After you struggle through labor and recovery after a cesarean section, the next question arises: when can you get pregnant again and do you have to go back to delivery by caesarean section? This article explains things you need to know about pregnancy after cesarean delivery.
When is the best time to get pregnant again after a C-section? In general, both women who gave birth vaginally and by caesarean section are recommended to wait at least 18 months and no more than 5 years after giving birth to avoid the risk of problems in future pregnancies.
Mothers can use various types of contraception to delay pregnancy, such as birth control pills, birth control injections, birth control implants, and spiral contraception or IUDs.intrauterine device).
Things to Do during Delaying Pregnancy
During postponing pregnancy, you certainly need to prepare your body for the next pregnancy by living a healthy lifestyle. Examples of things you can do are:
1. Maintain ideal body weight
After giving birth, mothers are recommended to reduce weight to reach the ideal body mass index (BMI) within 6-12 months after giving birth. The trick is to adopt a healthy diet and exercise regularly.
2. Adequate intake of folic acid
Mothers are also advised to take 400 micrograms of folic acid every day, at least 1 month before planning to get pregnant again. Consumption of folic acid is continued throughout pregnancy. Folic acid has the benefit of preventing birth defects in the baby's brain, nerves, and spine.
3. Stop smoking and consuming alcohol
Mothers who have a habit of smoking or using tools that contain nicotine, such as nicotine patch or vape, it is necessary to immediately stop the habit to reduce the risk of problems in future pregnancies. In addition to smoking, the habit of consuming alcohol also needs to be stopped.
If you find it difficult to quit smoking or consuming alcoholic beverages, try to consult a doctor.
4. Routine mcheck health condition
If you have a chronic disease, you are strongly advised to have regular health checks, adhere to medication, and maintain a healthy lifestyle while delaying pregnancy. Chronic diseases that need to be checked include:
- Sexually transmitted diseases, such as hepatitis B and HIV.
- Autoimmune diseases, such as lupus and rheumatoid arthritis.
- Hypertension and heart disease.
- Diabetes mellitus.
- Thyroid disorders.
- Epilepsy.
- Kidney illness.
- Antiphospholipid syndrome.
- Psychological disorders, such as postpartum depression.
If you have experienced problems during your previous pregnancy, such as gestational diabetes (diabetes that occurs during pregnancy) and preeclampsia, or if you experience complications after a cesarean section, you should have regular check-ups with your obstetrician.
Choice of Delivery Method for Future Pregnancy
Pregnant women who have given birth by caesarean section are generally advised to give birth by the same method in subsequent pregnancies. In addition, there are several conditions that require pregnant women to give birth by caesarean section, including:
- The pelvis is narrow or the fetus is too large to pass through the pelvis.
- Infection of the placenta and fetuschorioamnionitis).
- Eclampsia and HELLP syndrome.
- Fetal distress conditions that can cause a lack of oxygen to the fetus.
- The umbilical cord is bulging, ie the baby's umbilical cord is between the fetal head and the vagina so that it can cause the fetus to lack oxygen.
- The previous caesarean section wound was a classic caesarean section (vertical incision).
- Placenta previa or placenta covers the baby's birth canal, so the baby can't be delivered normally.
- The baby's position is breech or transverse.
- The uterus is torn.
In addition, pregnant women who previously underwent caesarean section are at risk of developing placenta accreta, which is the implantation of the placenta into the muscle layer of the uterus (myometrium). That is why, doctors will recommend a cesarean section again in the next pregnancy, to avoid heavy bleeding during delivery.
Normal Delivery after C-section
Mothers who previously gave birth by caesarean section may give birth normally in future pregnancies. It is also called vaginal birth after caesarean (VBAC). VBAC can be done with the following conditions:
- Mother does not have 2 transverse surgical incisions.
- There are no scars or abnormalities on the uterus.
- Never had a uterine tear.
- A normal delivery is then carried out in a hospital that is ready to perform an emergency caesarean section if needed.
Compared to delivery by repeated caesarean section, VBAC has several advantages, namely:
- The risk of the baby having breathing problems is smaller.
- The chances for early initiation of breastfeeding (IMD) and breastfeeding success are greater.
- Recovery after delivery is faster and pain is less, so the hospital stay is shorter.
- The production of the hormone oxytocin or the hormone 'love' is higher, so that the bond between mother and baby can be stronger.
- The risk of childbirth complications, such as infection, bleeding, or blockage due to a blood clot (thromboembolism), is lower.
- There is no risk of complications due to surgery and anesthesia.
- The risk of subsequent deliveries, such as placental disruption, ectopic pregnancy, and stillbirth, is lower than that of repeated cesarean sections.
But you need to know, if complications occur during the VBAC trial, an emergency caesarean section should be carried out which is more risky than a planned (elective) caesarean section. Therefore, you need to discuss with your obstetrician about the best choice of how to give birth in your next pregnancy.
Written by:
dr. Alya Hananti
