Cesarean delivery is one of the most commonly performed in-patient surgical procedures worldwide. Cesarean section is meant to be an emergency and not elective cesarean delivery. It is to have opted only in case of life-threatening situations for the pregnant woman or the fetus.
With the increase in the repeated number of cesarean sections, the risk of illness, impairment, or degradation of health also increases. Although not life-threatening, chances of the long-term complications associated with the cesarean section may arise. Even if this risk of repeated cesarean can be minimized by a combination of optimal prenatal care & counseling, nonetheless the general risks associated with operative delivery and frequently repeated pregnancies remain real.
Many clinicians suggest sterilization to women following 2 or 3 cesarean sections due to the risk of uterine rupture and several complications.
The recommended maximum number of cesarean sections that a woman may safely have is an ongoing debate. Successive cesarean deliveries, especially after the 3rd operation, increase complications for the fetus and the mother. There was a unique case of 10th repeated cesarean surgery on a 40-year-old woman. She delivered a healthy baby with a good APGAR score and the mother was healthy post-delivery.
Even during cesarean surgery, the chances are complications are high. Also, during cesarean delivery, women are at an increased risk of injury than they are during vaginal birth. In the case of repeated cesarean section women, they had a significantly higher risk of inadequate pain treatment after cesarean delivery.
Fourth and more repeat cesarean deliveries ought to be performed by experienced obstetricians in high-equipped tertiary hospitals.
An analysis of the National Family Health Survey of India shows that the rate of this form of delivery in states like Kerala, Goa, Andhra Pradesh, West Bengal, and Tamil Nadu is alarmingly high. The prevalence of repeated cesarean sections in India is 88 percent. The numbers vary from region to region and in different sections of society. Educated, rich, and urban region has higher cesarean section deliveries.
Vaginal birth after cesarean could be a solution to decrease increased cesarean delivery rates.
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