After the arrival in the world of the Infanta Sofia, the second daughter of the Princes of Asturias born by caesarean section, like her older sister Leonor, the question that has remained in the air is:How many caesarean sections can be done to a woman?
When the first birth due to any circumstance that the doctor determines should result in a cesarean, it does not necessarily mean that the second birth should also be by caesarean section.
In the case of Princess Leticia, the reason for the second caesarean section was not specified as it had been done in the first case “for non-progression of labor”, which means that the dilation is not adequate for a vaginal delivery to progress .
After two C-sections it is almost evident that if there is a third birth it will be by the same route. Although one study revealed that you can have a vaginal delivery after multiple caesarean sections, in practice it is not so.
But the big question is what is the number of deliveries that a woman can have by caesarean section.
In the words of Abc de María Benedicto, gynecologist at the USP San José Hospital in Madrid, “most of the doctors does not advise to perform more than three caesarean sections in the same woman”.
That maximum recommended is due to a great risk to which the woman is exposed if she becomes pregnant again.
That greater risk of a third caesarean section is the rupture of the uterine pouch, since the scar caused by the caesarean section weakens the wall of the uterus, increasing the chances that the pouch may rupture.
Bag rupture is one of the most serious obstetric complications as it is accompanied by high maternal and, above all, fetal mortality.
According to the specialist, the breakage rate after two previous C-sections quadruples.
However, he explains that although this is the recommendation of doctors, each woman is free to assume the risks that a fourth caesarean section may entail.
The medical advice is based on the time between gestations (the most advisable is between 12 and 18 months), the type of incision (the vertical ones are most dangerous) and if there was any complication in the previous caesarean section.
From there it is the patient who has the last word. There are women who have had up to five caesarean sections without problems, but it is not usual.
I think it is wise in these cases to follow medical advice.
