Reproductive health experts have warned that conceiving six months after undergoing a Caesarean section is dangerous and can cause serious health problems, Punch HealthWise reports.
According to the physicians, what many couples interpret as delayed conception after CS is usually medically-based advice for women not to get pregnant too early to safeguard against uterine rupture.
Based on MSD Manual, an online platform for gynaecology and obstetrics, uterine rupture is the spontaneous tearing of the uterus that could result in the foetus being expelled into the peritoneal cavity.
It explained that the condition is rare and can happen during late pregnancy or active labour, and occurs often along healed scar lines in women who have had prior caesarean deliveries.
The experts, Dr. Joy Agbara, a consultant Obstetrician and Gynecologist at the Lagos State University Teaching Hospital, Ikeja; and Dr. Adeyemi Okunowo, a consultant Obstetrician and Gynaecologists at the Lagos University Teaching Hospital, Idi-Araba, said women are usually advised to wait for at least two years after CS before conceiving, to allow for the scar to heal effectively.
According to Dr. Agbara, women who had especially their first child through CS are advised to wait between 15 to 24 months before embarking on another pregnancy.
“This is for their wellbeing and that of the child,” she said.
However, the expert said the timing might vary, as reproductive experts could decide on different waiting time. She explained:
“Some say the wait between the last delivery and the next delivery should not be less than 15 months; while others may say the time between the last delivery and the next conception should not be less than 12 months.
“But in all, what we advise is that women should wait for at least two years.
“The essence of asking a woman to wait a while before conceiving is to allow the scar to heal, especially for a woman who is just having her first child.
“This is so because, with CS, you are making a cut or incision on a woman’s abdomen and the uterus. Time should be allowed for proper healing so that the integrity of the scar is there. A clean wound, like that of a CS done as an elective, with all things being equal, is expected to heal within one to three months.
“If some people have a cut, it will heal neatly. Some might have minor scars, while for others, it might advance to keloid.”
The consultant noted that there are underlying factors that can impair a patient’s healing after CS or determine how fine the scar will heal. She added:
“The physical state of a patient matters after undergoing such major surgery. If the patient is malnourished, anaemic or has an infection, we urge them to wait in order to build up bodily cells, iron store and others.”
Dr. Agbara dismissed the belief that once a woman delivers through CS, subsequent childbirths will be through the same process, adding,
“If the indication for the surgery is not a recurrent one, all things being equal, she can be given a chance at trying vaginal delivery.
“A woman that had CS and the one that delivered vaginally have equal chances at conceiving. However, one major determinant is the integrity of the scar – it must be good.”
Dr. Agbara, however, said as much as CS cannot stop a woman from getting pregnant, certain situations surrounding the surgery could.
“The event that happens before and after surgery is very important and could determine the outcome of a future pregnancy.
“If, during labour, there was infection somewhere, it could counter the outcome of conception following the surgery.
“The infection can affect the lining of the womb up to the fallopian tubes. So, sometimes, they might have adhesion formation sites in the womb. The adhesion could also form outside the womb.
“In that instance, it might not just be about difficulty in getting pregnant, depending on what the problem is, she might have difficulty having her menses resume. In a situation where there is menses, it could be scanty and conception could still be difficult.”
Dr. Agbara urged people to stop referring to CS as abnormal childbirth procedure, noting that there are indications for the surgery.
Also speaking, consultant Obstetrician and Gynecologist, Dr. Okunowo, said CS can not affect a woman’s chance of conceiving, noting that aside from making an incision to bring out the baby, it is not different from vaginal delivery.
He warned that a woman that conceives six months after undergoing a CS stands the danger of having a ruptured uterus. The consultant said:
“That is why there should be a minimum of two years between deliveries. That means before a woman can decide to get pregnant again, it must be at least one year after the surgery, so that the time between the last CS and the next will be two years.
“It is important for those layers that were cut to heal properly. This is so it won’t rupture as it expands as the baby grows.”
Corroborating Dr. Agbara that certain factors could impede conception, Okunowo said if a CS is complicated by post-delivery infection in the abdominal cavity, it can create situations capable of reducing the chances of conception. Okunowo added:
“Just like a woman having a pelvic inflammatory disease, any infection in the abdominal cavity that can affect the patency of the fallopian tubes can reduce a woman’s chance of getting pregnant with ease.
“Even after having vaginal birth and infection sets in, it can affect conception, as the womb could stick together in such a way that the linings of the womb are not open.”