The article was professionally consulted with Specialist Doctor I Le Thi Phuong - Obstetrician and Gynecologist, at Vinmec Ha Long International General Hospital.
Despite the general recommendation of limiting cesarean sections to two for maternal and infant health, some women who desire a fourth cesarean section experience significant anxiety.
1. Fourth Cesarean Section: What You Need to Know
Typically, cesarean sections, whether it's the first or subsequent ones, carry inherent risks, and these risks increase with each additional surgery. However, healthy mothers who have had previous uncomplicated cesarean sections may be able to have 3-4 cesarean births. Generally, doctors recommend limiting cesarean sections to 2-3 to ensure the health of both mother and baby.
It's important to note that the more cesarean sections a woman has, the higher the risk of complications in subsequent pregnancies and births. These complications can include uterine rupture, placenta previa, placental abruption, … and postpartum conditions like uterine adhesions and incisional pain. In addition to the number of cesarean sections, the spacing between pregnancies is also crucial. It's recommended to wait at least two years between cesarean births to allow for adequate healing.
Women considering a fourth cesarean section should undergo preoperative tests and be closely monitored. If there are no warning signs such as incisional pain, frequent contractions, or leakage of amniotic fluid, elective cesareans are often scheduled around weeks 37-38. Most women with previous C-sections choose repeat cesareans due to the risk of uterine rupture during vaginal birth, which occurs in 0.2-1.5% of cases.
The sensation of incisional pain is subjective, and scheduling a cesarean section before the due date solely based on this discomfort could pose risks to the baby. Your doctor will carefully examine you when you report incisional pain to determine the optimal time for surgery, considering the well-being of both you and your baby.
2. Consultation on a 4th C-secsion
- To ensure the safety of both mother and baby, women must know the following 4th cesarean section advice:
Choose the same hospital and obstetrician as your previous three births. This allows the doctor to have a thorough understanding of your medical history, saving time on information gathering.
Opt for a reputable hospital specializing in obstetrics with a highly qualified medical team and advanced technology to ensure a successful delivery.
- Periodic antenatal check-ups as directed by the doctor: this is an important issue in monitoring the fetal development and the mother's health and safety. A full antenatal examination helps the obstetrician to detect abnormalities and intervene promptly.
- The mother needs to prepare a complete set of documents: pregnancy check-up papers, test results during pregnancy, information about postpartum complications (if any from previous births), personal notes, any drug allergies, recovery time, and dietary restrictions. This is a crucial step in the information exchange process for the doctor to provide advice on the fourth cesarean section and perform the procedure accurately, ensuring the safety of both mother and baby.
- The pregnancy process in the fourth trimester requires careful attention and prioritizes rest and propers care until the scheduled delivery date. Avoid heavy work that can affect the uterus, increasing the risk of miscarriage. Be comfortable, relax, do not be too stressed because of worrying about your baby's safety. Rest assured that your doctor has closely monitored your pregnancy and taken all necessary precautions to prevent any unfortunate incidents.
- Prepare enough supplies for mother and baby to give birth: With the experience of three previous births, the expectant mother can easily prepare a complete set of items for herself and the baby. A checklist can be created in advance to ensure nothing is forgotten.
- Monitor your body carefully: especially in the last months of pregnancy before the 4th cesarean section. As mentioned above, potential risks are always present, so when seeing unusual signs (abdominal pain, bleeding, discomfort, ...) pregnant women should immediately go to the hospital for examination.
- Don't hesitate to share your concerns and anxieties about your fourth cesarean birth with your husband or family members. Their support can be a great source of strength during this time.
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