Your ‘Ask the Expert’ C-section answers revealed

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Thank you all very much for sending in an extensive list of questions about C-sections. Our expert, Dr. Ang Huai Yan has helped answer one of the most frequently asked questions.

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While C-sections are necessary due to medical reasons, the latest research shows that children born by C-section may not get the probiotics or protective bacteria like children born naturally.

That is why we are here with expert advice on how to provide your baby with better protection. Dr. Ang Huai Yan is a gynaecologist and obstetrician expert at Gleneagles Hospital.  She is very warmly favoured by many parents-to-be. Dr. Ang has taken the time out to answer your questions regarding C-sections.

Question from a concerned parent: My first two babies are both big and weighed more than 3.5 kgs each at birth. As a result I chose to deliver them via a C-section operation. Would it be possible to undergo a natural delivery, if I were to get pregnant again? If not, how many more C-sections would be safe for me to have? 


The risks involved

Women who undergo a C- section for a non-recurring cause (i.e. breech presentation, fetal distress) have the option of attempting a natural delivery.

For such women the chances of a successful vaginal delivery can be as high as 70 percent.  However, there can be risks involved. There is a 0.6 percent chance of a uterine rupture occurring. If this happens, the baby must be delivered within a timeframe of four minutes in order to prevent irreversible brain damage to the child. This happens due to a lack of oxygen, known as hypoxia. Massive maternal bleeding is also a complication that results from uterine rupture.

What Singaporean women opt for

Most women in Singapore, prefer not to undertake the risk and opt for a repeat C-section. Hence, there is an increasing number of women who choose to have C-sections altogether.  Women who have already had two C-sections, they are strongly advised against natural labour as the risk of uterine rupture is even higher.

With regard to your query, both C-sections have been conducted for a recurring cause i.e. your babies were big.  Hence the chances of you having a successful vaginal birth will unfortunately be, very low.

How many C-sections are ok?

There is no scientifically established number of C-sections that are advised, however we know that with repeated surgeries the chances of adhesions, placenta accrete (placenta embedded in the scar tissue of the uterus) increase.  This makes the surgery more complicated and more dangerous to the mother.

We normally advise patients to stop at three C-sections.  There are reported cases of women having more than three repeat C-sections in countries where ligation is not allowed due to religious reasons.

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