home Thyroid How many hours later can you get up after a cesarean section? When is independent delivery possible? The connection between ovulation and lactation

How many hours later can you get up after a cesarean section? When is independent delivery possible? The connection between ovulation and lactation

According to statistics, doctors decide on cesarean section in 10-20% of births. But many women do not want to stop there and are planning another child. A new pregnancy after a cesarean section is a certain risk for a woman. Which, however, does not mean that you need to give up the idea of becoming a mother again. But carrying a baby will be safe only if a number of conditions are met.

In some cases, doctors categorically prohibit getting pregnant again after a cesarean section. This is always associated with serious diseases:

Diseases genitourinary system, For example, chronic pyelonephritis, stones in the bladder.
Asthma, chronic bronchitis
Diabetes
Severe thyroid diseases
Heart diseases

In all these cases, doctors, even in the maternity hospital, warn the young mother that she should not have any more children: this threatens the woman’s life. If you are generally healthy, then you can get pregnant again.

How to plan a new pregnancy

Preparations begin with choosing reliable contraception, because you cannot get pregnant right away. Important question: how long before you can get pregnant after a caesarean section.

It is possible to carry a fetus for the second time after cesarean section after 2 years. Early pregnancy can be dangerous.

The fact is that the scar that appears after surgery is not yet strong enough to withstand repeated stress. Scar failure can lead to uterine rupture during pregnancy or birth.

Keep in mind that over time, the scar loses its strength, so you shouldn’t delay your second pregnancy either. Optimal time– 2-4 years after CS. Maximum - 10 years.

However, much depends on the individual characteristics of the organism. If a woman wants to become pregnant earlier than two years after a caesarean section, she is advised to undergo full examination at the gynecologist. It is also necessary to do an ultrasound of the uterus in order to find out what condition the scar is in. In addition to ultrasound, there are techniques that can accurately assess the condition of the scar - its structure and thickness.

Hysteroscopy. Injected into the uterus special device- endoscope. The doctor will examine the scar and determine whether it has healed sufficiently. The procedure is most often performed under local anesthesia. It's not painful, but rather unpleasant. In commercial centers, the price of such a procedure starts from 3,000 rubles.
Hysterosalpingography. The scar is examined using x-rays. A special contrast agent is used and injected into the uterus. The procedure is usually performed without anesthesia. According to reviews on the forums, it is a bit painful, but tolerable. Price – from 4000 rubles.

Both of these methods are only suitable for non-pregnant women. If the scar is strong enough, pregnancy is allowed.

So, the universal answer to the question of when you can get pregnant after a cesarean section is 2 years. But individual “amendments” in one direction or another are possible.

How to get pregnant after cesarean? If you got pregnant easily the first time, if the operation went without complications, and your menstrual cycle is regular, then most likely there will be no problems with conception. The norm is to conceive within a year of regular sexual activity without contraception. If you have had more attempts, consult a doctor - you need to be examined.

“Thin ice”: what to do if you get pregnant earlier

But what to do if pregnancy occurs earlier than the period prescribed by doctors? Is it really impossible to save the child, and will you have to have an abortion? Time is of the essence here.

One and a half years after the CS

Don't worry. More likely, pregnancy will pass safely. Two years for the formation of a strong scar is a period “with a reserve”. Of course, pregnancy after a year and a half means walking around. thin ice. But the chances of a successful outcome are good. The doctor will probably allow you to carry the child. You just need to visit your doctor regularly, follow all his recommendations and take care of yourself.

One year after CS

What should you do if you accidentally become pregnant a year after your caesarean section? Formerly doctors without talking, they sent such mothers for abortion. Now that medicine has reached a different level, there is a good chance that everything will go well and a healthy child will be born.

It is important for you to register for pregnancy as soon as possible and follow all doctor’s recommendations. During pregnancy you will have to wear a bandage. In the third trimester, be prepared to go to bed. Most likely, you won’t be able to give birth on your own; you will have to undergo a repeat cesarean section (although there are exceptions). Your obstetrician-gynecologist will decide.

