How long after cesarean section can I have a second child?

Many women do not know much about fertility, such as how long after a cesarean section they can have a second child, which is directly related to the health of the mother. Gynecologists say that if the first child is born naturally, it doesn’t matter when the second child is born. However, if the first child is born by caesarean section, you will need to wait two or three years for the incision to heal before you can have the second child. I hope that through my introduction, everyone can have some understanding.

It is understood that 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 can easily cause problems for both the mother and the child during pregnancy and delivery.

Cesarean scar pregnancy threatens maternal life

It is best to have a second child two years after having a cesarean section for the first child

A normal placenta is attached to the posterior, anterior, or lateral wall of the uterine body. For pregnant women who give birth naturally (vaginal delivery), there will be no scar on the uterus. For pregnant women who have undergone cesarean section, the scar formed by the operation is like a pit. If they become pregnant again, the placenta will easily attach to the scar, and the lower edge of the placenta may even cover the internal os of the cervix. Even if the placenta survives, the blood supply to the cervix is ​​not as good as that to the fundus, so the placenta can easily implant itself in other places or even continue to grow outward to absorb nutrients. Once bleeding occurs, it will be very difficult to stop the bleeding, and in severe cases the uterus may have to be removed.

It is understood that the proportion of mothers who had a cesarean section for their first child and a second child with a scar pregnancy reached 15.2%. Some doctors suggest that women who have a cesarean section for their first child should give birth 2 to 3 years later to allow the uterine incision time to heal gradually. If you are in a hurry to have a second child and get pregnant too early, the development of the fetus will cause the uterus to continue to grow and the uterine wall to thin, especially at the surgical incision. The elasticity of the connective tissue has not yet been restored, and the fresh scar can easily rupture in the late pregnancy or during delivery, which can easily lead to the scar pregnancy mentioned above, resulting in placenta implantation and uterine rupture.

B-ultrasound to check the healing status of uterine scar

When a mother who had a cesarean section for her first child has a second child, she can use B-ultrasound to observe the thickness of the lower segment of the anterior uterine wall and the echo status of the uterine scar to diagnose the healing of the uterine scar. This is a safe and reliable method to predict the risk of uterine rupture before delivery.

Generally speaking, the results of B-ultrasound examination can be divided into two types: good healing of uterine scar and poor healing of uterine scar.

① The uterine scar healed well and is also a grade I scar. The thickness of the lower segment of the anterior uterine wall is ≥3mm, and the echoes of each layer of the lower segment of the uterus are continuous and uniform.

②Poor healing of uterine scars is divided into two levels, grade II scars and grade III scars. In grade II scars, the thickness of the lower segment of the anterior uterine wall is less than 3mm, and its echogenicity loses continuity. Tracking scans reveal local loss of myometrium, and there is no bulging of the amniotic sac when pressure is applied. In grade III scars, the thickness of the lower segment of the anterior uterine wall is less than 3mm, and local amniotic sac or fetal bulges may be seen, or strong light spots or patches of vernix caseosa may be seen in the amniotic fluid between the anterior uterine wall.

If it is the first type and the pregnancy is in good condition, you can consider continuing the pregnancy. At the same time, you should pay attention to more prenatal checkups, pay attention to the condition of the uterus and fetus, and go to the hospital in time if there is bleeding, abdominal pain, etc. If it is the second type, the chance of scar pregnancy is very high, and the risk of dangerous conditions such as heavy bleeding during delivery is also increased. The doctor may recommend termination of pregnancy.

Now everyone should have a deep understanding of how long you should wait after a cesarean section before having a second child. I hope that women who want to have a second child can follow the above principles, which are entirely for the sake of everyone's health. I hope women will have a comprehensive physical examination before preparing to have a second child, and must obtain the doctor's consent before having another child. This will benefit both the child and the mother herself.