Can I have more children after having a C-section?

Women have been having babies for centuries, but it wasn’t always as safe as it is today. Years ago, mothers or babies were at risk due to complications or other abnormalities throughout pregnancy.

Thanks to advancements, women can now give birth sometimes through a caesarean delivery, or c-section. This is a surgical procedure where an incision is made in the mother’s abdomen and uterus to deliver a healthy baby.

Cesarean delivery rates in the United States were at the highest levels ever, with more than 1.3 million cesarean deliveries (32.9% of all births) performed in 2009.

You may have a lot of questions about c-sections, and Dr. Kathleen Boswell, MD, an OB/GYN on the medical staff at Scott & White Clinic – Round Rock, provides some clarification for moms looking to have more children after a c-section.

Difference Between a Vaginal Delivery and a C-Section

“A cesarean section is a major abdominal surgery — typically women will have a longer hospitalization and recovery time,” Dr. Boswell said.

“A cesarean section is a major abdominal surgery — typically women will have a longer hospitalization and recovery time,” Dr. Boswell said.

You may hear it’s increasingly common for a woman to have a c-section, and this decision is usually made if there is a risk for the mom or the baby. You can talk to your doctor about your birth plan, and what to do if a c-section may be necessary for you.

More Children after C-Section

If you’ve already had a c-section, you may wonder if you can have more children. After one, possibly even two cesarean sections, Dr. Boswell said it is safe to attempt to have a vaginal birth. This is known as a Trial of Labor after Cesarean Section (TOLAC). A delivery after a c-section is known as a vaginal birth after cesarean section (VBAC).

“The most important factor in determining this is the operative note from your previous cesarean section,” Dr. Boswell said. “If the procedure was done in a different state or country, we need to be able to review the findings, indications and incision made on your uterus. This will allow us to provide you with the most information on risks and benefits of TOLAC or repeat c-section.”

If you’ve had a c-section and want to have more children, you can talk to your doctor about your situation.

To see if a VBAC is an option for you, Dr. Boswell said your doctor will look at:

• Monitoring your incision site
• Looking for signs of infection, poor healing or scar formation.
• Monitoring pain that is more than expected.
• Normal bowel and bladder function.
• Ability to breastfeed your newborn.
• Minimal vaginal bleeding after delivery.

“Your doctor should be able to evaluate from your indications for the previous c-sections if you are good candidate for a vaginal birth,” Dr. Boswell said. “If you desire to have more than two children, it may be in your best interest to attempt a vaginal delivery in order to decrease subsequent risks.”

The main risk of attempting a vaginal birth after c-section is that the uterine could rupture. However, this happens in less than one percent of the patients when a normal incision is made on the uterus, but is an emergency when it happens.

Risks of Multiple C-Sections

The reason your doctor may look at attempting a vaginal delivery is because, with each c-section, the risk of placenta problems and abnormal bleeding during the procedure may increase.

“The greater the number of c-sections you have, the greater the risk involved,” Dr. Boswell said.

This is because of the following risks tied to c-sections:

• Risk of having an abnormal placenta
• Risk of bleeding at time of delivery
• Risk of needing emergent hysterectomy at time of the birth of the child
• Risk of forming scar tissue or adhesions that may impact your bowls, intestines, bladder or other areas of your body.

No matter the risk, your doctor can find a way to help you in your family planning. Almost all women heal quite well after a c-section and their doctor can counsel them on a realistic path for their family.

Be honest and open about your concerns. Your doctor will help you develop a safe and probable plan for your children, no matter the way they enter this world.

Talk with your OBGYN about your family planning goals and options, or find an OBGYN near you.