However, if the cesarean section was corporal (it is performed infrequently, the only indication for it is the transverse position of the fetus), then usually a year is not enough for the scar to heal. Such a pregnancy will be risky.

6-9 months after CS

If pregnancy occurs 9 months after cesarean, and even more so after six months, this is a serious situation. The decision about whether to continue the pregnancy or not should be made carefully together with your obstetrician-gynecologist. If it is decided to keep the child, the pregnancy will take place under constant monitoring of the condition of the suture. In the third trimester, hospitalization is required.

2-4 months after CS

Pregnancy immediately after cesarean section is impossible: reproductive function has not yet been restored. Yes, and sexual relations are prohibited until it’s over postpartum hemorrhage. But already two months after cesarean section, the first ovulation is possible (provided that you are not breastfeeding). Most often, your period comes 3 months after a cesarean section. This means pregnancy is possible. However, both 2 months and 3 months after caesarean suture completely unprepared for repeated loads. During pregnancy, it can disperse, and this is a risk to the life of the expectant mother.

Therefore, if pregnancy occurs early after a CS, you need to have an abortion.

If pregnancy occurs 4 months after cesarean or earlier, then surgical abortion is dangerous for reproductive function. Pregnancy is terminated early with the help of medications. If you delay going to the doctor, you will have to have a surgical abortion. And this is fraught with infertility.

In any case, if a woman is pregnant, she needs to urgently consult a doctor, he will decide what to do: terminate the pregnancy or continue.

Gestation and childbirth

During pregnancy after a caesarean section, a woman needs to early dates register with a gynecologist. Ultrasound examinations are carried out much more often than with normal pregnancy. In the last trimester, you may have to go to bed for preservation.

If a woman becomes pregnant with twins after a cesarean section, she risks stretching the uterus. This is a high risk pregnancy.

A planned cesarean section is performed at 38-40 weeks of pregnancy, taking into account the individual indicators of each patient.

It happens that repeat pregnancy after a cesarean section successfully ends in natural childbirth. Having a baby without surgery increases your chances of having a second and third birth in the future. If childbirth was performed without surgery, the body recovers much faster.

Caesarean section must be repeated in the following situations.

The woman in labor suffers from chronic diseases.
Pathologies of pregnancy.
A woman became pregnant at the age of thirty.
More than two operations were performed on the abdominal cavity.

In other cases, the doctor must decide whether to give birth herself or do a cesarean section again.

The question of how many times you can give birth after a cesarean section directly depends on the body of the expectant mother and the condition of her uterus. General rule: CS can be done no more than three times.

So, the answer to the question of when you can get pregnant after a cesarean section depends on a number of factors. These include the condition of the seams, as well as individual characteristics the body of the mother and fetus.

If labor is over caesarean section, this may cause large quantities about questions a young mother has. The most common of which are, when is it okay to conceive again? Will it be possible to give birth to a second child on my own? How will the flow occur? new pregnancy, will there be any complications?

Is pregnancy possible after cesarean section?

Caesarean section is a method of delivery in which an incision is made in the lower abdomen, after which the surgeon delivers the baby. During the operation, not only tissue is dissected abdominal cavity, but also the uterus. That is why after childbirth this way a scar remains on this organ.

A scar after a cesarean section heals in about 3 months, and sometimes it takes several years for a uterine scar to form. Therefore, doctors advise women who have given birth this way to plan to conceive their next child no earlier than in 2 years. During this period of time, the body is completely restored, and pregnancy will proceed much easier.

During planning next conception you need to take into account a number of factors, because your body has just suffered a lot severe stress and the body needs time to fully recover.

During a caesarean section, a woman’s body loses 2 times more blood volume than during natural birth. As a result, there is a risk of developing anemia, that is, iron deficiency in the body. This is a condition that is not desirable for a pregnant woman, because iron is one of the most important minerals necessary for proper development and child growth. It will take time to replenish it in the body to normal.

