Should there be a maximum limit on the number of cesarean deliveries?

The article is professionally consulted by Master, Doctor Trinh Thi Thanh Huyen - Department of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital.

Currently, cesarean section is the method chosen by many pregnant women because of its advantages in pain reduction compared to vaginal delivery. However, not all cases can be delivered by caesarean section because this method has significant consequences for the next pregnancy.

Caesarean section is a method of using a local anesthetic injected into the spinal cord, or the epidural of the spinal cord to make pregnant mothers feel no pain during childbirth. Therefore, pregnant women usually do not take much time or suffer labor pains. If a vaginal birth can last up to hours, a cesarean section only takes about 30-45 minutes. In terms of obstetrics, cesarean section is the optimal method to reduce the risk of complications, ensure the safety of both mother and fetus if the pregnant mother encounters abnormal problems such as cardiovascular disease, complications. pregnancy, the fetus is too large or the fetus fails in labor. In case the mother suffers from some diseases during pregnancy such as ovarian cysts or uterine fibroids ... then the cesarean section, depending on the conditions, can be removed or left for next time treatment.

Causing cosmetic loss due to a large scar in the abdomen. Anesthesia used in surgery can cause side effects such as affecting the quality of breast milk or lowering blood pressure, causing allergies. After giving birth, the mother's recovery level will be longer and more painful than with a vaginal birth. The incisions after giving birth if not cleaned and cared for carefully, there is a risk of infection of the incision, cystitis, placenta accreta in the old surgery scar if the mother is pregnant for the second time. In particular, if the next pregnancy is less than 2 years after the previous surgery, there is a risk of having a cleft palate. The more times a caesarean section is performed, the higher the complication rate, especially if the pregnancy is implanted at the incision site, the scar will be bad, and the surgery will be difficult. The risk of pregnancy complications in the next pregnancy is higher than mothers who give birth vaginally. During a cesarean section, the baby is not exposed to the bacteria in the mother's vaginal environment, so the baby's immune system is also weaker. If you have had a cesarean section less than 2 years and have been pregnant again, it is very likely that you will have a caesarean section.

Due to the disadvantages of cesarean section above, mothers should only give birth by cesarean section in mandatory cases such as:
Mother with twins or multiples

Having same pregnancy complications as placenta previa, abruption, preeclampsia, fetal distress, umbilical cord prolapse... The mother had a cesarean section in the previous birth The mother had infections, kidney disease, high blood pressure , gestational diabetes, uterine fibroids, ovarian cysts The baby is too big to give birth normally The baby has birth defects Unfavorable or too high fetal position Premature birth Mother has a small, narrow pelvis.

Re-birth can cause certain effects on the health of both mother and baby. Especially, if the mother has had a cesarean section in the previous time, most will have to have a cesarean section in the following times. Therefore, mothers who have had multiple C-sections need to be careful about the spacing between births as well as the number of pregnancies and births. According to the recommendations of the Ministry of Health, each mother should only use caesarean section for a maximum of 3 times. In fact, the greater the number of cesarean deliveries, the greater the risk of complications in subsequent pregnancies and births.
In addition, the number of births by cesarean section depends on the mother's health status and incision. Therefore, the interval between pregnancies and cesarean sections also needs special attention. The most suitable time between two cesarean deliveries needs to be at least 2 years apart to ensure that the mother's uterus and cesarean scar are fully recovered.
If the pregnant mother gives birth by cesarean section too close, there will be a high risk of complications such as: placenta previa, placental abruption, placenta previa, uterine rupture ... or postpartum abnormalities such as adhesion inflammation uterus, incisional pain, old surgical scars that stick the viscera to the abdominal wall incision, especially the bladder. These effects can directly endanger the health and life of mother and baby.

If the pregnant woman has had 2 cesarean births and intends to have a 3rd pregnancy, it should be at least 3 years before the previous birth for the scar to recover well. Due to the cesarean section in the previous two times, the 3rd time will definitely be indicated for a cesarean section. To have a stable pregnancy and avoid birth risks, as soon as pregnant women intend to become pregnant, pregnant women should have an ultrasound examination to check the old incision, provide the doctor with information about the previous birth such as the time of cesarean section. , reason for surgery, recovery time, complications after birth... old, need to be hospitalized to be checked and monitored.