I think I’ve mentioned that our first daughter was a happy surprise. With our second daughter, we waited a good while after the time that my doctor said it was ok to get pregnant again after a C-section. Then we decided we were ready and went for it.

My husband got me pregnant on that first try.

But I didn’t realize it just yet. Nope. I went to teach like always and remarked to one of my fellow American coworkers that I thought something was wrong. “Maybe I’m dying,” I worried. She just laughed and said, “Ten bucks says you’re pregnant again.”

I sat there and thought about that for a moment. After all, I was fatigued, but I thought that was just because my eldest was a toddler hell-bent on stealing all my energy, and I taught little kids English, which is exhausting as well. And China. That’s exhausting all on its own.

I went through the early pregnancy signs in my head (if you’re curious what those are, I wrote about them here) and started checking them off. No nausea yet, but if I were indeed pregnant, I was at week 4 or week 5. Something definitely felt like it was up though.

And now, this is a little gross, but hey, that’s what I’m here for. I went to the bathroom to poop, and it came out in one long, snake-like poop just like it always did when I was in my first few months of pregnancy with my first.

“Go grab me a pregnancy test from the pharmacy on your way home,” I said to my husband on the phone. When he came home, I took the test. We waited for the allotted time, and there it was, confirmed. Pregnant again after C-section.

To be sure, we made an appointment to see the doctor who delivered our eldest, and she confirmed it. “Maybe boy this time,” she smirked. In China, they think a boy baby is the best blessing. No offense to boys or moms of boys, but I respectfully disagree. I don’t think there’s anything wrong with them, but I’m thrilled to the gills that I have two girls.

How Fast Can You Get Pregnant After a C-Section?

When we got pregnant with our second daughter, I had waited almost three years. Of course, we had sex lots of times after our first child was born. You can have sex six weeks after your C-section once you’re all cleared from the doctor. However, you should wait 18 to 24 months after your C-section before trying to get pregnant.

This is so your body can recover from that surgery. It’s not that you can’t physically get pregnant before then…you can! BUT…you have a larger chance of complications such as a lower birth weight baby or a ruptured uterus if you rush things.

I waited longer to be sure. Then, I deliberately scheduled a C-section again.

Do I Have to Have Another C-Section?

For those of you wondering if it is possible to have a normal delivery after a C-section, yes! It absolutely is. BUT, your doctor will have to evaluate if it’s an option for you. Known as a VBAC (vaginal birth after cesarean), it has a success rate of 60% to 80%.

The odds are definitely in your favor to deliver vaginally the second time around. However, those that aren’t successful have to go in for an emergency C-section. I’ve talked about how planning a C-section is so much less taxing than an emergency one (you can read that here).

To decide if a VBAC is right for you, talk to your doctor. Every one of us is different. In fact, my doctor asked me if I wanted to try. I told her no. She said I was the right candidate for it. I still told her no. I was worried I wouldn’t dilate enough like last time and that labor would stall and I’d have the same nightmarish experience of an emergency C-section like I did with my first. Nope, I wasn’t doing that again.

Only you and your doctor can decide which is right for you but if you have a choice, definitely go through those options for yourself. Whatever makes you most comfortable and that your doctor agrees with will be the right choice for you.

I will say VBACs will have a shorter hospital stay, and it can help you achieve your goals of having a larger family. The risks go up for you with every C-section you have. For one, you’re more prone to bowel and bladder injuries. For another, some adhesions can lead to bowel obstruction.

Cautions:

Heavy bleeding is another area of concern for repeat C-sections. While you’re generally okay with a second C-section, after a third one, you have a higher risk of needing a blood transfusion and a hysterectomy (where they remove your uterus). And once that hysterectomy happens, you can no longer bear more children.

Placenta problems may also come into play. Your doctor will be monitoring you with extreme care after your first C-section, especially if you’re going for another C-section.

You can take the gamble like Tori Spelling or Victoria Beckham famously did (each of them had 4 C-sections) but do know the more of these surgeries you have, the more dangerous it is for you.

Pregnancy After C-Section: Risks and Complications

Wondering what you’re at risk for when getting pregnant again after a C-section? If it helps any, every pregnancy bears with it some risk, doesn’t it? The younger and healthier you are, the more likely you are to have an uncomplicated pregnancy.

But as you start moving through your 30s, things change. And this can also affect how your next pregnancy after C-section turns out.

As I mentioned, my doctor kept asking me if I was sure I didn’t want the VBAC. Every checkup, she’d say, “You sure you don’t want a VBAC?” It made me nervous. Did she know something I didn’t? Was I going to die in the OR this time?