Second pregnancy after cesarean: features

If a woman is planning a second pregnancy after a cesarean section, the gynecologist should be informed about this first. It will be necessary to pass not only routine tests. It is important for the doctor to assess the condition of the uterine scar. For this purpose, ultrasound, hysteroscopy or hysterography are prescribed. Carry out healthy child a woman can if she has a small scar on her uterus. It matters what fabric it is made of. Great if it comes from muscle. Bad option, if connective. It is less durable.
After a caesarean section, a pregnant woman needs to consult a doctor who conducts an ultrasound examination and palpation of the uterus. Thanks to this, it becomes possible to detect the beginning of a seam divergence in time and take the necessary measures in time.

How long before you can get pregnant after a cesarean section?

After childbirth, a woman's body undergoes serious changes. It takes time to get back to normal. Therefore, doctors under no circumstances recommend getting pregnant earlier than 3 months after the operation. Even if an unplanned conception occurs!

It is advisable that the next birth take place naturally, and for this, the woman’s body must fully recover and gain strength. First of all, this needs to be done to restore a stable psychological state.

At the same time, there are cases when, after undergoing a cesarean section, women are prohibited from giving birth. Most often this happens if a longitudinal incision was made on the uterus during surgery. As a result, the risk that when next pregnancy there will be a rupture along the scar.

Childbirth after cesarean: possible dangers

After the postponed cesarean birth can also occur naturally - contractions, pushing, birth. At the same time, there are several differences. It is recommended that the woman in labor be hospitalized in advance, and the final decision on the method of delivery will be made only by the doctor. In this case, additional ultrasonography(ultrasound).
The best option for a woman is considered to be spontaneous childbirth, which occurs without surgical intervention. Several years ago, such women in labor had their bladder opened in advance, after which they waited for the contractions to begin. But today this method is undesirable, since there is a possibility of developing serious complications during labor activity.
At all times, a woman should be under the strict supervision of a doctor. If unforeseen complications begin, the woman in labor will be provided with immediate assistance and an unscheduled emergency will be performed.
Today, debates about the need for pain relief continue, as there is a category of specialists who believe that they may be missed painful sensations which appear during uterine rupture. It is also forbidden for a woman in labor to start pushing early and use the technique of pressing on the abdomen. If the birth takes place naturally, the doctor will need to examine the uterus and check the condition of the scar.
In any case, caesarean section is mandatory for women who have serious problems with health or physiological characteristics(narrow pelvis) interfere with successful delivery.

In modern obstetrics, cesarean section is the most frequently performed delivery operation. It is done under general or regional anesthesia (spinal or epidural anesthesia - with these types of anesthesia, the anesthetic is injected into the spinal canal at the lumbar level). When performing such anesthesia, only the Bottom part torso. Future mom during the operation he is conscious and can hear and see his child immediately after his birth. After the baby is removed, the woman is often given medication to help her sleep for the remainder of the operation. In this case surgical intervention easier to tolerate. Awakening occurs on the operating table. In this case, as a rule, the woman feels good and does not feel weak or faint. And when general anesthesia is used, the woman comes to her senses within 30–60 minutes after the operation.

It doesn't hurt at all
Before the operation, the woman is given a catheter into her bladder, as well as a catheter (thin tube) into a vein in her arm. Catheter from Bladder Usually removed at the end of the first day, this procedure is completely painless. The catheter is in the vein of the elbow until there is a need for intravenous administration medications.

The first day after caesarean section - intensive care ward

After the operation, the woman is transferred to the ward intensive care where she is under observation medical personnel. The ward is equipped with equipment that makes it possible to constantly monitor the condition of the young mother, and, most importantly, her well-being is monitored by an obstetrician-gynecologist and an anesthesiologist-resuscitator.

After the operation is completed, an ice pack is applied to the lower abdomen for 1.5–2 hours in order to prevent bleeding and the formation of postoperative hematomas (hemorrhages), improve uterine contraction, relieve postoperative edema fabrics.

