now..every kind i've been on so far has had severe side effects....was wondering if i should go ahead and get my tubes tied

by on Sep. 14, 2011 at 12:12 AM
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ColleenF30
by New Member on Sep. 14, 2011 at 5:57 AM

I had a 4th, but he was stillbnorn for unknown reasons.  No problems for me other than a small incisional infection after.  I am "approved" for a 5th.  My kids age differences are 9 yrs, 15 months, and 20 months.  Currently ages, 14, 5, and 3

Roadfamily6now
by Bronze Member on Sep. 14, 2011 at 2:39 PM

I will post some risks of multiple c-sections.


Roadfamily6now
by Bronze Member on Sep. 14, 2011 at 2:40 PM

Benefits & disadvantages of cesareans

There seems little dispute that when all things are considered, cesarean birth is less safe than vaginal birth for both women and their babies in most cases. Clearly, when a clear medical indication exists, such as placenta previa, a cesarean is the safest option. Also, if a baby was truly in distress a cesarean may be justified.

The difficulty is in determining the grey area of the non-absolute indications for cesarean. Whilst one caregiver may consider a baby to be in distress after reviewing the trace from the electronic fetal monitor, another may believe the baby to be fine. It is clear from the number of babies born by cesarean thought to be in distress but subsequently have perfect Apgar scores that it is difficult to truly determine the safest option. In addition, many babies are born by cesarean following the obstetricians advice that the baby is too large to be birthed vaginally while those same women go on to have subsequent vaginal births with larger babies.

Benefits of cesarean

Clearly the most significant benefit of cesarean section is that it may save the life or the mother or her baby if there are complications. In cases where a vaginal birth is contraindicated such as complete placenta previa women now survive childbirth where they would have died many years ago.

For many women a cesarean appears to be a viable alternative in the absence of clinical complications, as it appears to offer a more predictable environment with a greater level of control. For women who are afraid of the unknown territory of vaginal birth this may be seen as an overwhelming advantage.

In situations where the choices are less clear and the evidence not yet definitive such as breech birth and cephalopelvic disproportion the advantages of cesarean may be outweighed by the risks.

Risks of cesarean

The risks of cesarean birth have been well documented. It is major abdominal surgery and as such carries inherent risks associated with such surgery. Cesarean has now become so commonplace in many countries that these risks are often glossed over or fail to be communicated to the mother before her decision is made.

Complications for the mother

Risk

Maternal death

5-7 times higher than vaginal birth

Emergency Hysterectomy 1 in 110 cesarean births (d)
Injury to bladder, uterus & blood vessels 2%
Hemorrhage 1-7%
Blood clots developing in legs

6-20 per 1,000 (0.6-2%)

8 times higher than vaginal births

Pulmonary embolism 1-2 per 1,000 (0.1-0.2%)
Paralyzed bowel -- mild 10-20%
Paralyzed bowel -- severe 1%
Infection 50 times higher than vaginal birth
Require readmission to hospital 2 times higher than vaginal birth
Difficulties with normal activities 2 months later 10%
Pain at incision site perceived as a major problem 25%
Incisional pain 6 months or more after birth 7%

(d) The rate of emergency hysterectomy after vaginal births is 1 in every 824 vaginal births

Complications for the baby

Risk

Baby cut during surgery

1-2%

Lower Apgar scores than vaginally born babies 50% more than vaginal births
Babies require assistance with breathing 5 times higher than vaginal births
Admittance of baby to intermediate or intensive care 5 times higher than vaginal births
Persistent pulmonary hypertension in baby 4-5 times higher than vaginal birth

In addition to the inherent risks of cesarean for both the mother and the baby, the risks increase with accumulating cesarean operations.

Complications related to future fertility

Risk relative to women with no cesarean history

Incidence of placenta previa after 1 cesarean(*)

4 times the risk

Incidence of placenta previa after 2-3 cesareans

7 times the risk

Incidence of placenta previa after > 3 cesareans

45 times the risk
Placental abruption(U) 3 times the risk
Placenta accreta after 1 previous cesarean 1 in 1,000 (0.1%)
Placenta accreta after 2 or more previous cesareans(z) 10 in 1,1000 (1%)
Placenta percreta after 1 previous cesarean(¥) 25%
Placenta percreta after 2 previous cesareans 50%
Placenta percreta after 4 previous cesareans 70%
Hysterectomy after 1 cesarean 27 times the risk

* Placenta previa doubles the chance of the baby dying and increases the premature birth rate by six times

U Where placental abruption occurs, 6% of the babies will die and 30% will be born prematurely

z Nearly all women who have placenta accreta will need to have a hysterectomy, nearly half will have a major hemorrhage, 9% of the babies will die and 7% of the mothers will die

¥ Women who experience placenta percreta have a 10% mortality rate and almost 100% hysterectomy rate

The risks for both the mother and the baby are clearly significant. In one study, only 9.5% of women undergoing cesarean had no postoperative complications -- this means that almost 91% of women in the study did have some complications. The emotional factors that are more difficult to measure include extended separation from the family and other children, more difficulties breastfeeding, and separation from the baby in the first week.

