How long before you can get pregnant after a cesarean section will be answered by your doctor. The reasons for previous surgery should be considered before planning begins. It is also necessary to assess the general condition of the patient and identify the end of the recovery period. Only after this is a decision made on the nature of the upcoming birth.

Early pregnancy after cesarean section is unacceptable. The ban is associated with the presence of various processes in the body. The recovery period is accompanied by such processes as:

  • formation of scar tissue on the uterine wall;
  • restructuring of the hormonal system;
  • psycho-emotional change;
  • restoration of muscle tissue and reproductive system.

The main recovery involves the formation of scar tissue on the wall of the uterine body. This fabric is different from the usual one. The scar does not have all the usual properties of uterine tissue. It cannot make contractile movements and is not subject to stretching. This property of the scar affects the general characteristics of the uterine cavity during the second conception.

We should not forget about hormonal changes body. This is a very complex and lengthy process. Before pregnancy begins, a woman goes through her menstrual cycle. It is formed by estrogen, luteinizing hormone and progesterone. During the gestation period, the main substance is progesterone. Approximation labor activity causes an increase in the amount of prolactin and a decrease in the amount of progesterone. After surgery hormonal background is undergoing further changes. The body begins to return to the menstrual cycle. Estrogen increases. The amount of prolactin and estrogen affects the late appearance of menstruation. If the second pregnancy after a cesarean section occurs quickly, it may not survive. Risk increases spontaneous miscarriage.

After childbirth, a woman also experiences psycho-emotional stress. It is for this reason that postpartum depression is diagnosed. Recovery from this state may take a year or more. Lack of assistance from a specialist also increases this gap. It is for this reason that it is not recommended repeat pregnancy after caesarean section.

The body also needs to restore the elasticity of muscle tissue. After the operation, the girl is contraindicated for vigorous physical activity. Carrying a child is also included in this prohibition. If a woman is unable to fully recover and a second pregnancy occurs after a cesarean section, placental abruption may occur. Thanks to this process, late miscarriage occurs.

You also need to let the woman get used to the role of a mother. This doesn't always happen quickly. The early onset of the next gestation period can interrupt this process. A breakdown appears nervous system. It is all these conditions that you need to know before planning a 2nd child.

Reasons for the operation

Pregnancy immediately after a cesarean section is not allowed for other reasons. The doctor must explain to the patient the reasons for the previous intervention. There are two types of factors for the purpose of surgery:

  • straight;
  • relative.

Direct causes are related to the patient’s health characteristics. Surgery may have been recommended due to the presence of serious medical conditions. Intervention is often carried out in the presence of oncological tumors. Oncology causes disruption of the cell membrane and changes the characteristics of its nucleus. If additional external influences arise, the development of pathology intensifies. The woman is sent for surgery.

Also, the direct cause of the operation is the incorrect intrauterine position of the child. The location of the fetus depends on the location of the placenta. Independent childbirth is not recommended for women whose fetus takes a position transverse to the uterus. Such babies have a chance of developing hypoxia in the birth canal. Lack of oxygen has a negative impact on a child's brain function and overall health. In rare cases, such births can result in fetal death.

Section is recommended for women whose fetus has a large body weight. Normal weight should be no more than 4 kg. If the baby’s body weight is greater, then the woman will not be able to give birth on her own. Medical intervention is required. The problem worsens when there is a narrow pelvis. Large fruit may get stuck in the birth canal and cause injury. If the weight of the fetus is again large, then childbirth is carried out by section.

The operation is also used for multiple pregnancies. The development of several fruits during one gestation is complicated by a decrease in nutritional material. To save the lives of all babies, doctors advise giving birth by caesarean section. You should know that multiple pregnancies can recur. Second births are also performed surgically. After repeated intervention, the patient is not recommended to have another pregnancy.

The natural birth process is not recommended in the presence of myopathic syndrome. Severe vision loss does not occur without reason. In many cases, myopia is accompanied by problems with vascular tissue. Improper functioning of the vascular system leads to decreased functioning of the optic nerve and lens. The added pressure during pushing can cause blurred vision. For this reason, the next pregnancy will also be accompanied by surgery.

The relative reasons for surgery can be discussed with your doctor. Recommendations for reoperation arise due to the presence of uterine fibroids. Myoma is considered a conditionally pathogenic neoplasm that can easily degenerate into a malignant tumor. The presence of this disease must be monitored by a specialist. If the fibroid is actively developing, a secondary operation should be performed.

During childbirth, specialists monitor the divergence of the cervical canal and the contraction of the walls of the uterine body. Poor development of the process or its complete absence is an indication for emergency surgical intervention. This problem can occur both in the first and in the 2nd pregnancy.