2–3 hours after the operation, the woman needs to begin to move her arms and legs, and turn around in bed. You are allowed to sit down and walk around the ward 5–6 hours after the operation.

After a caesarean section, a woman is given a number of medications:

intravenous fluids are administered to replenish blood loss and restore water and electrolyte balance. After surgery, as a rule, an intravenous catheter (a tube inserted into the cubital vein) remains. Liquid flows through this catheter using a dropper. If the cesarean section operation was completed without complications, the drip remains in place for 2–3 hours;
Narcotic analgesics are prescribed, since the pain in the suture area can be quite severe. These drugs are administered 1–2 times a day for the first 2–3 days, and then gradually withdrawn. They provide the necessary degree of pain relief;
uterine contracting agents (oxytocin) are administered intravenously into a dropper or intramuscularly 2 times a day;
prevention of infectious postoperative complications after cesarean section is carried out using antibacterial drugs. The first dose of antibiotic is administered intravenously immediately after ligation of the umbilical cord and again 6–12 hours later during the first day after surgery. If a woman belongs to a high-risk group for the development of infectious and inflammatory complications after cesarean section (for example, if infections were detected during pregnancy genitourinary tract, more than 12 hours have passed from the moment of rupture of water to the operation, etc.), the administration of antibacterial drugs is continued for 5–7 days. If the operation was planned and passed without complications, then a single administration of antibiotics during the operation is possible. In any case, the use of antibiotics during and after surgery, as a rule, does not affect the ability to breastfeed. If necessary use antibacterial drugs, incompatible with breastfeeding, the doctor will definitely tell the young mother about this and explain how to behave in order to maintain the possibility of feeding the baby with breast milk after treatment.

On the first day after cesarean section, therapy is carried out aimed at restoring intestinal function. For this purpose, stimulants must be added to the administered solutions. contractile activity intestines (potassium preparations, etc.). At the end of the first - beginning of the second day after surgery, a cleansing enema is prescribed to activate the intestines.

On the day after a cesarean section, you are only allowed to drink and not eat. This limitation is necessary in order to minimize the load on gastrointestinal tract. You can drink water with lemon juice or mineral water without gas.

In the early postoperative period, the formation of blood clots in blood vessels is prevented. lower limbs: entered medications to prevent the formation of blood clots, it is recommended to bandage the legs before surgery or use special compression stockings- this measure improves venous drainage from the legs, helping to move blood through the veins. It is advisable to wear elastic bandages or stockings for at least seven days after childbirth.

If the operation went well, the mother and baby have no complications, then for the first time the baby can be brought to the intensive care ward for feeding, however, in most maternity hospitals this is not accepted, and more often the baby is brought to the mother in the postpartum ward.

After caesarean section: postpartum ward

At the end of the first - on the second day after a cesarean section, the woman is transferred to a regular ward of the postpartum department. She is allowed to sit down and walk around the ward. Also on the 2nd day the administration continues infusion solutions. In case of use medicines, which can have negative impact for a newborn, breast-feeding It is recommended to start later, after their effect has expired.

Within 6–7 days, the attending physician examines the postoperative suture, and the nurse bandages it once a day and treats it with antiseptic solutions. The sutures are usually removed 5–7 days after surgery.

To assess the condition of a young mother, they are prescribed various tests blood. On the 5th–6th day after the operation, an ultrasound examination of the pelvic organs is performed, which allows one to judge the size of the uterus, the condition of postoperative sutures, the presence of hematomas, blood clots, the size and contents of the uterine cavity.

After childbirth, the uterus is an extensive wound. The healing process is accompanied by the presence of discharge from the genital tract - lochia. After a cesarean section, just as after a natural birth, the lochia comes out first bloody, then bloody (brownish-pink) and will be released for 6-8 weeks after birth. It is recommended that a woman toilet her external genitalia after each urination, defecation, and change sanitary pad every 2–4 hours.

Features of nutrition after cesarean

The load on the gastrointestinal tract in the postoperative period should be increased gradually. On the second day, you can eat boiled meat, porridge, low-fat broth, and drink sweet tea. Starting from the third day, mother can afford more good nutrition including breastfeeding.