The most significant risk for the baby is that of respiratory distress syndrome and pulmonary persistent hypertension following a cesarean birth. Whilst it was always considered only babies born prematurely after either a cesarean or vaginal birth that were at risk of respiratory distress, it is now clear that term babies are also at increased risk after a cesarean. Researchers have discovered that a baby born at 37-38 weeks after a cesarean is 120 times more likely to be considered deficient of surfactant and require mechanical ventilation than a baby born at 39-41 weeks by cesarean.

Persistent pulmonary hypertension is up to 5 times more likely in babies born by cesarean than those who had vaginal births.

The cost of cesarean section is significant. Cost estimate studies have been carried out in the UK comparing the cost of cesarean birth to that of vaginal birth for the National Health Service. A cesarean costs approximately £760 (US$1,350) more than a vaginal birth. Estimates show that if there were a 1% decrease in the national cesarean rate there would be a cost of saving of five million pounds (US$9,000,000). This saving would represent the salary of 167 midwives.

Women are asked to sign a consent form before they undergo a cesarean operation. The surgeon is not able to carry out this operation without the woman's express consent for the procedure. In rare cases where the mother is unconscious a relative is asked to provide signed consent.

For most women, they view the consent for the first time when she is about to have the operation. This is an inappropriate time to see such information particularly in cases of unplanned or emergency cesarean. It is more difficult for her to carefully read the form, understand it and have the opportunity for her to ask questions. It can be beneficial for her to have the opportunity to read the form in advance. Most hospitals will provide a copy of this consent form if requested and this can then be shown to women while they are still pregnant so that if a cesarean is determined to be the choice for delivery the woman has had ample opportunity to read it beforehand.

lvmy3lilones
by Member on Oct. 2, 2011 at 5:22 PM
1 mom liked this

I am not able to have a  vaginal birth....i have had 3 c sections...and in may ...i will have my fourth

mrs_adams311
by New Member on Oct. 27, 2011 at 12:39 AM

 I also am mot able to have a vaginal birth. I have one son who is 2 years old and I do eventually want at least two more but I am scared about having multiple C Sections. I am glad to hear that I am not alone in not being able to have a vaginal birth. I have created a post about my inability to give birth vaginally and would love any input/information you are willing to share regarding multiple C Sections

CafeMom Tickers


Mrs. Adams

Maamuu6
by New Member on Nov. 4, 2011 at 2:48 AM
1 mom liked this

I had to have a C-section for my first due to GB, and have had 4 more since then. My children are 9, 7, 4, 2 and 3 1/2 month old twins. Is it scary, YES. Are there risks, YES. But there are also risks for having vaginal births. You are having Major Surgery, and are going to be bringing another beautiful life into this world. It's funny, every time I got my c-section scheduled the only thing I dreaded was the Spinal, I hate being poked!

Congrats on your pregnancy and I hope this helped!

Christiansmom44
by New Member on Nov. 4, 2011 at 3:15 AM
I am 18 weeks with #3 and #4. Both of my others were c sections. My kids are 6 and 3 1/2. My doctor told me that as long as you give your body plenty of time to heal, you can safely have as many c sections as you want to have. He gave me the option of vba2c, but anything can happen between now and then, so we'll see.
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Roadfamily6now
by Bronze Member on Nov. 4, 2011 at 1:34 PM


Quoting Christiansmom44:

I am 18 weeks with #3 and #4. Both of my others were c sections. My kids are 6 and 3 1/2. My doctor told me that as long as you give your body plenty of time to heal, you can safely have as many c sections as you want to have. He gave me the option of vba2c, but anything can happen between now and then, so we'll see.


It's not the actual cutting you open part that is the riskiest. It's the after effects, the risks you have DURING a preganncy after a c-section.  I have heard of women having 10 c-sections! But they are really putting their Pregnancy at risk each and every time they have another c-section.

As long as you are fully informed of the risks you and your family are taking, then I trust you are making the right choice.

Tammy

ICAN of Anchorage

Chapter Leader


BigRedNeckMom5
by on Nov. 5, 2011 at 12:57 PM

If I was you I would stop on number 3 and not have anymore. Because I will tell you why. Not to scare you or anything but my sister is 30 yrs old and has 7 kids she was working on her 8th one and was at 30 weeks and went into labor fast. She had all c-sections. She and her baby is not alive today!!! Because of the risk that happen. She started bleeding badly the baby was not moving in her and they had to take it out of her. She later died of to much bleeding the doctors lefted her after taking the baby thinking she was ok and one hour later they came back in there to check on her and she was gone. So if I was you I would ask for your tubes tied or HYSTERECTOMY.... Depending on your age.... Im 25 and had a HYSTERECTOMY Because I didnt want anymore kids. And I had to show them I was mental so they had no choice but to give me what I asked for.

selejessjrjr
by on Jan. 16, 2013 at 10:43 PM

don't listen 2 negative people...i know who has had 7 c -sections.....i had my 4 th c-section 5 yrs ago....someone needs 2 block "ROADFAMILY6NOW" like serious....i have seen her respond 2 other mothers and all she does is scare people!

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