Planning start dates

It is recommended to start planning the next conception after a cesarean section in the third year. During this period, the body manages to fully restore its functions. Attention should be paid to the characteristics of the postoperative scar. The scar has a dense structure, due to which improper attachment of the embryo can cause rupture of the walls. Rarely does an area of ​​thinned tissue appear after the first operation. Further gestation may be accompanied by severe stretching of the damaged tissue. The chance of uterine cavity rupture increases during the second trimester.

Some patients do not consider it necessary to adhere to these deadlines. They are not interested in when you can get pregnant after a cesarean section. Such women are subject to more thorough examination and monitoring by specialists.

The recommended period for starting planning should not be less than 24 months. This is the period after which you can start planning. If pregnancy occurs earlier, you should immediately consult a doctor. He will assess the risk of this condition and choose the right way to support the fetus.

Conducting the gestation process

Preparing for pregnancy should begin with a visit to the gynecologist. The doctor will examine the condition of the post-operative scar and check hormone levels. Only after this is it possible to begin planning. After the appearance positive tests the woman should immediately inform the specialist about this. Caring for the second pregnancy after surgery is not much different from the first. During the gestation period, the patient must visit the doctor frequently. The fetus is also examined more thoroughly. Ultrasound diagnostics in the second pregnancy it is carried out up to 6 times. Any sensations unusual for the body should cause anxiety. If you experience pain in the lumbar spine or lower abdominal area, you should consult a doctor.

Early second pregnancies should be managed more carefully. The patient is prescribed frequent tests. With any slight decrease in the positive progress of pregnancy, the woman is placed on support.

You should know the features physical activity. During the second pregnancy after surgery, a woman should limit physical activity. Refusal to carry heavy objects and long walks has a beneficial effect on the process. That is why after a cesarean section you can become pregnant three years later. The first child gains partial independence, and gestation occurs according to the rules.

Risk of a second surgery

The presence of risks causes an increase in the period of time after a cesarean section it is allowed to become pregnant. During the period of secondary pregnancy after surgery, the following risks arise:

The greatest risk is rupture of the wall of the uterine body. The uterus ruptures at the site of scar tissue. The scar does not allow this area to stretch normally. Rapid growth and development of the fetus aggravates this process. Modern doctors have learned to avoid this complication. This is done by changing the placement of the incision. Initially, the procedure was carried out using a vertical section. Such an incision increased the risk of not only uterine rupture, but also the appearance of a hernial orifice. The cavity between the diaphragmatic muscles of the peritoneum was dissected. The uterus was damaged along the entire anterior wall. On at the moment doctors reconsidered the location of the incision. Modern specialists use an incision on the top of the pubic bone. The incision does not exceed 20 cm and is made in an area with a dense convergence of tissues. This operation shortens the wound healing time and reduces the risk of developing associated complications.

A complication such as thinning of the uterine wall is also possible. This problem occurs in patients whose fetus has implanted in the area of ​​a previous pregnancy. Complications cannot be avoided. Usually in this case it is recommended to refuse further pregnancy. The woman is offered a sterilization procedure or ligation of the fallopian tubes.

In some cases, placental abruption occurs. The baby's place is formed from vascular tissue and endometrium. It is responsible for the nutritional function of the fetus and oxygen delivery. Detachment can occur due to weakness of the uterine wall. The lack of proper elasticity is revealed at a later date. This pregnancy is maintained in a hospital. The woman remains in the hospital until the surgical section is performed.

The risk of early labor increases. For this reason, the second cesarean section is not scheduled for the preliminary date of birth according to obstetric period, and at 35–36 weeks.

During this time, the child acquires all the necessary functions. Its further formation occurs in an incubator. Discharge takes place one month after the operation.

The chances of bleeding during pregnancy also increase. Early miscarriages occur due to rupture of vascular tissue. For this reason, women are interested in whether it is possible to become pregnant and carry a child to term immediately after surgery. The answer is always negative. Strengthening and restoration of the vascular system occurs only the next year after surgery. No medications can speed up the process. You should wait until your health is fully restored and only then begin planning.

Along with the development of risks, the question arises of how many procedures can be performed using surgery. Many doctors agreed that surgical childbirth can be resorted to no more than three times. After this, it is recommended to use protective equipment or sterilization.

Any planning should be accompanied by medical supervision. The doctor will assess the patient's general health and select the type of delivery that is most suitable for the patient. If the first pregnancy ended in surgery, you should ask when you can get pregnant after a cesarean section. Making a decision on your own in this case can cause various unpleasant phenomena during pregnancy. They can be fatal during natural labor.