Belly support after cesarean

Immediately after transfer to the postpartum ward, you can start wearing a postoperative bandage. It is worn over aseptic dressing. Postoperative bandage fixes sutures, abdominal muscles, reduces pain in the suture area and the likelihood of hernias. The bandage must be worn for 2 months after surgery.

Breastfeeding after caesarean section

Breastfeeding is allowed depending on the traditions of the institution, the condition of the mother and child on the 1st–3rd day after surgery. The formation of lactation after a cesarean section is almost no different from that in women who gave birth naturally. If the operation was planned (performed before the development of spontaneous labor), then milk may come not on the 3-4th, but on the 4-5th day, but colostrum begins to be released immediately after the operation.

It is most convenient to feed the baby lying on his side in the first days after a cesarean section. In this position, the postoperative suture will be subject to the least impact. In the future, it is possible to feed the baby while sitting or standing.

During normal course postoperative period mom is being discharged from maternity hospital on the 6th–7th day.

After returning home

10–12 days after discharge from the maternity hospital, it is advisable to visit an obstetrician-gynecologist at the antenatal clinic to make sure that recovery after surgery is proceeding normally.

Final recovery after caesarean section

Final healing postoperative wound on the uterus and scar formation occurs within 8 weeks after birth. During this time, it is recommended to visit your obstetrician-gynecologist again. In this case, it is imperative to do a control ultrasound examination of the pelvic organs to check the condition of the uterine cavity and postoperative scar.

Menstruation after a cesarean section is restored in the same way as after a natural birth. If a woman breastfeeds her baby, then menstruation returns 6–12 months after birth, in cases where the baby is on artificial feeding– usually 8 weeks after birth.

Upon resumption sexual relations It is necessary to use contraceptives, which your doctor will help you choose. An abortion performed within 1–2 years after surgery significantly worsens the prognosis of subsequent pregnancies. It is believed that the optimal condition of the scar ( full recovery muscle layer) on the uterus reaches 2–3 years after surgery. It is after this period of time that it is recommended to plan a subsequent pregnancy.

After cesarean section, sexual rest is recommended for 2 months after surgery.
For 2 months after surgery, it is not advisable to lift weights exceeding 3–4 kg (the weight of the child).
Be sure to follow the rules of personal hygiene: it is advisable to take a shower at least 2 times a day, and do not rub the seam area with a washcloth. After a shower, once a day it is recommended to treat the area of the postoperative scar with antiseptic solutions(brilliant green, 70% solution ethyl alcohol). After treatment, a disposable antiseptic bandage is applied to the suture area to prevent friction of the suture on clothing. After complete disappearance of crusts (on average 10–14 days after surgery) in the area postoperative suture The bandage may not be applied in the future.
The menu of a woman who has undergone a cesarean section and is breastfeeding should contain a sufficient amount of proteins, since they are the main building material for the synthesis of immunity factors and hemoglobin. Proteins are also present in large quantities breast milk. A lot of protein is found in meat, fish, cottage cheese, milk, and cheese. In this case, meat and fish should be lean, boiled or steamed. The cheese should be mild.
For 2 months after surgery, you should not exercise your abdominal muscles, as there is a risk of sutures coming apart. But after 1 month you can start light physical exercise aimed at restoring general tone body. To begin with, you can study for 15–20 minutes, then increase the study time to 40 minutes a day.

Breathing exercises

Already 2 hours after the operation, breathing exercises can be performed, aimed primarily at preventing congestion and inflammatory complications in the lungs, which can arise due to the fact that the woman has been in a lying position for a relatively long period. These exercises are especially relevant when general anesthesia, when in Airways a tube is inserted, it irritates the airways, causing increased amount mucus, which is a breeding ground for pathogenic microbes. Breathing exercises conducts nurse. It consists of combining the phases of breathing (inhalation and exhalation) with a certain frequency. You can also use balloon inflation for this purpose.

When can you get pregnant after a caesarean section?

