Saturday, 9 November 2013
HOW MANY CAESAREANS CAN YOU SAFELY HAVE?
All caesareans carry a risk of developing adhesions as you heal. Adhesions are bands of scar tissue which can cause connecting organs in your abdomen to stick to each other or to the inside of your tummy wall.
After one caesarean, about half of women have adhesions and this rises to 83 per cent after three caesareans. Adhesions can cause pain because they limit the movement of your internal organs. Occasionally, adhesions lead to fertility problems, as they can put pressure on or block fallopian tubes.
If you have a lot of scar tissue it can be trickier for your obstetrician to make the opening in your uterus. This may mean the operation takes longer. It also increases the chance that your obstetrician makes an accidental cut in your bladder or bowel.
Each caesarean you have also increases the risk of problems with the placenta in future pregnancies. These can include:
retained placenta (placenta acreta), which is when the placenta embeds itself deeply in a caesarean scar
low-lying placenta (placenta praevia)
Trying to remove the placenta after the birth is very difficult in these cases, and can result in serious bleeding. In the worst case, it may mean you'll need an operation to remove your uterus (hysterectomy). The risks of this happening are low, but if you're planning to have more babies, it's worth considering.
It used to be thought that if you had one caesarean birth you had to have the rest of your babies that way. This is no longer the case. Vaginal birth after a previous caesarean (VBAC, pronounced veeback) is now common and safe in many cases. Current thinking is that a caesarean should only be done for a good reason because, like any surgery, it is never without risks.
If you have had a caesarean birth, you should always talk to your consultant about the best way for you to have your next baby. There are many things that need to be considered, including your weight, age, medical history, fertility history, childbirth history, as well as personal choice.
The choices you make will also depend on why you needed to have a caesarean with your first two babies. See our article about having a planned repeat caesarean to find out more.