Hi and welcome, I understand that you want to have one more pregnancy. The risk in any pregnancy increases after each cesarean section. So person with one section is at more risk than person with none, person with 2 sections is at more risk than person with one and so on. So risk increases with every subsequent section. The only difference is the degree of risk. Let me explain it in a bit more details. Imagine that there is a cut on the body and it heals. The scar is formed. This scar tissue can never be similar to the original tissue however well it heals. Now if repeated cuts are given at the same place every time a scar worse than the previous one will be formed. Same is the case with uterus. With every c section a new scar is produced that makes that part thinner and weaker. How thin it will be depends upon person to person. Someone may form a bad keloid scar after small injury and other may hardly show a scar even after major injury. So it is difficult to predict how the scar will be. So you may be having a perfectly healthy scar with no risk at all or a thin scar. However, having said all this we can detect the thickness of the scar using techniques like sonography. So if you do want a pregnancy it must be done keeping in mind that already the uterus has 3 scars and these may give away at any point of time requiring emergency surgery. So you will need close monitoring of the scars after 20 weeks of pregnancy and if there is any indication of pain or labor pain will need to be in the hospital for monitoring irrespective of gestation. But with all these precautions pregnancy is possible. An elective C section may be needed at any time after 34 weeks depending on how the scar behaves. In the setup where I practice we do a tubal ligation surgery after 3 sections considering the risk associated with future pregnancies and even abortions if needed. So the amount of risk that you want to take is your call. If you feel that you can take all possible care then go for it otherwise better stay away. Hope this satisfies your query. Thanks for using HCM. Feel free to ask any more questions that you may have. Dr Madhuri Bagde Consultant Obstetrician and Gynecologist