A second pregnancy after a cesarean section is always associated with certain risks, but undergoing surgery does not mean that you will no longer have children, or that you have absolutely no chance of giving birth a second time on your own.

According to statistics, caesarean section is resorted to in 10-20% of all births, depending on the profile of the institution. In maternity hospitals focused on complex childbirth (in regional ones, for example), this percentage is always higher, because a difficult pregnancy means a greater likelihood that the woman will not be able or will not be able to give birth herself.

Depending on the reason why surgical delivery was chosen the first time, the doctor decides whether a second pregnancy is possible after a cesarean section.

Usually, recommendations regarding contraception and plans for the future are given in the maternity hospital. If you were operated on due to a serious general health condition, for example, if you have a serious heart disease, and childbirth is contraindicated in the future, sometimes even before the operation a radical method of solving the issues of preventing a new conception is proposed - sterilization. During the CS, the tubes can be ligated, then an unexpected repeat pregnancy after a cesarean section will definitely not threaten you.

If the indications were complications of this particular pregnancy and childbirth, for example, malpresentation fetus or the presence of genital herpes at the time of birth - then there are, of course, no obstacles to having a second or third child in your family in the future.

As a result of CS, a scar remains on the uterus. To remove the baby, doctors have to cut the wall of the uterus in its lower part, and then this wound heals with the formation of dense connective tissue. The scar is characterized by low extensibility and high strength, but it does not immediately become good and dense.

It is believed that the most best time for conceiving a second child this is 2 years after the intervention. Early pregnancy after cesarean section is dangerous due to the possible failure of the uterine scar. Doctors use this term to describe the inability of the scar to resist the stress of stretching the uterine wall, which can ultimately lead to its rupture during pregnancy or childbirth.

If you do not take protection and pregnancy occurs immediately after a cesarean section, most likely, you will be asked to terminate it in order to avoid this complication, although there are cases where women successfully carried a second baby even if the pregnancy occurred a month after the cesarean section. Such cases should be considered the exception, not the rule, and not expose yourself to risk.

Planning pregnancy after cesarean section

Preparing for pregnancy after a cesarean section begins with... contraception. Carefully protecting yourself is a vital necessity if you want to have a safe birth. The uterus needs peace and the opportunity to heal its wounds, and this takes time.

The incision, of course, will heal quickly, but for a long time the connective tissue here will be tender and not strong. For example, if you get pregnant in the first year after the baby is born, the risk of complications will be slightly higher than if you do it after two years.

A few statistics that will most likely reassure you in many ways:

Doctors have repeatedly and widely studied the problem of uterine rupture along a scar, and almost all studies have confirmed a risk not exceeding 0.5-1% for women who have had only one C-section, produced in the lower segment of the uterus (this is if the woman gives birth on her own for the second time). At the same time, all women were included in the studies, even if it was a twin pregnancy after cesarean with spontaneous labor or breech presentation, which in itself significantly increases the risks, or even if the pregnancy occurred six months after cesarean.

If there was a classic cesarean section with a longitudinal incision of the uterine wall, which is now used extremely rarely, then the risk increases slightly. A third pregnancy after two cesarean sections increases the risk of rupture of the uterine wall along the scar by 3 times, up to 1.8%, so if you have had 2 operations or a corporal cesarean section, be prepared that you will definitely not be allowed to give birth on your own.

Planning a pregnancy after a cesarean section requires prior consultation with a doctor, that is, without a visit to the gynecologist, you should not “make” the baby. Usually the woman is examined and an ultrasound of the uterus is prescribed to clarify the condition of the scar. If it is good, dense and durable, of sufficient thickness, the gynecologist will allow pregnancy.

Ideally, you need to plan conception 2-2.5 years after childbirth, at this time the scar is most durable, postpone pregnancy for more long term It’s also not worth it - because over time, the strength of the scar decreases and its atrophy occurs.

How is pregnancy after cesarean?

Signs of pregnancy after a caesarean section in the past are a reason to register with a gynecologist as early as possible. Ultrasound is often done during such a pregnancy, especially in later or if it is unusual, for example, you are carrying two or more babies. Multiple pregnancies after a cesarean section mean a slightly higher risk because the uterine wall stretches too quickly, making it harder for the scar to adapt to the rapidly increasing stress on it.

You should know that an early repeat pregnancy after a cesarean section, even if it is not wanted, puts doctors in a very difficult situation. The fact is that carrying a baby is dangerous, and having an abortion is also dangerous. Medical termination of pregnancy after cesarean for up to 5-6 weeks has almost no risks, as with normal pregnancy, but if the period has already exceeded the permissible period for the use of mifegin and other drugs, and instrumental termination of pregnancy is required, after cesarean this may even call into question your ability to bear children in the future, the risk of complications is very high.

