Roger Harms, M.D., Mayo Clinic specialist in obstetrics-gynecology

I don't have a finite number, but every Caesarean delivery increases the risks somewhat of surgical complications. Most people are not aware that after any kind of operation there are scars that are internal that we refer to as adhesions. And those adhesions develop variably from patient to patient. And so for an individual, a second delivery might be substantially more risky than the first one was. And for another woman who doesn't form adhesions, that risk is not increased greatly. But with experience, if you've done a second C-section and you see that there is a lot of scar formation, you can start to tell a patient, "By the time we're up to your fourth C-section, I'm afraid we're going to be in some difficult surgical situations." In general, most people in family planning should not have a great deal of concern with having three Caesarean deliveries. Beyond three, some women will face a substantial surgical risk that needs to be weighed against whether they really want to have that next baby.

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