limit to number of csections?

rn/writer, RN · Jan 2, 2007

I recently took care of a patient who had her fifth c-section with a classical incision (vertical). That is supposed to be the more fragile type. The only problem I noticed was that she had lost her belly button due to repeated skin removal. She had her tubes tied after baby #5.

DD #2, on the other hand, also had a classical incision with her second child and showed signs of incipient rupture when they opened her up with her third. She also had a tubal.

Guess it varies, just as being a candidate for a VBAC does.

SmilingBluEyes · Jan 2, 2007

Hmmm someone ought to tell that to our patients who have 5,6 or more kids by csection. Don't see how you can really put a limit on how many people decide to have---is it safe to have that many? Debatable. But not debatable is their right to have as many kids as their bodies and hearts allow.

I do know of one couple who planned more (after quite a few) til the doctor pointed out the friability and thin-membrane-like quality to the patient's uterus to her husband. He said that was enought to convince him this was the last one---it was nearly transparent. Quite dramatic. But not at all sure it was due to her number of csections so much.

Long Term Care Columnist / Guide · Jan 2, 2007

One of the Kennedys---I'm pretty sure it was Ethel---had ELEVEN cesareans. Makes me feel like a whiner having had only three.:uhoh21:

KellNY, RN · Jan 2, 2007

Having seen too many accretas lately on multip C/Sers, I'm not sure it's a bad thing that docs are trying to limit them.

Forcing someone to labor for 3 days with an IUFD? That's unethical.

MUSA91C · Jan 2, 2007

lol, my wife had 6 csections!! were done now tho...lol

mrscurtwkids4 · Jan 2, 2007

I had 5 c-sections. My personal opinion would be that the number of sections is dependent on the individual and the doctor they have. Just depends on how well the person heals and how "stretchy" the uterus is. After my last one, I ended up with a tubal. And started having other problems. Had so many adhesions and bleeding issues that I ended up with a hysterectomy a few years later. But I wouldn't have changed a thing in order to get my kids here. My first section was an emergency d/t placental abruption and the rest just followed suit. Anyway, I think it is a very individual thing as to how many is "safe" for each person.

dawngloves, BSN, RN · Jan 2, 2007

I wonder what his rationale is? I've been to several c/s that were mom's 4th, 5th, 6th. We get a heads up and the nurse will tell us, "Might be a while. It's her 6th c/s." And the smell from the Brovie cutting through all that scar tissue! Yuck!!!

MIA-RN1, RN · Jan 2, 2007

Forcing someone to labor for 3 days with an IUFD? That's unethical.

I totally agree. I wouldn't have put up with it myself.

MIA-RN1, RN · Jan 2, 2007

Thanks to all for the input. It sounded weird that he limited her but perhaps there is something anatomical, or perhaps some medical condition I am unaware of, that made the doc decide to limit. I personally thought vbacs are more risky than repeat c-sections (hemorrhage, rupture etc).

Thanks all!

33-weeker · Jan 7, 2007

I hear they are discouraged after 3 or 4 (but not 2). And letting baby die over it - cruel malpractice!!!

Just attended a 5th recently, but doc followed up with a planned tubal. I agree about the bovie smell - yuck.

At the root of the problem is preventing the PRIMARY section. Many of them could be prevented that aren't.

KellNY, RN · Jan 9, 2007

And letting baby die over it - cruel malpractice!!!

The baby was already dead. IUFD (or FDIU, depending on your regional vocab)