A subsequent pregnancy after a cesarean means that you should never give birth at home. Rupture of the uterus along a scar is not a myth, it is a possible reality, therefore, the child should be born only in a maternity hospital, where you can get help in case of complications. Not all maternity hospitals allow independent childbirth after cesarean section if you want to give birth to a baby naturally, this point must be clarified in advance. One cesarean is always a cesarean, this has long ceased to be true, because most expectant mothers are quite capable of giving birth to a baby naturally.

Childbirth after cesarean is carried out gently, avoiding stimulation. Indications for reoperation in the absence of other direct indications for surgical delivery most often include:

1. Early, too early pregnancy, for example, a year after a cesarean section, when the scar is still weak.

2. Pregnancy after a second caesarean section

3. History of corporal CS

4. Age over 30 years

Possible complications of pregnancy and childbirth:

1. Rupture of the uterus along the scar during pregnancy (late term) and during childbirth. The onset of this complication is manifested by acute pain in the lower abdomen in the area of ​​the scar.

2. True placenta accreta. The complication is associated with the failure of the endometrium of the uterus in the area of ​​the scar; it is thinned here and cannot provide the chorionic villi with the necessary for successful attachment; they grow into the wall of the uterus. The complication is extremely rare, but dangerous, and is detected in the 3rd stage of labor, after the birth of the child.

In most cases, pregnancy and childbirth after a cesarean section proceed safely, ending with the birth of a healthy, full-term baby. Don't worry if you've had surgery in the past, it didn't make you inferior or flawed, no. You can perfectly cope with the task of bearing a child, and even more than one.

Pregnancy after a cesarean section frightens many women, because carrying a child in a uterus that has a scar from surgery is quite a risky business. How long can it take to plan a pregnancy after a cesarean section without harm to your health? What points should you pay attention to first, and then to the doctor, and is it possible? natural childbirth after this operation?

All experienced obstetrician-gynecologists, without exception, will confirm that the second pregnancy after a cesarean section should not only be planned, but also timely. You can start planning for a child no earlier than 2 years after this operation. Where did this deadline come from? The fact is that it is during this time that the woman’s body will fully recover, and what is even more important, a good, strong scar will form on the uterus, which will not lose its consistency during the period of bearing the child. Remember that if the scar fails, uterine rupture is possible, in which case it is very difficult to save the life of the child, or the life of the mother, and removal of the uterus is required.

Before planning a child, a woman undergoes a mandatory examination, the purpose of which is to determine the thickness of the scar. For these purposes, an ultrasound of the uterus with a vaginal probe, hysterography or hysteroscopy is performed. In addition to thickness, the tissue from which the scar is formed is also important. Best option- if from muscle tissue, the worst is from connective tissue. By the way, all these parameters are also important for determining the method of delivery for a subsequent pregnancy.

  • Why can't you give birth right away?
  • Planning a pregnancy
  • Course of pregnancy
  • Special cases

Each repeat (whether planned or unexpected) pregnancy after cesarean section invariably involves a certain amount of risk. However, this does not mean that after such a serious and important operation it is forbidden to give birth at all. Some babies even manage to be born on their own, without surgical intervention.

According to statistics, today a large number of women successfully carry and give birth to babies some time after a CS. However, in many respects, a successful outcome of the case depends on how healthy the young mother is and whether she listened to the opinion of doctors when planning her pregnancy and during the cherished 9 months.

Prohibitions on re-pregnancy

In certain cases, a second pregnancy after a cesarean section is strictly prohibited by doctors. These are exceptional situations when a woman’s health has significant problems that directly threaten her life. If the operation had to be performed for the following medical reasons, it is unlikely that she will be allowed to give birth in the future:


  • heart disease: arterial hypertension, defects, rheumatism - lead to intrauterine growth retardation, placental abruption, premature birth;
  • illnesses genitourinary system: chronic pyelonephritis, stones in the bladder, cystitis - threaten premature birth, intrauterine infection of the baby, gestosis;
  • problems with the respiratory system: asthma, chronic bronchitis - provoke oxygen starvation fetus, developmental delay, intrauterine infection;
  • diabetes mellitus is fraught with various developmental defects in the fetus;
  • Thyroid diseases threaten miscarriages, decreased intelligence of the baby, and fetal developmental defects.

If the section was performed for one of these medical indications, doctors give the young mother recommendations regarding plans for the future. They explain that with such diseases, childbirth is contraindicated. In some cases, right there in the maternity hospital, even before surgery, they may offer a radical method of preventing a new pregnancy - sterilization. If consent is given by the couple, the tubes are tied during the CS to prevent unexpected unwanted pregnancy, fraught with complications and consequences, did not occur.

