limit to number of csections? - page 2

An acquaintance mentioned that she had two babies by c-section and had to deliver her third (FDIU) vaginally because the doctor said that if she had three c-sections, she wouldn't be able to have any... Read More

  1. by   Sugar9486
    I wat told by a doctor at the hospital I work at that it is discouraged after three or four because of scar tissue...
  2. by   strn96
    Quote from CoopergrrlRN
    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!
    It sounds to me like he was trying to prevent further scarring since the baby was IUFD. Probably the biggest concerns of docs about VBAC is that if the uterus ruptures baby can die (Chance of rupture is very small-around 1-2%, but if it happens, OMG!). In this case, the baby was already gone. It does seem a little cruel that he let her labor so long, but I can understand his reasoning for VBAC in this particular case.
    As to the safety of VBACs, it depends on the situation. If mom has only had one c/s with a low transverse "bikini line" incision, VBAC is usually an acceptable option, esp if she has hx of vag delivery before 1st c/s. The risk with multiple repeat c/s is scar tissue, which can complications like placenta accreta, damage to structures like bowel, bladder, etc. We actually had a repeat c/s pt (her 4th c/s, I think) with accreta that had an amniotic fluid embolysm and very nearly died (went into v-fib for a bit). So the answer as to the wisdom of VBAC vs R c/s is it depends on the situation. These days, a lot of hospitals in my area are refusing to do VBACs because they are risky, but IMHO multiple repeat c/s can sometimes be just as bad. I agreee with the previous poster about preventing the first c/s if possible.
    Last edit by strn96 on Feb 4, '07
  3. by   nj1grlcrus
    Twentyfive years ago, the rule of the day was, Once a c-section, always a c-section. Women would fight for a chance at a VBAC. There might be a reason why the doc chose the vaginal delivery, but it does sound fishy. That's why I had my last three kids delivered by a midwife (CNM). Got to love thoses nurses, they really are patient advocates first, as well are trained medical personnel.