 Next Pregnancy: How long should I wait
After a caesarean section before getting pregnant again?
The traditional advice was that women should have no more than three caesarean sections and that they should wait a year after one section before becoming pregnant again. Many obstetricians still stick to this advice, and there is a body of evidence that supports waiting at least six months before trying to conceive again.
In the vast majority of caesarean sections, the incision into the uterus is made horizontally into the lower segment of the uterus. Such an incision usually heals well in an otherwise healthy woman and is thought to be fully healed by three months after delivery.
In fact, the results of several studies suggest that the caesarean scar on the uterus continues to grow stronger and may cause fewer problems over time. This may be of particular interest if you want to try for a vaginal delivery next time, otherwise known as a latest VBAC. There is a very low risk of uterine rupture with VBAC and there is some evidence that the risks of the scar rupturing decrease as the gap between pregnancies increases (Esposito et al 2000; Rochelson et al 2005; Shipp et al 2001).
In one study of 170 women, the risk of scar rupture was significantly higher when the gap between pregnancies was less than six months (Esposito et al 2000). In another more powerful, study of 2,409 women who opted for a VBAC, the women who had conceived within 18 months of their previous section were three times more likely to have a scar rupture than women with a longer gap between pregnancies (Shipp et al 2001). In a third study an increased risk of scar rupture was seen for women who had had a premature delivery by caesarean section, particularly if they hadn't laboured at all before the section and if the gap between the deliveries was less than two years (Rochelson et al 2005).
Although these findings may sound alarming, the risks of scar rupture are very small, which means that most women who have a smaller gap between pregnancies have no problems at all during VBAC.
It is possible that problems with the placenta may also be increased with a smaller gap between pregnancies. Conceiving a second pregnancy within a year of a caesarean has been linked with an increased risk of placenta praevia and placental abruption (when the placenta prematurely separates from the wall of the uterus) (Getahun et al 2006). These findings came from a very large-scale US study of 187,577 women so, again, the increased risks are tiny.
There are other advantages to having a larger age gap between babies, whether you've had a caesarean or not. Read our article on different age gaps between siblings to find out more.
Caesarean section now accounts for around a fifth to a quarter of all deliveries in most maternity units in the UK. However, many women underestimate the amount of time it takes to recover and the effect it will have on them. A caesarean is fairly major surgery and women often feel exhausted afterwards. It can take several weeks to get back to a normal level of activity.
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