Statistics. Caesarean section is no longer a rare, frightening operation. They resort to it in 20% of cases.

Why can't you give birth right away?

If the reasons for surgical intervention in the natural process of childbirth are related to complications of this particular pregnancy (malpresentation of the fetus, herpes, etc.), the woman is not prohibited from having more children in the future. However, after the operation, the doctor warns the young mother about mandatory contraception in the next few years. This is due to the fact that imminent pregnancy immediately after a cesarean section will entail irreversible consequences. Complications can even be unpredictable.

  1. After a cesarean section, there is a scar on the uterus, the complete healing of which requires exactly this period of time: at least 1.5 years, and even better - 2 years or more. If conception occurs earlier (for example, already 3 months after the operation), the scar will not be able to resist the load that has fallen on it. Pregnancy will stretch the walls of the uterus, which will lead to its rupture.
  2. After surgery, the body experiences stress, so it requires a rehabilitation period. If it gets complicated new pregnancy, you may simply not have enough strength to bear a child. In this case, everything will end in a miscarriage.
  3. May begin serious problems with a placenta that turns out to be completely unprepared. Often in such cases, its detachment is diagnosed, which entails the death of the fetus.

This is why pregnancy after a cesarean section is dangerous if it is not planned in advance. If you do not take into account the recommendations of doctors and do not use protection immediately after childbirth, you will have to terminate the pregnancy to avoid serious complications. Of course, there are known cases of successfully carrying a second baby if he was conceived immediately after surgical birth (after 4-5 months, or even earlier). But you need to understand that these are exceptions, not rules, and you need to keep in mind all the consequences to which you expose yourself and your unborn baby.

FYI. If after a cesarean section a woman follows the recommended time frame, the risk of scar rupture is only 0.5%.

Planning a pregnancy

It is possible to avoid all these complications through careful and reasonable planning of pregnancy in the 2 years that will pass after a cesarean section. If there are no medical contraindications for childbirth, after such a period of time, if you want to become a happy mother again, you need to seek advice from doctors, but even before conceiving a child. Preparation will include several necessary activities at once.

  1. If you want to safely give birth to a baby, you will have to carefully protect yourself over the next two years.
  2. After this trial period, you need to visit a gynecologist. He will examine the condition of the scar and connective tissue on the uterus, make sure that it has healed and is ready for new challenges, and only then will he allow you to conceive again.
  3. Since you will know why you had a cesarean section the first time, you need to try to exclude this reason, that is, take preventive measures, and if necessary, treat all your sores before conceiving again.

Competent, mandatory planning of pregnancy after a cesarean section will prevent risks and complications and allow you to experience the happiness of motherhood once again. Any initiative in this matter or failure to comply with the recommended deadlines can lead to dire consequences.

Course of pregnancy

If you feel that you have conceived a baby and suddenly become pregnant a month after a cesarean section, try not to hesitate to visit the appropriate doctor. In this case, immediate medical interruption will be required to avoid complications, if time permits (5-6 weeks). Otherwise, instrumental abortion must be resorted to, which jeopardizes the woman's ability to have children in the future. If more than a year has passed since the operation, the significant 9 months will only differ slightly from the normal course of pregnancy. Here you will have to adhere to the following rules:

  1. Register with a gynecologist as soon as possible.
  2. During pregnancy after cesarean section, excessive, unbearable physical (or any other) stress is contraindicated, even despite a healed and seemingly durable scar.
  3. You will have to visit the gynecologist more often and follow all his instructions.
  4. As for the general condition of the woman, the sensations during such a pregnancy are no different from usual ones, if everything is in order. If the scar fails (if conception occurred after 6-7 months, or even earlier), if the child was left at his own peril and risk, nagging, sometimes even unbearable pain in the back and lower abdomen is possible.
  5. Ultrasound is performed much more often.
  6. In this case, home birth is strictly contraindicated.

The later conception occurs after such an operation, the more successful and prosperous both the carrying of the baby and the delivery itself will be. You need to understand that it is better in this case to get pregnant after 5 years (if age allows), so that the scar will finally heal and the uterus will be able to withstand all the stress that it will have to experience.

Special cases

Life can be so unpredictable that even the most prudent and calculating cannot foresee everything. Especially if it concerns the female body. Special cases of pregnancy after a CS are often diagnosed, which require a professional medical approach and the vigilant attention of the woman herself.

  • Two CS in a row

If pregnancy occurs after a second cesarean section, prepare for surgery again. There are only a few people who give birth naturally in such cases, and complications are almost never avoided. The connective tissue at the scar site loses its elasticity, which does not allow the uterus to withstand the load during delivery. In this case, the operation may be performed earlier.