There are no absolute contraindications to a new pregnancy after cesarean section, and about 30% of women plan to have more children in the future. It is believed that more favorable period for pregnancy and childbirth - after 2 - 3 years, since it is during this time that recovery occurs muscle tissue in the area of the uterine scar.

At this time it is very necessary reliable contraception, because with early pregnancy, a weak scar can disperse and cause tearing of the uterine wall. An abortion should also not be done during this period; any mechanical stretching or impact on the uterine wall can weaken it and cause rupture or inflammation.

Natural birth after caesarean section

The rule “one Caesarean - always a Caesarean” has long lost its force. The mere presence of a scar on the uterus is not an indication for surgery. Moreover, expert organizations in Europe and the USA assure that natural childbirth is desirable for women who have had a caesarean section.

As a rule, a natural birth is possible after one caesarean section. After two cesarean doctor will insist on surgery.

The probability of a successful natural birth after cesarean is about 60 – 70%. This largely depends on the reason for the previous operation. It’s worth a try if the reasons for cesarean delivery were related only to the course of the previous pregnancy, and did not recur in subsequent ones:

breech presentation of the child;
toxicosis of the second half;
pathological condition of the fetus;
active stage of genital herpes.

In the case of “clinically narrow pelvis“It is also possible to give birth in a previous pregnancy without the help of a surgeon. This diagnosis often hides simply the weakness of labor, so there is a chance that it will not happen again.

Features of labor management after cesarean section

In Russia, doctors are still reluctant to undertake natural births after cesarean sections. There are often a number of strict requirements for pregnancy:

The time between the first cesarean and the second pregnancy should be at least 3 and no more than 10 years;
The incision on the uterus is preferably horizontal (transverse);
The placenta should be located high enough, preferably along the back wall;
The fetus must be in a cephalic position;
The condition of the seam should be good.

If all these conditions are met and there are no contraindications, then you will most likely be allowed to have a natural birth.

During natural childbirth after cesarean section, stimulation and anesthesia cannot be performed. This can increase uterine contractions and increase the likelihood of uterine rupture.

Should you try to give birth on your own?

Is it worth the hassle of trying to give birth a second time after a cesarean if you end up having to cut anyway? This question can be answered this way: your baby would thank you for your efforts.

Firstly, for everything to work out, you always need to tune in for the best. Secondly, children born by cesarean section, but after the onset of contractions, find it easier to adapt to environment than their peers who were born before the onset of labor. Their breathing improves much after childbirth and their hormonal levels are better.

Is uterine rupture possible?

The main reason for refusing natural childbirth after cesarean is the fear of uterine rupture. In Russia, only 30% of women give birth naturally after a caesarean section (for comparison, in some clinics in the West the number of such women is close to 70%). However, this risk is largely exaggerated. There are cases where women gave birth naturally even after two operations on the uterus.

The fact is that many years ago an incision in the uterus was made longitudinally in its upper part, that is, where the likelihood of rupture during childbirth is greatest. Nowadays it is almost always done transversely in the lower part and can almost never cause a rupture.

According to official data, the risk of uterine rupture in the case of a transverse incision is only 0.2%, respectively, the probability of a successful birth outcome is 99.8%! In addition, not a single woman or child in our time dies from uterine rupture, regardless of what kind of incision was made. Fortunately, the threat of an incipient rupture can be easily identified by ultrasound and CTG; its condition is determined at 36–38 weeks and before birth.

How many times can you have a repeat caesarean section?

Usually doctors undertake to perform a caesarean section no more than three times, but sometimes you can meet women with a fourth. Each operation weakens and thins the uterine wall.

If you are planning a third caesarean section, it is worth talking to your doctor about the possibility of surgical contraception using tubal ligation during surgery. This method will reliably protect against subsequent pregnancy and possible surgery on the uterus.

IN last decades There is a tendency to expand the indications for surgical delivery.

Moreover, more than half of the women who underwent surgery later.

In this regard, questions about the management of pregnant women in this risk group are becoming increasingly relevant.

