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Getting pregnant again after a caesarean

Many women who have had a caesarean birth have vaginal births afterwards. This is called vaginal birth after caesarean (VBAC) and is a safe option for many women.

If you need a caesarean birth again, consider the size of the family you wish to have. Having more than 3 caesarean sections increases your risk of complications. Scar tissue can make the operation more difficult.

Read more about birth options after a caesarean

Complications after more than 3 caesareans

Having more than 3 caesarean births can lead to complications. These may include damage to your bowel or bladder. In rare cases, there can be damage to your ureter (the tube connecting your kidney to your bladder).

You may have a higher risk of bleeding. If you have severe bleeding, you might need a blood transfusion or in rare cases a hysterectomy (removing your womb).

Placenta problems

You may have problems with the placenta, such as placenta accreta. This is when the placenta attaches itself to the old caesarean scar in your womb.

Placenta accreta makes the placenta difficult to remove during the birth. In some cases, a hysterectomy (removal of the womb) is needed to remove the placenta. If you are diagnosed with it during your pregnancy, a caesarean will often take place a month or more before the due date.

Your baby is likely to need to be cared for in a special baby unit. You will sometimes need blood transfusions. You may receive some of your care in an intensive care unit (ICU).

If you have had a caesarean birth before, you'll have a scan in the second or third trimesters to check the position of the placenta.

Ask your doctor about placenta problems. It is very important that placenta accreta or placenta praevia (low-lying placenta) are diagnosed early so that plans can be made to deal with it.

Tubal ligation

If you do not want any more children, you can discuss having your tubes tied at the time of the caesarean birth.

This is something to consider if your family is complete and you're having your third or more caesarean section.

You'll need to have a discussion with the doctor and sign a consent form. The procedure is usually permanent and irreversible. But it has a very small failure rate. It is done at the end of the caesarean section and takes a few minutes extra to do it.

The doctor will remove most of both fallopian tubes. This can also reduce the risk of ovarian cancer when you're older.

The tubal ligation adds a small amount of risk to the caesarean. A tubal ligation is a planned procedure. It is generally not an option with urgent or emergency caesarean sections.

Read more about female sterilisation

Read more about the risks of having a caesarean

Page last reviewed: 9 December 2021
Next review due: 9 December 2024

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 8.