  • Three CS in a row

If you are pregnant after 3 caesarean sections, don’t even count on a natural birth. In addition, in recent weeks, given the repeated recurrence of scars, the doctor will suggest you to lie down for preservation. There is too great a risk that the uterus will not be able to withstand such a burden for the fourth time and may rupture as the baby’s weight increases. By observing the condition of the fetus, mother and scar, the gynecologist may decide to perform the operation a little earlier. The modern level of medicine allows us to reduce risks to a minimum.

  • Multiple pregnancy

There are often cases when a twin pregnancy is diagnosed after a cesarean section, and in this difficult case, the young mother will also not be allowed to give birth on her own, since the uterus will not bear such a burden. Moreover, if there are three (four, five, etc.) fetuses in the womb. Throughout your pregnancy you will have to be under the constant supervision of doctors, have constant ultrasounds, and in the last stages you will have to go to the hospital.

Caesarean section is a serious abdominal operation that disrupts the course of natural childbirth, so it cannot but have consequences. If the pregnancy then occurs too early or is complicated by some processes, repeated surgery cannot be avoided. At least in most cases it saves lives. Although, with normal pregnancy, a woman can give birth herself, that is, naturally.

Legend or fact? There is an opinion that after a CS, repeat pregnancies often turn out to be multiple. However, there is no exact statistical data about this, and a scientifically similar fact is not confirmed or explained in any way.

Childbirth: natural or surgery again?

The debate continues about whether the next pregnancy after a cesarean section will necessarily end surgically. Or is a normal, natural birth possible? Everything will depend on the health status of the young mother, the course of pregnancy and how much time (months, years) has passed since surgery.

Natural childbirth is allowed:

  • when at least (even more) 2 years have passed since the cesarean section;
  • in the absence of serious illnesses in the mother;
  • if the pregnancy progressed without complications or pathologies;
  • short-term pregnancy after the second cesarean section, when there was no time to prepare the woman in labor for the operation;
  • with correct presentation of the fetus;
  • if pregnancy occurs a year after a cesarean section, but the condition of the scar is beyond doubt among doctors (everyone has a different rate of healing), the woman may be allowed to give birth on her own, but this only happens in 30% of cases; so if you find the first signs that you are having a baby already 8-9 months after the operation, you will most likely be offered a termination.

Surgery is again inevitable if:

  • an early pregnancy has occurred after a cesarean section (approximately 1-11 months), in which the scar has not yet healed - in this case, you will have an abortion (medical or instrumental) or, if you want to leave the baby at all costs, a repeat Caesarean section, if you bring it to term;
  • the mother has chronic, serious, untreated diseases that are medical indications for surgery;
  • pregnancy pathologies (improper presentation of the fetus, placenta, etc.);
  • age after 30 years;
  • the third pregnancy after two cesarean sections will definitely end exclusively with surgery, since in this case the risk of rupture of the uterine walls is maximum;
  • pathologically long healing of the scar under the influence of certain factors (sexually transmitted infections, unhealthy lifestyle, physical activity);
  • if during a previous CS a longitudinal incision was made in the uterine wall;
  • Several babies are expected at once.

If there is concern for the life of the mother or child, the opinions of doctors are almost always clear: a planned operation is performed. If no complications are expected, there are no pathologies, gynecologists, obstetricians, neonatologists only welcome the natural outcome of events and will provide all the necessary assistance.

Today, a second pregnancy after a cesarean section does not surprise anyone if it was planned according to the recommendations of doctors. Only in this case can any complications be guaranteed to be avoided. In other situations, a woman must understand all the responsibility that she takes upon herself, unable to withstand the time interval of several years after the CS. There are chances for a successful outcome in this situation, but they are minimal. A happy delivery occurs very rarely and is the exception, not the rule.

In recent decades, there has been a tendency to expand the indications for surgical delivery.

Moreover, more than half of women who have undergone surgery to remove myomatous nodes plan to become pregnant in the future.

In this regard, questions about the management of pregnant women in this risk group are becoming increasingly relevant.

How is a caesarean section performed?

In order to understand the features and risks of managing pregnant women after a cesarean section, it is necessary to understand the course of the operation.

  • The first step is dissection of the anterior abdominal wall.

Layer by layer: skin, subcutaneous tissue, aponeurosis, muscle separation, parietal peritoneum. And only after all these layers is access to the abdominal cavity.

  • The most important step is making an incision on the uterus.

It is usually performed as follows: the wall of the uterus in the lower segment is incised with a scalpel, after which the surgeon index fingers continues the cut.

This access is justified by the fact that the risk of damage to the vascular bundles located along the uterine rib is minimal. With a corporal incision, the uterus is dissected longitudinally.

