With the continuous improvement of the social and economic level, the richness of human spiritual and material wealth, the past family planning policy has led to the current social structure of the population and its unreasonable, people’s concept of marriage and childbirth also changed, especially the implementation of China’s “separate second child” policy, how many families looking forward to this news finally rushed to the “last train” before the last ticket. The last ticket was obtained before the “last train”, resulting in a large number of elderly women who have the desire to have children again, but the eligible families have mixed feelings, the good policy, the opportunity can not be lost, but the worry is that the significant increase in pregnancy complications when the elderly women have another pregnancy and their own birth experience will have an impact on the mode of delivery of another pregnancy. The choice of the most favorable delivery method for the mother and fetus is important to reduce maternal and infant complications and improve perinatal health care. In the past two decades, China has experienced and is experiencing an increase in the rate of cesarean delivery, and since the implementation of the “separate two-child” policy, women whose first pregnancy was delivered by cesarean section have become scarred uteruses, which has increased the phenomenon of incisional pregnancy. The risk of bleeding or uterine rupture in the early stages of pregnancy is very high. In the early stages of pregnancy, only an experienced doctor can detect the abnormality through ultrasound examination, so early diagnosis and treatment are especially important. After cesarean section, the uterine scar is replaced by fibrous tissue, which is much less stretchable than muscle and lacks elasticity, and as the uterus increases in the process of another pregnancy these tissues are stretched and may cause localized philtrum and even rupture and bleeding; moreover, there are relatively more serious complications such as placenta praevia, placenta implantation growth and invasion, etc. Currently, postpartum hemorrhage is caused by factors such as aggressive placenta praevia in the clinic It is not uncommon to have resuscitation, and some of them even end up undergoing total hysterectomy. For such women with scarred uterus, the first choice is to perform a term cesarean section after checking the gestational week before delivery; for women with signs of labor and indications of previous cesarean section, emergency cesarean section should be performed. There is another group of women who have a history of uterine fibroid surgery after vaginal delivery in their first pregnancy and before having another baby, they need to understand the location and type of fibroids, the way of removal, the presence of secondary infection after surgery, and the status of uterine recovery. If you are trying to give birth vaginally, you need to be evaluated by a senior asset physician to score the scarred uterus, but the health of the mother and baby is a prerequisite! At the same time, “advanced age” also increases the probability of pregnancy complications and complications to some extent. Pregnant women over 35 years of age are more likely to suffer from pregnancy-related heart disease, diabetes mellitus, gestational hypertension, preeclampsia and eclampsia, cholestasis during pregnancy, and other comorbidities; they are at a significantly higher risk of cardiopulmonary decompensation, chronic heart failure, excessive amniotic fluid, large fetus, fetal growth restriction, intrauterine distress, eclampsia convulsions, HEELP syndrome, postpartum hemorrhage, obstructed labor, and other complications. The risk of postpartum hemorrhage, obstructed labor and other complications is also significantly higher; for those who have these comorbidities or complications, regardless of whether the first pregnancy is delivered vaginally or by cesarean section, cesarean section is the preferred delivery method to improve the quality of birth and reduce maternal and fetal morbidity and mortality. Therefore, for senior women, having a second child is both a joy and a challenge. When we welcome a second baby with hope, please choose a reasonable and safe delivery method carefully.