That’s a lot of C-sections!

I recently found this article on a women’s website a friend recommended to me, and just had to share it. Wow. A woman had all of her children by Cesarean — seven total surgeries! And it mentions another doctor who performed thirteen C-sections on one woman back in the 1970s. Incredible!

However, I will point out, that statistically, the risk of adverse complications (both during the C-section and in a subsequent pregnancy) do increase with every C-section, sometimes exponentially. So, if you can avoid a C-section in the first place, or have a vaginal birth after Cesarean, that’s going to be better for you and any future babies. I don’t know if these grand multip C-section moms have been studied to see what the rate of adverse events (like hysterectomy, hemorrhage, hemorrhage requiring hysterectomy, future placenta previa/percreta/acreta, etc.) are. There probably aren’t enough of them to do anything but case studies.

Still, that was incredible to me. I honestly would have assumed that the rate of complications would have been so high that most women would have ended up with a hysterectomy or chosen to have their tubes tied (or been coerced into it, as was attempted for this mother, or even sterilizing her without her consent) , or in some other way just stopped having babies. I was wrong. I’m not sure if these women are “beating the odds” necessarily. As long as the rate of X is below 50%, then odds are that they will not have X problem. But, the odds of a hysterectomy or hemorrhage or any of these other bad things with a VBAC is much lower than with a repeat C-section — especially when you get into higher numbers of C-section.

I would assume that the mother from the 1970s would have had a classical or vertical incision, which is contraindicated for VBAC attempt (although I know a woman by email who did have a VBAC after a classical C-section, and the labor was induced or augmented with Pitocin, which adds another layer of contraindication; but her uterus did just fine), so she may have been a poor VBAC candidate (especially at a time when “once a C-section, always a C-section” was the rule of the day). But there is no indication why the other mother had any of her C-sections, either the first, or any of her repeats.

Interesting. Very interesting.

~*~

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9 Responses

  1. My mil had 4 cesareans. She had a vertical incision and after the 3rd they told her no more kids. she got pregnant 6 yrs later on accident and had her 4th cesarean.

    Another interesting thing is I have heard docs limiting the # of vbacs u can have. My friends neighbor had one cesarean, then 3 vbacs, and was told she had to have cesareans again and had 3 more cesareans (7 kids total).

    I know they caution no more than 3 cesareans, but especially in my state (utah) people have a lot more kids than that. I think people having a lot of kids and have had one cesarean already make it hard for docs to caution against the risks. Which would bring into play the sterilization, with or without consent.

    Great post!

  2. This was very interesting. I had looked into the possibility of c-section long before I was pregnant (due to a genetic issue no one was sure when I was a kid if I could successful birth a baby) and was always told you couldn’t have more than 3 due to scaring and complications. These women must have been good healers! It seems like a womb so scared as that wouldn’t hold through the full pregnancy!

  3. The rate of complications starts to really rise after about 3 c/s so some docs put a limit on you and force you to sterilize (which I think is just unconscionable). Others do not, though. You can find studies on pubmed on higher order c/s; there are plenty of them out there.

    They show that while the risks do go up QUITE a lot with each c/s, and especially after 3, many mothers with higher order multiple c/s do just fine. There’s a lot more bleeding and adhesions but in terms of really life-threatening stuff, most do okay. It’s not ideal, but if someone really does need to have c/s, they don’t have to automatically stop at 3.

    Ethel Kennedy (Bobby’s wife) is always quoted as someone who had a LOT of c/s. Just how many is different in every source, but I believe it’s something like eleven c/s. Given the time frame (the 60s), I would assume those were all vertical/classicals, so that boggles the mind. But apparently she was okay.

    As noted by Kayce, some docs have indeed tried to limit the amount of VBACs a person could have. Their thinking was that the risk of rupture might go up as you become a grand multip. But that’s foolish thinking; the greater risk is to be doing that many more c/s. And what studies we have on grand multips and VBACs show they do just fine.

    So it’s stupid, stupid reasoning to tell a woman who has already HAD VBACs (and is therefore at less risk for rupture) that she can only have xxx VBACs and then have to go back to c/s, when we know that higher #s of c/s place the mom and future babies at much higher risks. Totally screwy reasoning, but a lot of docs aren’t really thinking this through well.

  4. They stopped using the classical cut on the uterus in the 1940′s to early 1950′s. The cut on the outside may still be vertical, while the cut on the uterus is horizontal. I doubt anyone had a routine classical uterine incision in the 70′s.

    • Oh, I thought it was more recent than that — just based on the number of sources I’ve read that advised mothers who had had a C-section to ask their doctor specifically about incision type. Since these books were written for women in the 80s or possibly the 90s, it made it sound like vertical was still possible/likely.

  5. My mother had 8 c-sections, the last of which was 40 years ago. They use to perform c-sections with a vertical incision. Why she did survive and live many many happy hears later she did have a radical hysterectomy and some scar tissue fussing to her badder and therefore badder repair.
    .

  6. Hi, I have had eight c sections…the ages are 16, 15, 14, 12, 11, 10, 8 and 11 months. the first seven are all boys my last child is a girl. The first two were trial labors of three days I only progressd to 3 sonometers. The third and fourth and fifth were premature 4 and 5 were 25 and 26 weeks gestation. but all of my babies are healthy and big…lol. I suffered a ruptured uterus with baby nmber six and both my tubes burst and were destroyed. I still have my uterus…I hope. and was told repeatedly I would die without a hyserectomy. Still to my knowledge haven’t had one. And funny enough my lil girl was the biggest baby.

  7. Oh let me add I am 36. I was married the first time at 19. Had my first son at 20.

  8. I also have an aunt who has had I think as many as me if not more

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