The “separate second child” (a second child can be born if one of the spouses is an only child) policy, which has been delayed for several years, has finally come to fruition. The sudden relaxation of the policy has made many “separate” families happy, but also unprepared for a series of health questions about having a second child. “The first one is the first one to be born. “If I had a C-section with my first child, will I have to have a C-section with my second child?” “How long should I go between my first child and the birth of my second?” Indeed, the policy conditions are in place, but are the mothers physically ready? This is a question that needs to be studied and learned. Two types of issues are of most concern: cesarean delivery and advanced age. Recently, some people who are going to have their second child came to the hospital clinic for consultation, and we can clearly feel the change after the relaxation of the policy, which we hardly ever met in the past, because the good news came suddenly and people lacked preparation. To sum up the problems of the consultants, they can be roughly divided into two categories: women who are worried about their age and the danger of giving birth at an advanced age, and women who are in the normal childbearing age range but had their first child by cesarean section, and wonder whether they must also have a cesarean section for their second child. China’s family planning policy has been implemented for more than 30 years, the first batch of only children are now 33 or 34 years old, if they are women who have just given birth to a child and had a cesarean section, according to the health standards of the best interval between the two children more than 2, most of them have their second child at an age of more than 35 years old, they are at an advanced age. The cesarean section, folk say, the first production is cesarean, the next regeneration can only be cesarean, you see the Taiwan actress S, three children are cesarean out. Of course, there are also some women who have had normal births and come to consult with the routine contents, such as endocrine checks, ovulation monitoring, etc. They are naturally in a more relaxed mood than women who have had a cesarean section. The first cesarean delivery of the second child faces the risk of hemorrhage from the scarred uterus “I heard that the first child was not born in the normal way, and it is not possible to give birth in the normal way afterwards, because I am afraid that the scarred area cannot withstand the impact, is that so?” Xiao Jia is a mother of a two-year-old child, she is very concerned about whether she can have a normal birth again. She was prepared for a normal delivery when she was pregnant with her first child, but at 8.5 months, the baby’s umbilical cord was wrapped around her belly for three weeks and her fetal heart became weak, so in order to avoid fetal asphyxia, the doctor decided to have a cesarean section immediately. Around us, we can find a lot of young mothers like Xiao Jia who had a cesarean section. “It is true that the rate of cesarean section is higher now, the general statistics of the hospital’s obstetrics and gynecology department is about 30%, and in large tertiary hospitals, this figure is even higher, because there are more critically pregnant women admitted here, and most cases must be cesarean.” So there are many people who are concerned about whether they will still have to have a C-section for their second child. “If you have a cesarean section for your first child, you have to have a cesarean section for your second child.” This is not absolute, but cesarean sections do face the risk of scarred uterine pregnancy. The medical definition of cesarean scar pregnancy is “pregnancy in the scar of the isthmus after cesarean section of the lower uterus”, which is a rare and special ectopic pregnancy, but in recent years, with the rise of cesarean section rate, its incidence is on the rise. Let’s understand this pregnancy in layman’s terms. For aesthetic reasons, today’s cesarean incision is usually chosen in the lower part of the uterus, about the edge of our pants, so it is also called a bikini incision. If a fertilized egg happens to fall on the post-cesarean uterine scar, it is a cesarean uterine scar pregnancy. It is now recognized that uterine scar pregnancy is an ectopic pregnancy located outside the body cavity of the uterus. Because of the weak muscle wall and fibrous tissue in the cesarean scar, it is prone to serious complications such as uterine rupture and hemorrhage after pregnancy here, which endangers the life of the patient. Regular ultrasound to check for scarred uterus “Last week we just rescued a patient with a scarred uterus who had a hemorrhage, her life was saved, but her uterus had to be removed, fortunately the baby was removed in time by cesarean section, and the little one was healthy”, this female patient was in a special situation, she had a central placenta praevia combined with placental implantation, the placenta was directly The risk of death is particularly high, and her bleeding amounted to 7,500 ml at the time. However, there are still a few cases like this that are particularly serious, and most mothers can still have their second child with the help of doctors. To avoid a scarred uterus pregnancy, it is important to have regular ultrasound examinations after pregnancy to see if the gestational sac lays close to the scarred area. As the fetus grows, the position of the distance from the scar changes and is not fixed in one place. If you can move further and further away from the scar or keep a certain position with it, you can give birth without worry. In case of central placenta praevia combined with placental implantation as described above, doctors usually recommend early termination of pregnancy, otherwise the uterus will rupture and hemorrhage at any time, and the life of the baby will be threatened if the fetal blood supply is insufficient and the fetal heart drops. The best thing to do is to wait a year and a half before getting pregnant. Overall, the prime time to have a child is generally between the ages of 25-29. If a mother is planning to conceive a second child it is best to consider being under the age of 35 because the health risks such as gestational diabetes and hypertension are significantly higher after the age of 35 for both the mother and the baby than for those who are 35 years old. It also addresses the concern about the interval between the two babies. If the first baby was born by cesarean section, it is recommended to have the second baby two years later. The reason is that after a cesarean section, the uterine incision gradually grows and heals, and if you get pregnant too early it will lead to poor recovery of the endometrium, (embryonic implantation) forming the placenta, which can easily lead to placental implantation and uterine rupture. If the first baby is born in the normal way, theoretically it is possible to have a second child if the couple had sex during the first pregnancy for about six months after the normal menstrual flow. However, from the point of view of eugenics and breastfeeding common sense, if the first child is being exclusively breastfed, it is recommended to delay the birth of the second child by 0-2 years. Therefore, it is recommended that mothers with normal births prepare for their second child after one and a half years. Another question that is both medical and private is “Will the vagina be more lax if I have another normal birth, which will affect my normal married life, and how to remedy it?” With the development of the society, the concept of the country has changed, and it is no longer as taboo to talk about sexual happiness as it was in the past, and more and more women who have given birth are asking related questions. The vagina will be dilated and relaxed due to the pressure of the fetus and the squeezing during the delivery, but it will return in about a month. There is a solution for this – pelvic floor exercises, including anal lift and equipment, which are very popular abroad and have some effect on laxity. If you are eligible for a vaginal birth after a cesarean section, you can consider a vaginal birth for your second child. If you had a cesarean delivery with your first child and one of the following conditions occurs while you are pregnant with your second child, then you may still need to choose a cesarean: 1. If the indications for your first cesarean delivery are still present, such as pelvic stenosis, cephalopelvic disproportion, fetal malposition, soft birth canal malformation or stenosis, and medical and surgical comorbidities, such as heart disease. 2. You have serious obstetric complications in your second pregnancy, such as intrauterine distress, placental abruption, etc., which are not suitable for vaginal delivery. 3, you have problems with the fetal baby in your second pregnancy, such as intrauterine hypoxia, multiple pregnancy, intrauterine infection, oversized fetus, etc. 4.The uterine incision of your last caesarean section is not healing well, such as uneven thickness of the uterine incision, too thin at the incision sore, hard crack or rupture of the uterine incision, or the first surgical incision is a longitudinal uterine incision, ⊥-shaped incision or serious laceration of the uterine incision and repair surgery, etc. 5, your second pregnancy in vaginal delivery during the trial of labor if the progress of labor is not smooth, or there is fetal hypoxia, there is a uterine incision suspected (or has been) hard rupture, the need for emergency cesarean section. In other words, if you do not have any of the five conditions listed above, you can have a normal delivery.