How long should you wait to get pregnant after a C-section?
Getting pregnant after having a C-section can be a complicated decision. Knowing when you can start trying, making birth plans, and even knowing if you are a good candidate for VBAC (Vaginal Birth After Cesarean) can be overwhelming.
It is understandable to be filled with questions and uncertainty, especially if you want your children to be close in age.
So, what is the need-to-know about getting pregnant after having a Cesarean section? Let’s dig in. We will go over all the essentials like pregnancy intervals, how to prepare for your pregnancy, the risks of getting pregnant “too soon,” and how to increase your chances of having a VBAC.
When you should get pregnant after a C-section
Most medical experts recommend waiting anywhere from 6-15 months after having a C-section before getting pregnant again (or 15-24 months between births) to reduce the risk of complications like uterine rupture.
There are four published studies that go over these risks, each showing different interval recommendations. Here’s what the research tells us:
- A retrospective study of 1,768 people planning for VBAC by Bujold (2010) shows that the rate of rupture to be 1.3 percent with birth intervals of 24+ months, 1.9% with inter-birth intervals of 18-23 months, and 4.8% with intervals of less than 18 months.
- A retrospective study by Stamilio et al. (2007) only saw an increased risk of rupture of 2.66% with less than 6 months between pregnancies (15 months inter-birth interval).
- Another retrospective study by Shipp et al. (2001) found an increased risk of rupture with less than 18 months between births (9 months between pregnancies.
- According to the Mayo Clinic, research generally suggests waiting between 18 and 24 months.
These studies suggest that longer intervals between pregnancies MAY decrease the risk for uterine rupture. However, the optimal spacing is yet to be determined as results are conflicting and the sample size in the studies is not big enough to be conclusive.
Ultimately, the timeline that is right for you should be based on your unique circumstances and it is best to discuss it with your provider.
Planning a pregnancy after C-section
There are specific factors to consider when trying to decide when it is best to get pregnant after Cesarean. Some things to think about are:
- Your overall health: Being in your best physical health will not only increase your chances of a vaginal birth but, your chances of having a healthy pregnancy.
- Your age: If you are over the age of 35, you might want to consider getting pregnant sooner, due to potential risks associated with later in life pregnancies.
- Fertility: How easy is it for you to conceive? Those with a harder time conceiving might want to start trying sooner than those who don’t.
- VBAC or C-section? If you are planning a vaginal birth, a longer pregnancy interval might help you find a more supportive provider and decrease your risk of rupture.
- Overall family size: How many kids you want should be a deciding factor in when and how to have them. The overall risks go up with each Cesarean and down with each VBAC.
What are the risks of getting pregnant too soon?
Your decision on how long to wait to get pregnant after a C-section should consider the risks of not waiting long enough.
Risks of getting pregnant too soon after a Cesarean include the increased risk of uterine rupture, preterm birth, low birth weight, a longer recovery time, and a more difficult pregnancy.
Can you have a vaginal birth after a C-section (VBAC)?
Up to 80% of women who attempt a VBAC will be successful. Here are some factors that make you a good candidate for a VBAC:
- Low-risk pregnancy
- If you are pregnant with twins, VBAC is considered safe as long as you have a low transverse incision.
- Have a low-transverse (or bikini cut) uterine scar
- Have a special scar, unless carrying multiples (with the exception of a classical incision)
- Do not have any other contraindications for a vaginal birth
ACOG suggests a few things to be contraindications to VBAC including:
- A prior high, or classical, uterine incision
- A prior uterine rupture
- Certain types of uterine surgery like fibroid removal
- An unknown scar type that is suspected to be a classical scar
Overall, choosing to birth after a Cesarean is a preference-sensitive decision and should be made for your unique circumstances with a provider who aligns with your birth goals.
How to increase your chances of a successful VBAC
It goes without saying that sometimes, Cesareans are life-saving; I have seen it myself as a doula. However, there are several things you can do to avoid an unnecessary Cesarean and increase the likelihood of having a VBAC.
Get educated about VBAC
There’s a lot to know besides how long to wait to get pregnant after a C-section. What are the risks? Does hypnobirthing work to ease the process?
Know your options, learn as much as you can about the risks of VBAC and repeat Cesarean, and take our VBAC Prep Course.
Find your support
Having a supportive team that knows you and your preferences will make the biggest difference n how your birth unfolds. Start with a VBAC supportive provider, find a VBAC trained doula, and know who in your social circle and family you can lean on to support you on your journey.
Trust and honor your intuition
Education and intuition are such a powerful force when used together. Trust in the things you have learned and tune into your intuition to drive your birth choices.
When your head and your heart align, you will know what you need to do.
Is it hard to get pregnant after C-section?
Generally, you should expect to conceive about as easily as you did the first time. Only rarely is there an increased risk of infertility due to Cesarean.
How fertile are you after a C-section?
Your fertility is not typically affected by having had a C-section and, most medical experts recommend waiting at least 6 months before trying to conceive. Some may find it harder to conceive based on their incision type.
What happens if you get pregnant right after a C-section?
If you get pregnant right after having a Cesarean, research suggests that you are 2-3 times more likely to experience a uterine rupture.
How long does it take for a Caesarean to heal internally?
Typical healing for a Cesarean incision is six months although your whole body takes 12 months before it returns to “normal.”