How many caesarean sections is safe

It is a common belief that if you have had one caesarean section, you can only have only one more child if it is also by caesarean section. I believe that this misconception arose from the time of "two is enough" family planning policy in Singapore, and those who had a caesarean section were encouraged to have their tubes tied after their second caesarean section. In actual fact one can have as many children as one wishes by caesarean section and I have personally done six caesarean sections on one woman. The risks however increase with each caesarean section although a great deal depends on who performed the operation and the healing process that takes place afterwards.

The main risk is that the placenta implants on the caesarean section scar and this results in a placenta that is low down in the womb and one that becomes difficult to remove during the operation and the possibility of heavy blood loss. The other main risk is that with each operation there may be sticking of the bladder to the womb and injury may occur during the operation. During the second caesarean section, your obstetrician will most likely be able to advise you as to whether you would be able to have more children.