Dear Dr Mitchell,
How soon after a C-section can one get pregnant again and deliver a healthy baby?
A caesarean section is sometimes done as an emergency intervention, or it may be done as a planned procedure. Depending on the indication for the caesarean section, it might be necessary to do another C-section for all subsequent deliveries. Some women can deliver vaginally after a previous caesarean section if the indication for the first section is not a recurrent one, and if there are no contraindications to vaginal delivery.
It is ideal to have proper pregnancy spacing between each baby to allow time for the growth and development of the infant before bringing another baby on board. In addition, the woman’s body needs to heal and repair itself properly before another pregnancy.
Straightforward pregnancies have occurred and babies have been successfully delivered within one year of a previous C-section without any complications. The risk, however, is that of a ruptured uterus, especially if the type of C-section was a classical one. In this situation the incision in the uterus is done in the upper body of the uterus in the midline instead of the lower segment of the uterus. A classical caesarean section is done if there are problems such as large fibroids in the lower segment of the uterus, placenta previa (placenta lying in the lower segment of the uterus), or if the foetus is in a transverse lie, rendering delivery difficult. In some cases of extreme prematurity, the lower uterine segment is not well formed and a classical caesarean section is done. The risk of uterine rupture is greater than that associated with a prior lower-segment C-section delivery.
It is ideal to wait at least one year before conception and to have at least two years between the deliveries to reduce the risk of complications. If you have had a classical caesarean section, you absolutely should have a repeat caesarean section for all subsequent deliveries. If you have had a lower-segment caesarean section, then delivery can be done vaginally once there are no contraindications, since the risk of uterine rupture is significantly reduced.
It is important to ensure that your blood count is good in subsequent pregnancies by taking iron supplements and eating an appropriate diet containing iron-rich foods, since the blood lost from repeat surgery is usually significantly greater. Consult your doctor who will advise you further.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to firstname.lastname@example.org; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.