Repeat Cesarean Sections: Understanding Limits & Risks

Question
How many cesarian sections can you have?  I have heard you can only have three.  Is that true?

Answer
The number of repeat cesareans one can have must be decided on a case by case decision. I have performed 5 cesareans on a patient in the past. There is no limit. However, remember that each time a cesarean is performed, the bladder is tacked up higher. This can present a problem opening up the abdomen. At times, the tissue is destroyed so much that we see a "window" where the old scar is located which does not even need to be incised. We would then suggest that the patient do not become pregnant again.  However, if your tissue is healthy and there is no problem, you can continue to have repeat cesarean sections.  Many obstetricians will not allow you to attempt a VBAC (vaginal birth after cesarean) if you have had more than 2 cesarean sections in the past because of the weakness of the uterine scar and the risk of rupture of the uterus if you are to go into labor.