How soon can I get pregnant after stillbirth?
Dear Dr Mitchell,
My first pregnancy ended tragically — after several hours of attempting natural birth I gave birth to a baby girl via C-section. Unfortunately she aspirated meconium as the labour lasted for more than six hours at 41+ weeks.
This happened in late June 2019. I did a total check-up and everything is fine, but I need to take care of my insulin so I am taking Inofolic preventatively.
Also, I did both vaginal and stomach ultrasounds which showed everything is OK. Some doctors told me to wait for a year before conceiving again and some told me six months would be fine.
My next pregnancy should end in an elective C-section. Considering that I am 34, in your experience what are the chances of possible complications if I conceived a few months before the 12 months gap?
I am truly sorry to learn about your unfortunate outcome with your labour and delivery. The problem with prolonged pregnancy beyond your expected delivery date is that the baby gets bigger and also the risk of meconium in the amniotic fluid is increased. The presence of meconium in prolonged pregnancy increases the risk of aspiration of meconium during the delivery process and this can lead to severe breathing problems with lung infection and death of the baby. Prolonged labour will also increase the risk of this happening.
The risk of becoming pregnant too early after a Caesarean section is that of rupture of the uterus. It is important to allow time for the scar on the uterus to heal properly. In addition, it is important to have perfect control of your blood sugar before becoming pregnant. Ideally your hemoglobin A1c (HbA1c) should be within the normal range at the time of conception. This will reduce the risk of birth defects as a result of poorly controlled blood sugar. It is also important to try and lose any extra weight that you gained in the pregnancy and achieve your ideal weight for height. This will help to reduce your risk of developing high blood pressure during the pregnancy and also reduce the risk of developing clots in your legs and lungs during the pregnancy and after delivery. Once you have achieved your ideal weight for height it will become easier to control your blood sugar during the pregnancy.
You should wait at least six months before trying to conceive again. You can be sexually active but you should use effective contraception to allow yourself the time to be in perfect health before trying to become pregnant. In the perfect setting the usual recommendation is at least two years between each pregnancy, but if you conceive a year later you should be within a safe zone.
Delivery should definitely be done by planned Caesarean section at 38-39 weeks gestation. In preparation for pregnancy you should start taking daily folic acid at least three months before conception and this should be continued throughout the first trimester to reduce the risk of birth defects in the brain and spinal cord.
I know that this is really difficult for you, but you are still young at age 34 and you should be able to become pregnant and have a healthy baby in short order.
Best regards.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
DISCLAIMER:
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.
