Things to note if you get pregnant again one year after a caesarean section

Many women are always worried about whether to give birth naturally or by caesarean section during pregnancy. Medically speaking, natural birth is recommended first, and caesarean section will only be performed when it is absolutely necessary or conditions do not permit. Doctors generally recommend that women who have undergone caesarean section wait three years before having another baby, in order to allow the wound to heal better. So, what should you pay attention to if you get pregnant again one year after having a caesarean section?

1. How long does it take to get pregnant after a caesarean section?

The incision on the uterine wall after a cesarean section does not heal well in the short term. If you become pregnant too early, the development of the fetus will cause the uterus to continue to grow and the uterine wall to become thinner. In particular, the connective tissue at the surgical incision lacks elasticity. Fresh scars can easily rupture in the late pregnancy or during delivery, causing massive abdominal bleeding and even life-threatening.

Therefore, it is best to get pregnant again two years after the surgery to give the uterus a longer period of time to heal, which will be safer. Of course, everyone’s recovery is different, so the specific time can be a little flexible.

2. What should I pay attention to when getting pregnant again after a caesarean section?

The uterus that has undergone a cesarean section is a scarred uterus, and is more likely to have placenta previa, and most of them are invasive placenta previa, which makes it easy for both the mother and the child to have problems during pregnancy and delivery.

① Mothers who have had caesarean sections should go to the hospital for an ultrasound examination in time if they find that they have stopped menstruating or have tested pregnant themselves to determine whether there is a possibility of scar pregnancy (the gestational sac is implanted in the original scar of the uterus). If the fertilized egg accidentally settles down there, it would be like living in a "dangerous building". The small room would not be able to accommodate the growing fetus, and the risk of rupture and bleeding would be too great, so the child could not be kept at all. The uterine seromuscular layer of some uterine diverticula may be only a few millimeters thin. Even if the fertilized egg does not settle in this "dangerous house", as the fetus grows, the diverticula may rupture before the delivery date. In this case, not only the baby's life will be in danger, but the mother may also suffer life-threatening uterine bleeding. Therefore, if you have had a cesarean section, you must check whether there are any "dangerous rooms" in your uterus before preparing for pregnancy again, and ask your doctor to assess whether they need to be "removed" to avoid future problems.

②Fetal movement is the irregular movement of the fetus in the uterus. The speed of fetal movement is one of the early manifestations of the fetus's safety in the uterus. After a caesarean section, if the scarred uterus has a slight rupture or placental abnormalities, it will lead to fetal death. At this time, the fetal heart sounds disappear. 24-48 hours before fetal death, fetal movement slows down or disappears. Therefore, paying attention to changes in fetal movements can help detect fetal abnormalities in advance so that timely measures can be taken.

③In the late stages of pregnancy, prevent the abdomen from being squeezed. To prevent the scar from cracking, it must be protected and not squeezed. In daily life during the late stages of pregnancy, you should avoid crowded places when riding in a car or walking, do housework appropriately, sleep on your back or side, and have a moderate sexual life to avoid pressure on your abdomen.

④ Seek medical attention as soon as abdominal pain occurs. The scarred uterus may rupture spontaneously in the late stages of pregnancy, with abdominal pain being the main symptom. Due to poor healing of uterine scars, intrauterine pressure increases with the progression of pregnancy. Even without any inducement, the uterus may swell and rupture from its scars. When the uterus ruptures, abdominal pain of varying severity may occur. Sometimes the abdominal pain is mild but the uterus has already ruptured, so you must be vigilant.

⑤ It is advisable to be hospitalized in advance to prepare for delivery. The closer the scarred uterus is to delivery, the greater the risk of rupture. To prevent uterine rupture or fetal death, you should be hospitalized two weeks in advance to prepare for delivery so that problems can be discovered and dealt with in a timely manner.

3. Can I have a natural birth again after a caesarean section?

If the interval is more than 3 years, and the baby is healthy during regular prenatal checkups, you can do more exercise in the later stages, such as climbing stairs more often, and you can basically have a natural birth.

However, you should listen to the doctor's advice and choose the most appropriate delivery method based on your own physical condition and the development of the fetus. If the doctor thinks that the second child can be born naturally, then accept the doctor's arrangement. However, if the doctor makes a comprehensive judgment that the situation is not suitable for a natural birth, then do not force it.

4. In what cases is a caesarean section still necessary?

① The indications for the first cesarean section still exist, such as pelvic stenosis, cephalopelvic disproportion, malposition of the fetus, malformation or stenosis of the soft birth canal, and internal and external surgical complications, such as heart disease.

② If there are serious obstetric complications during the second pregnancy, such as severe preeclampsia, placenta previa, placental abruption, etc., vaginal delivery is not suitable.

③ There are problems with the fetus during the second pregnancy, such as intrauterine hypoxia, multiple pregnancy, intrauterine infection, or excessive fetus.

④ The uterine incision of the first caesarean section heals poorly, such as uneven thickness of the uterine incision, too thin in the incision scar, hard cracks or ruptures of the uterine incision, or the first surgical incision was a longitudinal uterine incision, or the uterine incision had severe lacerations and required repair surgery.

⑤ During the vaginal delivery trial of the second pregnancy, if the labor does not progress smoothly, or fetal hypoxia occurs, or there is suspected (or already) hard rupture of the uterine incision, an emergency cesarean section is required.