Long gone are the days when it was believed that after a cesarean section it was undesirable for a woman to give birth more, and even more so there was no question of how many times after such an operation it was possible to repeat it. Now the attitude towards caesarean section has changed, it is done more often, and more and more often women are thinking about a second or subsequent pregnancy after they become mothers thanks to the work of surgeons.
In this article, we'll show you how many times you can have a caesarean section.
About the operation
Caesarean section ("royal cut" - translated from Latin) is an alternative way of birth.
Using an incision in the anterior abdominal wall, the baby is removed from the uterus. He does not pass through the birth canal, and the woman does not experience pain. But with all the visible advantages, it is impossible to do a cesarean just like that, for example, because of fear of childbirth, in our country. There must be strict indications for the operation.
This operation is one of the most ancient. Until the 16th century, gluttony was performed only on dead pregnant women in the hope of saving children. Since the 16th century, they began to try to do the operation and live, but these attempts were not crowned with success, since it did not occur to the surgeons of that time to sew up the uterus, they were limited only to the sutures on the peritoneum.
In the 19th century, they decided to reduce maternal mortality and began to remove the uterus after the operation to remove the child, and then they learned how to sew it up, which gradually enabled the woman not only to survive after the operation, but also to dream of future children.
Indications
The indications for the operation are:
- a narrow pelvis and a clear discrepancy between the size of the fetus and the size of the pelvis of the pregnant woman;
- placenta previa, when the "child's place" overlaps the internal pharynx, interfering with the exit of the child in natural childbirth;
- the presence of uterine fibroids;
- the presence of scars on the uterus (from previous operations for any purpose), threatening rupture of the genital organ during contractions;
- diseases of a woman in which natural childbirth is contraindicated (especially cardiovascular, kidney disease, retinal detachment and myopia);
- the presence of gestosis;
- improper placement of the fetus in the uterus (pelvic or longitudinal);
- multiple pregnancy (not always);
- polyhydramnios;
- genital herpes (so that the baby does not come into contact with herpes infection when passing through the genital tract).
For all these indications, the operation will be done as planned. There are also emergency indications, in this case the operation will be called an emergency caesarean section.
It is carried out when a woman has a weakness in labor forces at any stage of labor, if drug stimulation is ineffective. Also, the operation will be urgently done with signs of fetal hypoxia, with a threatening rupture of the uterus in the labor process.
The operation is performed under general anesthesia or epidural anesthesia. In the first case, the woman is in deep medication sleep, and in the second, she is simply deprived of sensitivity in the lower half of the body.
For whatever indications a cesarean section was performed, soon a woman may have a question about when she can become a mother again and whether she can give birth on her own. We will try to answer these questions.
When can you get pregnant?
A woman after a cesarean section can become pregnant after the same time as after a natural birth. Physiology is such that a new pregnancy will be possible with the normalization of the menstrual cycle.
Usually, during the period of breastfeeding in women, the so-called postpartum natural sterility occurs. But pregnancy is also possible while breastfeeding.
This is especially well learned after a cesarean section. It is not recommended for a woman to become pregnant for 2 years. This period is needed to restore the body after surgery, as well as to heal the scar on the uterus left after surgery.
The main danger is precisely an insolvent scar, which creates the likelihood of rupture of the uterus.
During pregnancy, the reproductive organ enlarges almost 500 times. Surgeons, of course, try to make an incision in the lower uterine segment, which is least susceptible to stretching as the uterus grows. but the likelihood of a rupture exists. Often it leads to the development of massive bleeding and death of the pregnant woman and the fetus.
It takes at least two years to form the most elastic tissue in the scar area.
If pregnancy occurs earlier, in addition to the risk of uterine rupture, it can cause other troubles. Often he is the main reason in the development of low placenta previa, placental insufficiency during subsequent pregnancy, the risk of isthmic-cervical insufficiency increases. Women who become pregnant too early after surgery face the threat of miscarriage, with delays in the intrauterine development of the baby.
Apart from pregnancy, no uterine surgery or curettage is recommended for the two-year period after surgery. Therefore, a woman should pay close attention to the issues of contraception.
How many operations can be done?
The answer to this question may surprise you. But a woman can have a cesarean section as many times as needed.
Each subsequent operation is performed on the previous scar. After removing the baby from the uterus, the surgeons excised the old scar and put new stitches. For this reason, each subsequent scar is slightly thinner than the previous one, which means that each subsequent pregnancy is a more risky business than the previous one.
In the USSR, it was not recommended to get pregnant again after a cesarean section. Doctors dissuaded women from such a decision not because they did not know how to perform repeated operations on the old scar, but because the technologies and suture material were different, the scars turned out to be rough and the risk of their discrepancy during repeated pregnancy was high.
By the end of the last century, doctors pointed out to women who had a chance to give birth by surgery to the possibility of having another child, but not earlier than 3 years later. In the 2000s, three operations were tacitly allowed. Until recently, it was this number that was considered the only possible, extreme.
Before the third cesarean section and today, doctors suggest that women consider the possibility of surgical sterilization, in order to even theoretically exclude the possibility of another pregnancy. Many agree. But those who do not sign such consent sometimes come for the fourth child.
The fourth and even the fifth caesarean today will not surprise anyone. Victoria Beckham performed 4 operations, and Angelina Jolie - three. By the way, the author of this article also performed four cesarean sections and does not regret it at all.
How many times can a cesarean be done - it's up to the woman herself and her doctor to decide, who will assess the patient's age, her health status, the condition of the scar after the previous operation, associated risks.
If the doctor is lucky, he will always find the right words to encourage a woman. If you are unlucky (and so far, according to reviews, it happens often), a woman will be actively dissuaded from giving birth in the antenatal clinic even after the second caesarean section.
To observe a pregnant woman after 2, 3, 4 operations on the uterus in history is a big risk. If something happens to her, the doctor will be personally responsible. That is why women begin to be told the horrors of a thin scar, unsightly prospects of a break. Uterine ruptures are rare. Unfortunately, abortions because of fear of a breakup are frequent.
Planning a pregnancy after a CS
The correct lifestyle and attitude to your health will help a woman to prepare as well as possible for her next pregnancy. Here are some simple tips to follow if you want to become a mom again (or two, or three):
- after the operation for 3 months, you should refrain from physical exertion, lifting weights over 2 kilograms in weight;
- you can begin to live sexually after the bloody discharge from the genitals stops;
- the first month it is better to use barrier contraception, and when the menstrual cycle is normalized, you should contact your gynecologist to choose any other method, with the exception of the intrauterine device;
- after 2 years, which are required for complete rehabilitation after surgery, a woman needs to consult a gynecologist, take all tests, make smears, as well as an ultrasound of the pelvic organs and hysteroscopy to assess the scar.
See the following video for all the facts about caesarean section.
