Repeat Cesarean Deliveries

Still there is no specific answer and researches did not confirm the exact number of repeated C sections that can be considered safe, it is only about knowing the risks and it differs from case to another.

– Looking at the last operative report is always important.
– Asking your doctor who did the last C-section is mandatory.

Some evidences showed that the risks increase after the third C-section.

Every time the C-section is repeated, there is a low chance of having complications with the anesthesia.

The following risks are all increased with the increasing number of cesareans:

1. Adhesion complications:
a. Longer surgery duration.
b. Bowel or bladder injury.
c. Excessive bleeding.
d. Difficulties with fetal extraction in case of dense adhesion.
e. Difficulties in surgery
f. Bladder’s adhesion to the lower part of uterus.
g. Bladder position distortion.
h. Bowel obstruction.

2. Complications with placenta:
Placenta previa and accreta, that may increase the risk of hemorrhage, need for blood transfusion and hysterectomy.

3. Complications related to trying the vaginal birth after cesarean in next pregnancy.

read more about it here:

Normal Delivery after C Section

Vaginal Delivery after Two C sections

4. Complications related to incision:
a. Hernia
b. Problems with rectus muscles
c. Pain in the area of incision
d. Infection
e. Scars

Tubal Ligation:
It is a procedure to block or remove the fallopian tubes to prevent pregnancy.

It is a permanent form of birth control.

This procedure is used when a woman is prone to repeat cesarean deliveries in a way that may put her in greater risk.

Pregnancy rate with tubal ligation is around 1/1000 in the first year and 2/1000 after 5 years.

Tubal ligation procedures:

1. It can be done at the same time of the cesarean section. The same incision for the C-section will be used to perform the ligation. It is done once the baby is delivered.

2. Laparoscopic sterilization:
Done under general anesthesia.
Laparoscope is used through a small incision near the belly button in lower abdomen.
Sometimes heat is used to seal the tubes or rings to block them, or the tubes are removed completely.
Patient can leave the hospital after few hours.

After tubal ligation:
Patient may experience some cramps similar to period cramps.
It’s advised to avoid sexual intercourse for 2 weeks.

Tubal ligation can cause changes in menstrual periods such as fewer days, losing lower amount of blood and less pain.

In case of pregnancy after tubal ligation, the pregnancy is likely to be ectopic. Therefore, the lady should visit the doctor immediately if she experiences any signs of pregnancy.

It is common to advise the lady to do tubal ligation after the fourth cesarean to reduce the potential complications.

Tubal ligation complications:
Low possibility of:
1. Internal bleeding
2. Wound infection
3. Injury to other organs
4. Side effects of the anesthesia