  • Then the fetus is carefully removed from the uterine cavity.

After this, the placenta is manually separated. Remaining placental tissue is removed using a curette.

  • Before suturing the uterine wall, you need to make sure that the outflow of bloody discharge will be complete - for this you need to check the opening of the cervical canal.
  • Suturing the uterus.

Correct technical execution of this stage of the operation largely influences the further prognosis. At the moment, the preferred suture material is vicryl. It is quite durable due to the fact that it consists of several woven threads, and is also an absorbable material. The time for its complete resorption ranges from 60-90 days, which is enough for the uterine walls to grow together.

  • After an audit of organs abdominal cavity All layers are sutured sequentially in the reverse order.

When do stitches fuse after a caesarean section?

The healing time of external and internal sutures does not coincide. On the skin, the seam heals much faster, which is due to the contact of the skin tissue with the air. The suture on the uterus takes the longest to heal. The type of incision in the uterus is important.

Features of scar formation in the lower segment

  • It has been proven that with access to the lower segment, the regeneration process occurs much faster.

This is due to the fact that the incision runs parallel to the muscle fibers, which means that most of the smooth muscle cells retain their integrity, and therefore functionality.

  • In addition, due to the good blood supply to this area, the healing process is faster and better.
  • Another argument in favor of access in the lower segment is the peculiarity of uterine contraction in the postpartum period.
  • The processes of involution (reverse reduction in size) of the uterus occur in such a way that the area of ​​the lower segment is almost completely reduced, which means that the area of ​​the scar is noticeably reduced.
  • In general, regeneration processes occur in the suture area within 3 months.

“Scar phenomenon” after corporal caesarean section

Completely different processes occur with longitudinal access. This area has a much worse blood supply. In addition, with this incision, a large number of muscle cells are dissected, which leads to a noticeable decrease in the contractility of the uterus.

Moreover, it has been proven that over a long period of time after surgery, almost complete replacement of the suture site with scar tissue gradually occurs. This means that when a longitudinal section is made along the suture, there are practically no muscle cells left, and almost complete atrophy occurs.

This is the “uterine scar phenomenon” after corporal access. After a long period of time it does not become stronger. The principle “the longer the better” does not work here.

But this does not mean that with this access it is necessary to plan pregnancies earlier than two years after the operation. Getting pregnant too early is also dangerous due to the risk of uterine rupture due to an incomplete scar.

Thus, the process of uterine regeneration after a corporal incision proceeds much more slowly, worse, often with the formation of an inferior scar, and many years after the operation, the suture site is almost completely represented by connective tissue.

A second pregnancy after cesarean is possible after 2-6 years. Many women neglect this rule and try to get pregnant a year after a cesarean section. Although for some this does not happen as planned. Early pregnancy after cesarean has its own risks, since the uterus is not yet ready to bear the fetus again.

How quickly does reproductive function recover after surgery?

It is no secret that a cesarean section is an alternative method of delivery that was not at all intended by nature.

This bypass of the physiological processes that occurs with a woman during childbirth was not at all foreseen. It is for this reason that the so-called “scissors” arise.

Restoration of the reproductive function of the body occurs much earlier than can be achieved in practice.

For example, in the absence of breastfeeding, the first menstruation (and therefore the restoration of the menstrual cycle with possible ovulation) can occur as early as 2 months after the operation.

However, the suture on the uterus by this time is completely “not ready” for the processes of stretching the myometrium during pregnancy. Of course, it is not possible to get pregnant immediately after a cesarean section, since the body’s reproductive function needs time to recover, but the ovaries can still begin to ovulate 40-50 days after the operation.

The connection between ovulation and lactation

If a woman breastfeeds her baby, the likelihood of pregnancy is much lower. Since the process of lactation leads to suppression of ovulation.

When continuing breastfeeding, you must adhere to the following rules: feeding should be every 3-4 hours, at regular intervals.

In such a situation, the likelihood of ovulation occurring is reduced. But only hope for breast-feeding it is forbidden. In women after surgery, early onset of gestation is very dangerous, so it is recommended to use contraceptive methods.

How long before you can get pregnant after a cesarean section?

The most optimal period for pregnancy is considered to be 2 years after surgery.

This period of time was chosen for many reasons: within 2 years, the final formation of a scar on the uterus occurs, and the woman’s body has time to recover.

This period is determined with some “margin” to minimize the risk of complications.

However, this does not mean that any pregnancy occurring before this period must be terminated. The main factor determining the outcome of pregnancy is the assessment of the consistency of the scar. In other words, in case of an unplanned pregnancy, it is necessary to use individual approach. So how long after cesarean can you get pregnant?

