How many times can a caesarean section be performed?

Many people know that when women give birth, they are unable to have a natural birth due to some reasons and have to choose a caesarean section. This situation is very stressful for women and often requires a longer recovery period. A common clinical situation is that the fetal head is significantly larger than the current hip width, in which case cesarean section is the only option. However, a caesarean section involves making an incision in the mother's abdomen to remove the fetus, directly opening the uterus, which causes great harm to the mother. However, there are also families who want to have more children, and they have many babies born through caesarean sections. So how many times can a woman have caesarean sections at most?

"I've seen someone have five caesarean sections, but this is extremely rare!" There is no definitive answer as to how many babies can be born through caesarean sections, as there are individual differences. A few years ago, I saw a woman from another province in Guangzhou who had successfully undergone four caesarean sections. When she was pregnant for the fifth time, her uterus ruptured spontaneously and she bled heavily before giving birth. Her family rushed her to the hospital for emergency surgery in time, and she was able to save her life.

For women who have already had a caesarean section, whether they can continue to have a caesarean section during their next pregnancy depends on their body's recovery.

Clinically confirmed, the average amount of blood loss during cesarean section is over 300 ml, more than double the amount of blood loss during vaginal delivery; cesarean section can cause wound infection, intraoperative amniotic fluid embolism, surgical accidents, uterine injury and resection, etc. The chance of postpartum hemorrhage and accidental death is higher than normal vaginal delivery; the mother recovers slowly after surgery and is prone to complications such as venous stasis, chronic abdominal pain caused by adhesions of pelvic and abdominal tissues, pelvic inflammatory disease, endometriosis, etc. Caesarean section can only be chosen again when the complications left over from the previous caesarean section have disappeared.

In addition, the most appropriate time interval between two caesarean sections should be about 2 years. "If you get pregnant again within a short period of time, the scar will not heal firmly and there is a high risk of uterine rupture, endangering the safety of mother and child. If the time interval is too long, the uterine scar will have become fibrotic, more brittle, and easily torn." Many women want to have a "natural birth" when they get pregnant again because they cannot bear the pain after a cesarean section. However, this requires comprehensive consideration based on prenatal examinations, such as the size and position of the fetal head, and the situation of the labor process after delivery.

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"The uterine scar left after a cesarean section will bring many risks to future childbirth." If you become pregnant again after a cesarean section, the placenta will occupy more and more space in the middle of pregnancy, which will expand and pull up the uterus. If the placenta implants in the uterine scar, uterine rupture is likely to occur.

There is another situation where the gestational sac implants in the uterine scar at the beginning of pregnancy, which is likely to cause heavy bleeding, and this situation can easily be misdiagnosed as miscarriage. Wang Xiaoyi once rescued a 22-year-old patient whose first child was delivered by caesarean section. Less than three months into her second pregnancy, she suffered heavy bleeding because the gestational sac implanted in the uterine scar. The amount of bleeding reached 6,000 to 7,000 milliliters. "The more caesarean sections you have, the more fragile your uterus becomes, and the greater the chances of premature birth or uterine rupture leading to intrauterine fetal death."