I was honestly a bit scared, but the baby had to come out one way or another.

The risks are just a bit higher for you with each pregnancy you have after a C-section. That repeated opening and stitching shut of your abdomen is not suitable for you. This is why you should think about the size of family you truly want.

For me,

I never wanted more than two kids. I have friends that come from big families, and I’d always feel overwhelmed going to their homes. I grew up in a traditional nuclear family, and that’s what I felt comfortable with. If you have your heart set on having 4 or 5 kids (or more!), then you really should consider the VBAC if it is on the table as an option for you.

If you had a vertical incision during your C-section though, you would know right away you won’t be a good candidate for VBAC. It’s much riskier for causing a uterine rupture.

What Can You Expect During This Second Pregnancy After C-Section?

Well, you remember what being pregnant was like the first time around, right? It’s going to be mostly the same. You might, as I did, feel unusual very early on, which can tip you off you’re pregnant.

You may have some of the same food cravings as before (I did!) or different ones. The same goes for aversions too. But some of your symptoms of pregnancy may be more extreme than the first time around – not all of them and not always, but sometimes.

This is important:

Some women experience severe cramping during the next pregnancy after a C-section. If these cramps just come and go, it’s nothing serious, though anything that concerns you should be brought to your doctor’s attention immediately. Call up the office and express your concerns. They’ll let you know for sure if it’s something to worry about or not.

Swollen feet are another one other moms have told me about with their next pregnancy after C-section. I honestly never had this problem because we lived in cold weather. I only experienced it once when we went to a hotter city during my first pregnancy. My feet looked like Fred Flintstone’s!

But the thing I do remember my doctor constantly monitoring me for was my blood pressure. “You have to stop worrying so much,” she told me. I was a ball of nerves during this pregnancy because I was worried about having another C-section but too afraid that a VBAC wouldn’t go well for me since my last attempt at vaginal delivery failed.

The other thing was that my mother-in-law, sweet as she is, would cook with too much salt. Thus, my doctor was always on me about my blood pressure. I didn’t realize why she was so concerned until I found out about the Preeclampsia Foundation.

You’re in danger of developing preeclampsia even after a healthy pregnancy and birth. Even after a planned C-section. Even if all went all after your recovery! And you can be in danger for it when you get pregnant again after a C-section.

The bottom line with blood pressure:

Reduce your stress and watch what you eat to keep it at a reasonable level. And if you do notice anything off about it, particularly if you ever have stomach pain, see spots, have swollen hands and feet, severe headaches, and shortness of breath all at once.

I realize some of these symptoms, like swollen feet, for example, are fairly common pregnancy symptoms. But edema (that’s what it’s called) isn’t a massive concern on its own. Coupled with the other symptoms, I just listed though, it is, and you should get immediate medical attention.

What to Know About Ectopic Pregnancy Post C-Section

You’re right to have concerns about ectopic pregnancy after having a C-section. This is when your fertilized egg attaches somewhere else instead of in your uterus. Please don’t stress out too much but it is more likely to occur in those that have a C-section for their first child than not. You’re also more at risk if you’re between 35 and 44 years old.

One study found that women that have a C-section have a more substantial risk for ectopic pregnancies or stillbirths in the second pregnancy. This risk is not very large overall, but it becomes more significant with every consequent C-section you have. It could be due to scar tissue forming in that area which can keep your fertilized egg from getting to your uterus where it needs to go.

This should all be taken with a grain of salt though as C-section births have risen over the years too. The Center for Disease Control and Prevention (CDC) found that C-section rates have gone up. From 1996 to 2009, it went from 20.7% to 32.9%. The last year of data it shows is 2017 at 32%.

With C-sections becoming more regular, the data may seem like it’s a larger chance for ectopic pregnancy, but the possibilities haven’t grown. It’s only the number of people having C-sections that have. In other good news, that same research team didn’t find an increase in miscarriage rate in a second pregnancy after a C-section.

How do you know if you might have an ectopic pregnancy?

The symptoms generally include sharp pains that come in waves to your abdominal area, which may also radiate through your pelvis, neck, and shoulders too. Your concern level should rise if you feel severe pain on any one side of your abdomen, discover vaginal spotting or heavy bleeding, you feel dizzy or even faint, and if you have any rectal pressure.

If you KNOW, you are pregnant, and you experience these symptoms, get immediate medical treatment. If you’ve been trying to get pregnant and aren’t sure you are yet (perhaps it’s only been a few weeks), contact your doctor and report these symptoms at once.

