How many children you want changes the whole calculation
Cesarean risks stack. Each one raises the next.
The single most important question that is almost never asked before a first cesarean is: how many children do you hope to have?
Placenta accreta is a condition in which the placenta grows into or through the uterine wall in a later pregnancy and cannot separate after birth. It often requires removal of the uterus and massive transfusion. Its risk rises sharply with each cesarean.
| Cesarean number | Placenta accreta | Hysterectomy at that delivery |
|---|---|---|
| First | 0.24% | 0.65% |
| Second | 0.31% | 0.42% |
| Third | 0.57% | 0.90% |
| Fourth | 2.13% | 2.41% |
| Fifth | 2.33% | 3.49% |
| Sixth or more | 6.74% | 8.99% |
Read the fourth row again. Between the third and fourth cesarean the accreta risk nearly quadruples. If you want four children, that risk belongs in the conversation before the first operation, not after the third.
Where this comes from:
268. Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA, et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol. 2006;107(6):1226-1232.
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This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you. If you are worried about a symptom now, see urgent warning signs.