In order to understand the features and risks of managing pregnant women after pregnancy, it is necessary to understand the course of the operation.

The first step is dissection of the anterior abdominal wall.

Layers: leather, subcutaneous tissue, aponeurosis, muscle separation, parietal peritoneum. And only after all these layers is access to the abdominal cavity.

The most important step is making an incision on the uterus.

It is usually performed as follows: the wall of the uterus in the lower segment is incised with a scalpel, after which the surgeon index fingers continues the cut.

This access is justified by the fact that the risk of damage to the vascular bundles located along the uterine rib is minimal. With a corporal incision, the uterus is dissected longitudinally.

Then the fetus is carefully removed from the uterine cavity.

After this is carried out manual release placenta. Leftovers placental tissue removed using a curette.

Before suturing the uterine wall, it is necessary to make sure that the outflow bloody discharge will be full - for this you need to check the opening of the cervical canal.
Suturing the uterus.

Correct technical execution this stage surgery greatly influences the future prognosis. On this moment preference is given suture material- vicryl. It is quite durable due to the fact that it consists of several woven threads, and is also an absorbable material. The time for its complete resorption ranges from 60-90 days, which is enough for the uterine walls to grow together.

After inspection of the abdominal organs, sequential suturing of all layers is carried out in the reverse order.

When do stitches fuse after a caesarean section?

Healing time of external and internal seams does not match. On the skin, the seam heals much faster, which is due to the contact of the skin tissue with the air. The suture on the uterus takes the longest to heal. Important looks like a cut in the uterus.

Features of scar formation in the lower segment

This is due to the fact that the cut runs parallel muscle fibers, which means that most of the smooth muscle cells retain their integrity, and therefore functionality.

In addition, due to the good blood supply to this area, the healing process is faster and better.
Another argument in favor of access in the lower segment is the peculiarity of uterine contraction in the postpartum period.
The processes of involution (reverse reduction in size) of the uterus occur in such a way that the area of the lower segment is almost completely reduced, which means that the area of the scar is noticeably reduced.
In general, regeneration processes occur in the suture area within 3 months.

“Scar phenomenon” after corporal cesarean section

Completely different processes occur with longitudinal access. This area has a much worse blood supply. In addition, with this incision, a large number of muscle cells are dissected, which leads to a noticeable decrease in the contractility of the uterus.

Moreover, it has been proven that over a long period of time after surgery, almost complete replacement of the suture site with scar tissue gradually occurs. This means that when a longitudinal section is made along the suture, there are practically no muscle cells left, and almost complete atrophy occurs.

This is the “uterine scar phenomenon” after corporal access. After a long period of time it does not become stronger. The principle “the longer the better” does not work here.

But this does not mean that with this access it is necessary to plan pregnancies earlier than two years after the operation. Getting pregnant too early is also dangerous due to the risk of uterine rupture due to an incomplete scar.

Thus, the process of uterine regeneration after a corporal incision proceeds much more slowly, worse, often with the formation of an inferior scar, and many years after the operation, the suture site is almost completely represented by connective tissue.

A second pregnancy after cesarean is possible after 2-6 years. Many women neglect this rule and try to get pregnant a year after a cesarean section. Although for some this does not happen as planned. Early pregnancy after a cesarean section has its own risks, since the uterus is not yet ready to bear the fetus again.

How quickly does reproductive function recover after surgery?

It's no secret that a caesarean section is alternative method birth, which was not at all intended by nature.

This bypass physiological processes what happens to a woman during childbirth was completely unforeseen. It is for this reason that the so-called “scissors” arise.

Restoration of the reproductive function of the body occurs much earlier than can be achieved in practice.

So, for example, in the absence of breastfeeding, the first menstruation (and therefore the restoration menstrual cycle With possible ovulation) can occur as early as 2 months after surgery.

However, the suture on the uterus by this time is completely “not ready” for the processes of stretching the myometrium during pregnancy. Of course, it is not possible to get pregnant immediately after a cesarean section, since the body’s reproductive function needs time to recover, but the ovaries can still begin to ovulate 40-50 days after the operation.

