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Is it safe to go for a fourth C-section delivery?

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Posted on Sat, 29 Mar 2014
Question: I have had three csections. Wonderful pregnancies, zero problems. Would love a fourth child but scared of potential issues with repeat csections. My old obgyn told me risks are huge after three. Another obgyn told me risks are greatest after four and to not worry. Why difference in opinion? New research indicating at which csection risks are greatest? Worth the risk or be happy with my three healthy kids already?
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Answered by Dr. Chobufo Ditah (2 hours later)
Brief Answer: Each previous CS adds to the risk! Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about these past cs and the present inconveniences this has caused you as regards the prospects of becoming pregnant again I will be very sincere with you and make this simple. Pregnancy in itself is a risk and every previous cs adds to this risk. For sure, a person with three cs has a lower risk than another person who has had four previous cs. There is no clear cut as to say after this number(x), there is an exponential increase in risk but it is rather a continuum of an uprising curve when looking at number of past cs and complications during pregnancy. I am therefore not surprised your doctors are both reporting a difference in this rather very vague arbitrary number that represents nothing in the real world. There are persons who have gone on to have as many as 7cs without any problems and others develop great problems even after just one. My lone advice to you is that the risk increases as the number if previous cs increases. It is for you to know that the risk is higher than was with the last pregnancy and whether you would want to take it or not. Risk in no way means certainty and so, feel free to follow your heart and deal with challenges because there is no NO or YES response to this question. I understand the need and how you feel about having the fourth child. If you were my wife or sister, I would recommend that we spare ourselves the risk of a fourth baby and rather guarantee staying healthy and enjoying the three we already have. If you should choose to go on and have your baby, no one would for sure say whether you would have serious complications or not. All I will advise is for you to make sure you are followed up closely so as to address any red flags and intervene when there is still time to limit any potential damages if any complications set in I wish you well. Feel free to ask for more information or clarification if need be. Thanks for using our services. Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chobufo Ditah (31 minutes later)
Do you have a rough estimate of the likelihood of me developing placenta previa? your advice was wonderful and honest and succinct. I really appreciate it. Thank you very much. This has helped me a lot. I've been over thinking this for a yr now.
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Answered by Dr. Chobufo Ditah (36 minutes later)
Brief Answer: Thank you for your kind words Detailed Answer: Hi and thanks fr following up with me. Studies have shown that women with previous history of cs have about 1.5-2times higher chances of having placenta previa than women who don't. Studies have not specifically looked at this after 3 cs. Does it mean you would have it? No. The best way to avoid placenta previa if we are too scared of is not to get pregnant. Sure you must be saying to yourself that this doctor is a joke!! This is the truth and our knowledge of different possibilities should not stop us from daring if we really feel so strongly about. It should rather help us to be more alert and ready to intervene if complications were to happen. If it were for sure, I would have said, please do not get pregnant but because it remains a probability, I will like you to take your chances and go for what you feel strongly about. I wish you well. Thanks. Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chobufo Ditah (2 hours later)
Thanks! I really appreciate your response. I have discussed these issues with my obgyn but hearing it and seeing it in writing helps. I'm not a risk taker by nature and I'm not getting any younger. We shall see. Thanks again!
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Answered by Dr. Chobufo Ditah (14 hours later)
Brief Answer: Thanks Detailed Answer: Hi and thanks so much for your kind words. I am humbled knowing I have been able to offer some form of help or clarifications to you. That is the single and most important goal that I have every day i send out a response to a client. I wish you. Feel free to direct future queries to me in future if need be. Than you so much for using our services. Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

Answered : 6320 Questions

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Is it safe to go for a fourth C-section delivery?

Brief Answer: Each previous CS adds to the risk! Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about these past cs and the present inconveniences this has caused you as regards the prospects of becoming pregnant again I will be very sincere with you and make this simple. Pregnancy in itself is a risk and every previous cs adds to this risk. For sure, a person with three cs has a lower risk than another person who has had four previous cs. There is no clear cut as to say after this number(x), there is an exponential increase in risk but it is rather a continuum of an uprising curve when looking at number of past cs and complications during pregnancy. I am therefore not surprised your doctors are both reporting a difference in this rather very vague arbitrary number that represents nothing in the real world. There are persons who have gone on to have as many as 7cs without any problems and others develop great problems even after just one. My lone advice to you is that the risk increases as the number if previous cs increases. It is for you to know that the risk is higher than was with the last pregnancy and whether you would want to take it or not. Risk in no way means certainty and so, feel free to follow your heart and deal with challenges because there is no NO or YES response to this question. I understand the need and how you feel about having the fourth child. If you were my wife or sister, I would recommend that we spare ourselves the risk of a fourth baby and rather guarantee staying healthy and enjoying the three we already have. If you should choose to go on and have your baby, no one would for sure say whether you would have serious complications or not. All I will advise is for you to make sure you are followed up closely so as to address any red flags and intervene when there is still time to limit any potential damages if any complications set in I wish you well. Feel free to ask for more information or clarification if need be. Thanks for using our services. Dr. Ditah, MD.