How Many C-Sections Can You Have?

Health risks increase with each subsequent Cesarean, yet some people get six or more without complication. So how many times can you have a C-section? We spoke with experts to find out.

Newborn and mom in hospital after C-section
Photo: Getty Images

Having a C-section is not a decision that doctors or laboring people take lightly. Thankfully, in the United States, the surgeries are performed by qualified professionals that can navigate any associated risks. So how many C-sections can you have? The answer isn't clear-cut, but we spoke with experts to break down the deciding factors.

Considerations for Having Another C-Section

Wondering how many C-sections you can have? Doctors will consider your history of VBAC and C-section, complications for the parent and baby, and your recovery process when making the decision.

Your History of VBAC or C-Section

After a C-section, some people will try having their next child vaginally. This is called vaginal birth after cesarean (VBAC). If you have a low-risk pregnancy, the procedure has a success rate of 60 to 80%, according to the American College of Obstetricians and Gynecologists (ACOG). However, most medical societies don't recommend VBAC for those who've had two or more C-sections. That's because the risk of uterine rupture—a tearing in a past C-section scar or uterine muscles that can be life-threatening to the parent or baby—rises with each surgery.

Possible Risks and Complications for Subsequent C-Sections

While there is no one magic number for how many C-sections you can have, experts agree that certain risks increase with repeat Cesareans; this might influence whether you can have another C-section. Risks might include:

  • Uterine rupture
  • Heavy bleeding that leads to blood transfusion
  • Injury to the bladder or bowel
  • Hysterectomy at the time of delivery (The risk rises to more than 1% chance after a person's third C-section, and it soars to nearly 9% after the sixth surgery)
  • Abnormal implantation of the placenta
  • Adhesions that develop with increasing thickness each time a new C-section is performed
  • Hernia
  • Diastasis recti (when the stomach muscles separate and the abdomen protrudes)
  • Numbness and pain at the incision site
  • Endometriosis in the incision

Your C-Section Recovery Period

C-section recovery looks different for everyone. You might always recover at the same rate, or you might experience more difficult post-operational periods each time. Alternately, you could bounce back faster after each subsequent C-section, according to David Ghausi, D.O., department chair of obstetrics and gynecology at Los Robles Hospital in Thousand Oaks, California. Your health care provider will take your past recoveries into account when deciding whether you can have another C-section.

How Many C-Sections Can a Person Have?

There's also no set rule when it comes to the number of C-sections you can have. "I have performed a woman's sixth C-section with virtually no complications or difficulties, and I have performed second cesarean sections with many adhesions and potential complications," says Jason S. James, M.D., chairman of the Department of Obstetrics and Gynecology at Baptist Hospital of Miami.

Everyone is different, so doctors need to analyze each person's health, history, and concerns before deciding on the right path.

To help prevent any complications, Dr, Ghausi recommends waiting at least 6 months after C-section before getting pregnant again; other doctors suggest waiting 18 to 24 months. But note that Dr. Ghausi has had patients get pregnant one, two, and three months after a C-section and be just fine. "There's no magical number," he says. By following your doctor's advice, the chances of a healthy pregnancy will rise dramatically.

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