The connection between ovulation and lactation

If a woman breastfeeds her baby, the likelihood of pregnancy is much lower. Since the process of lactation leads to suppression of ovulation.

When continuing breastfeeding, you must adhere to following rules: feeding should be every 3-4 hours, at regular intervals.

In such a situation, the likelihood of ovulation occurring is reduced. But you can’t rely only on breastfeeding. In women after surgery, early onset of gestation is very dangerous, so it is recommended to use contraceptive methods.

How long before you can get pregnant after a cesarean section?

The most optimal period for pregnancy is considered to be 2 years after surgery.

This period of time was chosen for many reasons: within 2 years, the final formation of a scar on the uterus occurs, and the woman’s body has time to recover.

This period is determined with some “margin” to minimize the risk of complications.

However, this does not mean that any pregnancy occurring before this period must be terminated. The main factor determining the outcome of pregnancy is the assessment of the consistency of the scar. In other words, in case of an unplanned pregnancy, it is necessary to use individual approach. So how long after cesarean can you get pregnant?

In general, if pregnancy occurs a year after surgery in the lower uterine segment (with a satisfactory condition of the scar), then such a woman has a high chance of safely bearing the baby.

The situation is different with a corporal cesarean section. Usually one year is not enough to form a lasting scar. Therefore, in this situation, the decision to continue pregnancy is made on the basis of methods for assessing the postoperative suture.

Steps “on thin ice” or what to do if pregnancy occurs within the first year after surgery?

Despite the fact that doctors advise not to plan a pregnancy in the first 2 years after surgery, it happens that an unplanned pregnancy occurs. The most important thing is not to panic! You should weigh all the risks and undergo a full examination.

What to do if a woman becomes pregnant 6 months after the operation?

If pregnancy occurs six months after a cesarean section, this situation must be taken extremely seriously. This pregnancy must be carried out under careful monitoring of the condition of the suture on the uterus. It is important to remember that the woman must be hospitalized in advance at 35 weeks.

Pregnancy occurred 3-4 months after surgery

In such a situation, the woman is offered to terminate the pregnancy, since its continuation is extremely undesirable. There is a very high probability of uterine rupture and placental tissue ingrowth into the postoperative suture site. These complications pose a serious threat to the mother's life.

What to do if pregnancy occurs 2 months after cesarean section

Pregnancy after 2 months is strictly subject to termination, as the risk of complications is extremely high. 2 months is not enough time for the formation of a scar on the uterus.

Such a strict approach to the possibility of maintaining pregnancy after surgery is due to the danger to the mother, and in some situations - the appearance real threat her life. Uterine rupture is the most urgent (emergency) situation in obstetrics. The volume of blood loss in a matter of seconds reaches the entire circulating blood volume in a woman’s body!

Is it worth saying after this that the doctor’s strictness during pregnancy, which occurs in an unacceptably early period after the operation, is due precisely to concern for the woman?

In such a situation, the method of abortion deserves special attention.

No abortion method is safe. Any technique has its drawbacks.

The most dangerous is the classic surgical method, so there is a high probability of perforation of the uterus with a curette (especially in the presence of endometritis).
Medical abortion also carries risks, since a scarred uterus has a reduced ability to contract, which means that ovum is not always eliminated (removed). In addition, drugs used for medical abortion may also cause seams to come apart.
Vacuum aspiration is the “lesser evil,” but this method is also not safe.

Considering all the risks of early pregnancy after surgery, as well as the dangers of its termination, the use of contraception is considered necessary in this category of women.

It is preferable to use either barrier methods(condoms), or hormonal drugs, allowed during lactation (“Charosetta”, “Laktinet”, “Excluton”).

Maintaining the optimal time interval after surgery until desired pregnancy, as well as the use of methods for assessing the uterine scar significantly reduce the risk possible complications. A favorable course of pregnancy and careful delivery help preserve a woman’s reproductive potential.