How long should you wait to get pregnant after having a C-section?

If you've recently had a C-section and want to have another baby, you might be wondering when you can start trying again.

Every situation is different and varies based on factors such as age, fertility, birth complications and more. However, there are some general guidelines when it comes to conceiving post-C-section. 

When is it safe to start trying again post-Cesarean?

As a general rule, hold off on trying to conceive again for 18 to 23 months – about the same waiting period recommended for women who deliver vaginally. However, it's important to note that this isn't a hard and fast rule, as it depends on your individual situation, your age, and the circumstances of your previous pregnancies (such as whether they were high-risk or not), and also whether you plan to delivery vaginally in the future.

In addition, you also have to consider how your last C-section went: Did you have any surgical complications with your most recent delivery? Or any other issues giving birth? If that's the case, your doctor may have you wait longer until your body completely heals. You've just had major surgery in addition to giving birth, and you need to let your body recover and replenish lost nutrients as well.

For instance, you may be anemic because of the iron transferred to your baby and placenta during pregnancy, or because of the blood loss you experienced during childbirth. Women who deliver via C-section lose twice as much blood – about two pints on average – as women who deliver vaginally. So, waiting a bit longer before conceiving again might be necessary to optimize your health and that of a future baby's.

What are the risks of getting pregnant soon after a C-section?

There are several risks when it comes to getting pregnant too soon after a C-section. Studies have shown that women who conceive less than six months after giving birth may have a higher risk for complications, such as:

• Ruptured uterus: A uterine rupture is a tear in the wall of the uterus, most often at the site of a previous C-section incision. In a complete rupture, the tear goes through all layers of the uterine wall, which can be dangerous for you and your baby.
  
  Studies have shown that the rate of uterine ruptures decreases the longer one waits to conceive after their previous C-sections, with it being 5 percent in those who had less than 18 months between deliveries, almost 2 percent in those who waited 18 to 23 months, and just over 1 percent for those who waited 24 months or longer.
• Placenta accreta: Placenta accreta is a very high-risk pregnancy complication that occurs when the placenta becomes abnormally embedded in the uterine wall. It can lead to hemorrhaging and even death of the mother and baby.
• Preterm birth: A preterm birth is when the baby is born early (before 37 weeks), which could lead to longterm complications for your baby. Studies show that less time between pregnancies (specifically less than 18 months) can increase the risk of preterm delivery
• Low birth weight for the new baby: Even if your next baby is delivered at term, studies show a slight increase risk in low birth weight if you get pregnant less than 18 months after your previous pregnancy. Experts say this is likely due to the excessive stress and strain on a mother's nutrient levels, however other theories exist.

Are there reasons to get pregnant again soon after a Cesarean?

If you want to conceive again less than 18 months after your previous Cesarean, definitely talk to your provider to see if there are any risks involved in your particular situation. Many times, women want to try to get pregnant again because they're worried about their fertility and the chances of getting pregnant if they wait too long. In fact, if you're in your late 30s, it might make more sense to begin trying to conceive 9 to 12 months after having a C-section.

It's not uncommon for women over 35 to have trouble getting pregnant, and the risk of having difficulty conceiving increases with age. If this is the case for you and you want to try to conceive early, check in with your doctor. If you didn't have any complications in your last birth you may get the go ahead to start trying earlier.

What happens if you get pregnant soon after a C-section?

Even if you plan to wait to conceive after getting a C-section, it's possible that you may accidentally get pregnant soon after.

But don't worry: Risks vary depending on a number of factors, such as age, complications with your previous delivery, and how well you've healed. Talk to your provider about your own unique situation. They can help you determine whether there are any precautions you need to take.

Will you have to have another C-section or can you try for a VBAC?

VBACs (vaginal births after Cesarean) are safe for most women to attempt.  It isn't recommended in every case, but it's likely that even if you've had two C-sections in the past, you may still be able to deliver your next baby vaginally. 

In order to determine whether that's a viable option for you, talk to your doctor. They'll review your specific risks based on how your previous birth and delivery went. They may also use an online calculator to discuss your likelihood of a successful VBAC.

You'll want to talk with your ob-gyn or midwife prior to delivery, as certain hospitals or birth centers have specific safety protocols in place for women who are having a vaginal trial of labor (VTOL) (which essentially just means you're trying to have a VBAC). And some midwives and ob-gyns aren't able to perform VBACs, so you'll need to talk with your provider about the best place to deliver in your area.

Why talking to your doctor before trying to conceive is important

Talking to your provider before trying to conceive again is so important because every individual is different, and what works for a family or friend may not work for you. Ask your doctor how long they recommend you wait until trying to conceive again, based on your previous pregnancy, age, and overall health, especially if you don't feel like you can wait the recommended length of time before getting pregnant again.

Also, in case you become pregnant earlier than recommended, having a plan in place with your doctor can be helpful. They can walk you through any additional precautions you'll need to take during pregnancy, such as scheduling extra ultrasounds to check the health of your uterus or placenta, and also whether you're eligible for a VBAC.