Chances of Pregnancy After a Tubal Ligation During a C-Section

It’s not very common to get pregnant after getting a tubal ligation during your C-section, but it’s still possible. Your chances of an ectopic pregnancy are also higher in this instance, but again, this is still pretty rare.

So worrying for nothing is not a good idea. If you have had a tubal ligation and you feel cramps or something else amiss, it’s wise to schedule an appointment with your doctor to check it out.

You shouldn’t get a tubal ligation during your C-section unless you are 100% sure you don’t want more children or if your doctor has advised you because you are at extreme risk of danger for any future pregnancies. You can get it reversed, but there is a pretty good risk that you still might not get pregnant again.

Many women choose to do it while they’re already going to be on the operating table. You don’t need to though. If you’re not sure, you can always do it later on, even months after your delivery. Talk it out with your doctor, though if the risks to your health or a future baby’s health are so extreme with another pregnancy, it might be best to take care of it immediately to prevent serious complications.

Other Pregnancy After C-Section Pains to Know

There are a few more things I want to touch on to help you get comfortable with pregnancy after a C-section.

Hip pain

Treat hip problem!

Often caused by your baby’s head pushing down on those front bones in your pelvis, your doctor may call it separated pubic symphysis. It can be painful and last for a few months after pregnancy, and it may become an issue during your next pregnancy after C-section. Your doctor may recommend physical therapy, massage, certain pillows, rest, and girdles.

If you’re feeling pain in the hips or pelvis, it’s nothing to worry about though talking with your doctor can give you some relief.

Tailbone problems

Your tailbone, also known as the coccyx, is at the end of your spine. For most women, there is no issue here though if your baby hits at the wrong angle, it can leave you bruised there, or in extremely rare cases, become fractured.

The pain can be intolerable when you sit, stand for too long, go to the bathroom, or during sex. If you feel this type of pain, talk to your doctor about how to ease the pain. Heating packs or ice packs can help. Pillows when sitting are also lovely. Try the ones with a hole in the tailbone area. You can use that for hemorrhoids too (more on those in a second).

Hemorrhoids

Hemorrhoids happen when the veins in your rectum swell up. And boy, do they hurt! I didn’t experience them during my first pregnancy. During and after my second pregnancy and C-section, I did. And even to this day, I still sometimes get them.

This can be attributed to the disruption in your abdominal and bowel areas from C-section surgeries. But it’s important to note that even your friends who delivery vaginally will suffer from them too. If you want to avoid them as much as possible, eat clean and drink plenty of water.

I find that when I slack off on eating right and don’t get enough fruits and vegetables, it makes me constipated. That, in turn, leads to harder poop which can irritate those sensitive rectal walls.

If you have hemorrhoids, you can use topical creams and those pads to relieve your butt. Trust me, they work, and you’ll feel tons better.

Sex

One thing that might help you avoid getting pregnant too soon after your c-section is sex itself. It hurts so much after a C-section. Even though you didn’t push anything out of there, the walls of your vagina become more sensitive. It will be like this for a few weeks. Eventually, you will feel better when you have sex, but in the beginning, once you feel that pain, you may make up excuses for your husband to avoid it.

Can C-Sections Make You Infertile?

According to research, C-sections do decrease your chances of fertility, BUT it’s a small effect. If you’re concerned at all about your fertility, you should most certainly have a conversation with your doctor.

Not all C-sections can be avoided, but look at how many of us go on to have more babies after we have one! In fact, we got pregnant with our second daughter on our first try. We didn’t know it at the time. We only figured it out after that pregnancy test and our resulting trip to visit her when she gave us a time frame for conception. We traced that back to the first day we tried.

So my advice, as long as you’re healthy and your doctor says it’s ok, go for it!

Does Cesarean Birth Affect Future Pregnancies?

For the last question I’ll answer, I’d like to go into more about why C-sections affect future pregnancies that have nothing to do with your fertility.

They have everything to do with your fear.

So you may feel wary about getting pregnant again after going through a C-section in the first place, especially if you had an emergency C-section like me. You may wait a few years like I did too. And then, one day you will look at the little toddler playing adorably with her toys on the floor and you are hit with the crazy idea of doing it all again.

Parenthood. It’s maddening, I tell you! I wouldn’t change it for the world, though.

Author

Leslie Berry lives with her husband and two young daughters in Los Altos, California where she loves helping other moms get comfortable with motherhood and embracing the insanity with facts peppered with laughs. She loves eating too much sushi, exercise, and jamming out on her Fender.

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