After Mother struggled through labor and recovery after a caesarean section, the next question arises: when to get pregnant again and whether to go back to birth by caesarean section? This article explains the things you need to know about pregnancy after a caesarean.
When is the best time to get pregnant again after a cesarean section? In general, both women who give birth normally and by cesarean section are advised to wait at least 18 months and no more than 5 years after giving birth to avoid the risk of future pregnancy problems.
Mothers can use various types of contraception to delay pregnancy, such as birth control pills, birth control injections, implant birth control, and spiral birth control or IUD (intrauterine device).
Things to Do During Pregnancy Delay
During postponing pregnancy, Mother certainly needs to prepare for a healthy 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, Mother is recommended to reduce body weight until reaching the ideal body mass index (BMI) within 6-12 months after giving birth. The trick is to adopt a healthy diet and regular exercise.
2. Adequate intake of folic acid
Mother is also advised to consume 400 micrograms of folic acid every day, at least since 1 month before planning to get pregnant again. Consumption of folic acid continues 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 the habit of smoking or using nicotine-containing devices, such as nicotine patch or vape, need to immediately stop the habit to reduce the risk of problems in the next pregnancy. In addition to smoking, the habit of consuming alcohol also needs to be stopped.
If you find it difficult to stop smoking or consuming alcoholic beverages, try to consult a doctor.
4. Routinely check the health condition
If you have a chronic illness, you are strongly advised to routinely carry out health checks, comply with medication, and maintain a healthy lifestyle while delaying pregnancy. Chronic diseases that need to be examined 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 experience disturbances during a previous pregnancy, such as gestational diabetes (diabetes that occurs during pregnancy) and preeclampsia, or if you experience complications after a caesarean section, you should do a routine check-up to your obstetrician.
The choice of delivery method for the next pregnancy
Pregnant women who have given birth by cesarean 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 cesarean section, including:
- The pelvis is narrow or the size of the fetus is too large to pass through the pelvis.
- Infection of the placenta and fetus (chorioamnionitis).
- Eclampsia and HELLP syndrome.
- Fetal distress that can cause oxygen deficiency in the fetus.
- Umbilical umbilical cord, the baby's umbilical cord is between the fetal head and vagina so that it can cause the fetus to lack of oxygen.
- Previous cesarean section wounds were classic caesarean wounds (vertical incisions).
- Placenta previa or placenta covers the baby's birth canal, so the baby cannot be born normally.
- The position of the breech or transverse baby.
- The uterus is torn.
In addition, pregnant women who previously underwent caesarean section are at risk of having placenta accreta, which is the implantation of the placenta in the uterine muscle layer (myometrium). That is why, doctors will recommend a cesarean section again in subsequent pregnancies, to avoid excessive bleeding during labor.
Normal delivery after Caesarean section
Mothers who previously gave birth by cesarean section could have given birth in a subsequent pregnancy. This is also called vaginal birth after caesarean (VBAC). VBAC can be done with the following conditions:
- Mother does not have 2 transverse surgical incision scars.
- There are no scars or abnormalities in the uterus.
- Never experienced a uterine tear.
- Normal delivery is then performed in a hospital that is ready to perform an emergency cesarean section if necessary.
Compared to labor through the method of repeated caesarean section, VBAC has several advantages, namely:
- The risk of babies experiencing respiratory problems is smaller.
- The opportunity for initiation of early breastfeeding (IMD) and breastfeeding success is greater.
- Recovery after delivery is faster and pain is lighter, so that the hospital stay is shorter.
- The production of the hormone oxytocin or the hormone 'affection' is higher, so the bond between mother and baby can be more closely intertwined.
- The risk of labor complications, such as infection, bleeding, or blockage due to blood clots (thromboembolism), is lower.
- No risk of complications due to surgery and anesthesia.
- The risk of subsequent labor, such as placental disorders, ectopic pregnancy, and stillbirth, is lower than repeated caesarean section.
But you need to know, if complications occur during the VBAC trial, emergency caesarean section should be performed which is more risky than planned (elective) cesarean section. Therefore, you need to discuss with your obstetrician about the choice of the best way to give birth in your next pregnancy.
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