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How many cesareans are safe?


Updated June 24, 2014

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Question: How many cesareans are safe?

As the cesarean section rates soar and the number of vaginal birth after cesareans (VBACs) fall, there are more women having multiple cesareans. The science behind the safety of multiples cesareans says that the more cesarean surgeries you have, the riskier they are for you and the baby. Risky enough that the National Institute of Health (NIH) said that you probably shouldn't choose a cesarean if you wanted more then two or three kids.

Among the risk factors for multiples cesareans includes a risk of placenta previa, placenta accreta and hysterectomy. These risks go up with each cesarean and have health ramifications on the life of the mother and baby.

There are also maternal problem directly related to the cesarean surgery, like bowel injury, ICU admissions, post-operative ventilator use, cystotomy and more. These also increase as the number of cesareans increase.

This has an impact on the health of mom, the health of baby, the rates of future pregnancies as well as the health of future pregnancies.

The decision for a cesarean section should not be lightly or without medical reason, according to the American College of OB/GYNs.


Multiple cesarean section morbidity. Makoha FW, Felimban HM, Fathuddien MA, Roomi F, Ghabra T. Int J Gynaecol Obstet. 2004 Dec;87(3):227-32.

Maternal morbidity associated with multiple repeat cesarean deliveries. Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA, Moawad AH, Caritis SN, Harper M, Wapner RJ, Sorokin Y, Miodovnik M, Carpenter M, Peaceman AM, O'Sullivan MJ, Sibai B, Langer O, Thorp JM, Ramin SM, Mercer BM. Obstet Gynecol. 2006 Jun;107(6):1226-32.

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