Refer a Patient. A C-section may not have been part of your birth plan. No matter how you feel about cesareans, you might be concerned about your ability to conceive after multiple C-sections or wonder what to do for your next delivery. During a C-section, you might experience:. Placenta accreta can happen when the placenta implants itself near the c-section scar.
If it stays there unrecognized, you can potentially bleed to death during a future delivery. In the past, the rate of death from accreta was 50 percent. Now, thankfully, most women are not at high risk of dying. Delivering at a place where doctors are experienced with accreta is important. If you've had a prior C-section, your doctor might suggest an ultrasound to check where your placenta is located during your next pregnancy. Doctors recommend you wait at least six weeks after a C-section before having sex and generally encourage using birth control until six to 18 months postpartum.
After a C-section, some women will try having their next child vaginally. This is called vaginal birth after cesarean VBAC.
If you have a low-risk pregnancy, the procedure has a success rate of 60 to 80 percent, according to the American College of Obstetricians and Gynecologists ACOG.
That's because the risk of uterine rupture—a tearing in a past C-section scar or uterine muscles that can be life-threatening to Mother or Baby—rises with each surgery. C-section recovery looks different for everyone. You might always recover at the same rate, or you might experience more difficult post-operational periods each time.
Alternately, you could bounce back faster after each subsequent C-section, according to David Ghausi, D. There's also no set rule when it comes to the number of C-sections you can have.
James, M. Every woman is different, so doctors need to analyze each woman's health, history, and concerns before deciding on the right path. To help prevent any complications, Dr, Ghausi recommends waiting at least 6 months after C-section before getting pregnant again ; other doctors suggest waiting 18 to 24 months.
At any rate, the fact is that the existing system creates a financial incentive to perform a C-section—or a disincentive to manage labor—that may make the difference in the clinical gray areas. Indeed, studies have shown that the more physicians are paid for C-sections relative to vaginal births, the higher the C-section rates become. And when these differentials are reduced, C-section rates decrease. Now, just in case any reader is jumping to the conclusion that the only reason she will have a C-section is because her doctor wants more money—or because her doctor wants to leave the hospital, or because she herself is not a physician—that is not what we are arguing at all.
If this were true, C-section rates would be even higher than they are now. What we are arguing is that medical care is complex and labor management is subject to myriad pressures. While we may not be able to alleviate all the pressures at play, we may be able to reform one of them.
One simple approach is to lower the C-section payment, raise the vaginal-birth payment, and meet in the middle. So we propose an alternative: Raise the payment rate for vaginal births to the C-section rate, and leave the C-section rate where it is. Policy makers will object that this method is expensive. Medical costs in the U. Simply paying more for something risks making that problem worse.
What this argument misses, though, is that the public will get much of its money back—possibly quite a lot of it. C-section risks can include excess scar tissue formation, infection a risk that which is doubled when compared to vaginal births , blood clots and injury to the bladder. Potential problems that rise with each subsequent C-section include placenta accreta—when the placenta implants abnormally—and bowel obstruction.
Every subsequent C-section increases the risk of placenta accreta. In fact, the chances of a placenta accreta occurring with one, two or three prior C-sections increases, but remains at about 0. However, once you have four C-sections, the chances of the condition increase to 2 percent, and if you have six C-sections, the chances are 6 percent. Also, scar tissue forms after surgery, and if you keep operating on the same spot, you may be damaging the scar tissue—which can cause a bowel obstruction.
As recently as the s, it was standard practice that the physician decided if the baby was born via a C-section—and if the mother delivered once by C-section, any subsequent delivery would be carried out the same way.
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