How many caesarean sections can you have?

Caesarean section is a procedure where a baby is delivered by cutting through the front wall of your abdomen to open your uterus.

There is no limit to the number of caesarean sections you can have. However, the risk of some complications during pregnancy and birth is higher if you have had one or more caesarean sections before. This is because having a caesarean section produces a scar on your womb where the incision is made. The risk of complications doesn’t necessarily get higher if you’ve had more than one caesarean section.

One or more caesarean sections can also increase your risk of developing complications if you get pregnant again. Although very rare, complications could include:

  • placenta praevia, when your baby’s placenta attaches near or on the opening of your cervix, and
  • placenta accreta, when your baby’s placenta grows in the lining of your womb and into or through the muscle in your womb.

Both of these conditions increase your risk of complications when giving birth such as serious bleeding, shock, and emergency hysterectomy.

Having had one or more caesarean sections can also increase the risk of complications for your baby in later pregnancies. However, the risk of serious complications as a result of caesarean section is only slightly higher than that from vaginal births. For example, the risk of stillbirth is 2 in 1000 for women who have never had a caesarean section compared to 4 in 1000 for women who have.

The other complications you could be at a slightly higher risk of developing include:

  • premature birth (when your baby is born too early),
  • low birth weight,
  • injury to the brain or spinal cord,
  • stillbirth (death before birth), and
  • death of your baby shortly after birth.

If you have had one or more caesarean sections, there is also a slightly higher risk of the following:

  • infertility (when you find it difficult to get pregnant),
  • ectopic pregnancy, and
  • placental abruption (when the placenta detaches from your womb before your baby is born).

When you give birth, your doctor will take account of:

  • your preferences and priorities,
  • the overall risk and benefits of caesarean section, or vaginal birth, and
  • the risks to you and your baby’s health around the time of the birth.

The medical reasons for having a caesarean section far outweigh the potential risks to any future pregnancies, or to the health of you and your baby.

Sometimes, it may not be possible to have a vaginal birth if you have had one or more caesarean sections in the past. This is because there is a chance that your womb could tear along the scars from any previous caesarean sections (a uterine rupture) when you give birth. If you have had a caesarean section previously your doctor should be prepared to carry out an emergency caesarean section if complications develop during a vaginal birth.


NHS Choices

Published Date 2010-07-23

Last Review Date 2009-01-15

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