How Long Should I Wait Between C-Section And VBAC?

Many women wonder how long they should wait between c-section and VBAC (vaginal birth after c-section) for their next pregnancy.

If you have had a c-section, the period of time you need to wait before your next pregnancy is up to you.

Most care providers recommend waiting at least 6 months, preferably 12 months, before becoming pregnant again after a c-section.

How Long Should I Wait Between C-Section And VBAC?

This is the advice commonly give to all women, regardless of how they previously birthed.

The World Health Organization recommends the mother should ideally leave a gap of 24 months between pregnancies to “reduce the risk of adverse maternal, perinatal and infant outcomes”.

However, this might not be practical or align with your preferences.

To help you decide what’s best for you, here are 3 reasons why it is recommended you wait at least 12 months between a c-section and a VBAC:

Reason #1: Uterine Scar Problems

The main concern about becoming pregnant soon after a c-section is it might not allow enough time for the uterine scar to heal. Waiting lessens the risk of rupture during pregnancy or labour.

After a c-section there are several layers to heal. The skin incision usually heals within the first two weeks. The uterine incision takes about 12 weeks to heal completely. Scar tissue forms and the main concern is the area might be weaker than the surrounding tissue.

Studies suggest the risk of uterine rupture is higher if you fall pregnant within 18 months of a previous c-section, but the overall risk is still less than 1%.

Fertility returns at about 2 months after birth. If conception happens then, it will be at least 12 weeks after the c-section before the uterus begins to expand. Although some women report feeling an internal ‘itching’ as their scar stretches, the gentle expansion is unlikely to cause the scar to rupture. Birth is unlikely to happen until 12 months after the previous c-section.

When women choose to have a VBAC their care providers counsel them about the risks of uterine scar rupture during labour. Although this is very rare, it can be life threatening for babies, putting them at risk of oxygen deprivation.

This is a frightening thought, but the risk of your baby dying from oxygen deprivation during a VBAC is very small – about the same risk as for a woman who is having her first baby.

Your care provider will most likely monitor you and your baby carefully during labour for signs of possible uterine rupture.

Reason #2: Recovery

Pregnancy takes a huge toll on a woman’s body. For nine months, most of her physical resources are focused on maintaining the perfect conditions for pregnancy and growing her baby.

Depending on her nutritional state before conception, a mother might begin her next pregnancy already depleted in certain nutrients, such as iron.

Women who have c-sections lose twice as much blood, on average, as those who birth vaginally, meaning they might be more at risk for anaemia after pregnancy.

Even with the best intentions regarding diet and nutrient intake, the reality can be quite different.

This can affect your recovery after a c-section, particularly in terms of how well your scar heals and how your body recovers from major surgery. If you add the ongoing depletion while you are breastfeeding, there is an increased chance your health status will affect your success of having a VBAC.

Always allow time to restock your nutrient reserves, and be gentle on yourself physically. This will help you to have more energy and heal better, in preparation for your next pregnancy and birth. You are more likely to be stronger and healthier when trying for a VBAC.

Reason #3: Placenta Problems

Having a c-section increases the risk of problems with your placenta in your next pregnancy. Although risks remain low, they appear to increase when there is a smaller interval of time between pregnancies. These risks will potentially affect your chances of a successful VBAC.

One of the problems is placenta previa. This is when the placenta attaches to the lower part of the uterine wall, either partially or completely covering the cervix. This can lead to preterm labour or the need for a repeat c-section.

Another is placental abruption, which is when the placenta partially or completely peels away from the uterine wall. This is a serious complication, which can mean preterm birth, growth problems for the baby, and severe blood loss for the mother.

Although there are definite advantages to wait between a c-section and VBAC, the important thing to remember is there is no hard and fast rule.

If you’re not already pregnant and want to have a VBAC, it’s recommended you allow at least 12 months before conceiving again. This will give your body time to heal and allow you to build up your reserves.

Older women might feel they don’t have so much time to delay. Arrange to talk with your care provider about the slight potential for complications that come from a short pregnancy interval after a c-section, as opposed to the increase in risks that come with your age.

If you’re already pregnant within a year after a c-section, talk to your care provider about the best way to optimise your chances for a successful VBAC.