In general, if pregnancy occurs a year after surgery in the lower uterine segment (with a satisfactory condition of the scar), then such a woman has a high chance of safely bearing the baby.

The situation is different with a corporal cesarean section. Usually one year is not enough to form a lasting scar. Therefore, in this situation, the decision to continue pregnancy is made on the basis of methods for assessing the postoperative suture.

Steps “on thin ice” or what to do if pregnancy occurs within the first year after surgery?

Despite the fact that doctors advise not to plan a pregnancy in the first 2 years after surgery, it happens that an unplanned pregnancy occurs. The most important thing is not to panic! You should weigh all the risks and undergo a full examination.

What to do if a woman becomes pregnant 6 months after the operation?

If pregnancy occurs six months after a cesarean section, this situation must be taken extremely seriously. This pregnancy must be carried out under careful monitoring of the condition of the suture on the uterus. It is important to remember that the woman must be hospitalized in advance at 35 weeks.

Pregnancy occurred 3-4 months after surgery

In such a situation, the woman is offered termination of pregnancy, since its continuation is extremely undesirable. There is a very high probability of uterine rupture and placental tissue ingrowth into the postoperative suture site. These complications pose a serious threat to the mother's life.

What to do if pregnancy occurs 2 months after cesarean section

Pregnancy after 2 months is strictly subject to termination, as the risk of complications is extremely high. 2 months is not enough time for the formation of a scar on the uterus.

Such a strict approach to the possibility of maintaining pregnancy after surgery is due to the danger for the mother, and in some situations, the emergence of a real threat to her life. Uterine rupture is the most urgent (emergency) situation in obstetrics. The volume of blood loss in a matter of seconds reaches the entire circulating blood volume in a woman’s body!

Is it worth saying after this that the doctor’s strictness during pregnancy that occurs in an impermissible early dates after the operation, is it due to caring for the woman?

In such a situation, the method of abortion deserves special attention.

No abortion method is safe. Any technique has its drawbacks.

  • The most dangerous is the classic surgical method, as there is a high probability of perforation of the uterus with a curette (especially in the presence of endometritis).
  • Medical abortion also carries risks, since a scarred uterus has a reduced ability to contract, which means that ovum is not always eliminated (removed). In addition, drugs used in medical abortion can also cause sutures to dehisce.
  • Vacuum aspiration is the “lesser evil,” but this method is also not safe.

Considering all the risks of early pregnancy after surgery, as well as the dangers of its termination, the use of contraception is considered necessary in this category of women.

It is preferable to use either barrier methods (condoms) or hormonal drugs approved during lactation (Charozetta, Lactinet, Excluton).

Compliance with the optimal time interval after surgery until the desired pregnancy, as well as the use of methods for assessing the scar on the uterus, significantly reduces the risk possible complications. A favorable course of pregnancy and careful delivery help preserve a woman’s reproductive potential.

Childbirth is a natural process. However, there are situations when delivery is carried out by caesarean section. What to do if a baby is born in an unconventional way, and mom would like to get pregnant again? Is pregnancy possible?

2nd pregnancy after cesarean – planning

If a child was born through surgery, then the next pregnancy after a cesarean section is possible no earlier than 2 years later. This is due to the fact that the scar on the uterus needs to fully form. If a repeat pregnancy occurs a year after a cesarean section (or even earlier), when the muscle tissue has not yet had time to heal, then the woman may be at risk of uterine rupture along the scar - a situation that is extremely dangerous for the life of the expectant mother and child.

Planning a pregnancy after cesarean section must begin with an examination of the uterine scar, no earlier than 6-12 months after the operation. The doctor will evaluate the condition of the scar using hysterography (x-rays in two projections) and hysteroscopy (examination using an endoscope inserted into the uterine cavity). Permission for a 2nd pregnancy after cesarean can be obtained only if the scar is almost invisible and is formed from muscle tissue. The situation is slightly worse when the scar tissue consists of mixed fibers. If connective tissue predominates, the scar is considered incompetent, which means that repeated pregnancy is contraindicated for the woman.

Natural birth after cesarean – everything is possible

As a rule, the pregnancy of a woman who has undergone a cesarean section is no different from a normal one. True, at each appointment the gynecologist will examine the scar on the uterus. Expectant mother She can even give birth naturally. However, this should be decided by the supervising doctor, as well as the obstetrician-gynecologist of the maternity hospital, if the following conditions are met:

If pregnancy occurs less than a year after a cesarean section, you will not be allowed to give birth on your own. Pregnancy after a second cesarean section will most likely also end in surgery. As a rule, doctors allow no more than three surgical deliveries, since each surgical intervention is more difficult to tolerate than the previous one.