Some doctors say 3 c-sections are enough, some say 4. why is that? are the risks that different? is having a 4th c-section safe for mom and baby?

Uterine Rupture: I know of no OB or Family Doctor that would advise a pregnancy after three C-sections let alone a fourth c-section.

Too many not safe: Hi Judith850 The more C-sections, the greater the scar tissue that can form inside the abdomen making it hard to get to the baby, esp. in emergencies, also higher chance of injuring other organs. The uterus is weaker where it is scarred, increasing risk of the scar opening or bursting at the start of labor, or before labor. This can cause hemorrhage or separation of placenta, dangerous to both.

More risk each time: The risk for complications increase with each additional c-section. Placental problems and internal scarring are the main causes. Risk of the placenta attaching too deeply into the scar range from 0.2% with the first c-section, up to ~8% with the 6th time. When a placenta attaches too deeply, an emergency hysterectomy is required after delivery, and that comes with significant risks to you.