The “second child liberalization” policy is a “sudden” good news for many people, and for many of the mothers who have already given birth to a child, they will face many challenges in giving birth again. There has been a lot of news on the internet and in the circle of friends recently: whether there are elderly people to help take care of the child, whether there is enough financial support, whether the “older child” is ready to accept a younger sibling ……
The most important thing is to make sure that your body is ready. The actual fact is that you can find a lot of people who have been in the clinic and have asked me a lot of questions about this, so I hope this will help you.
1.What are the risks of having a second child after having a cesarean section for the first child, and when can I have a second child?
Many women have to accept the doctor’s recommendation to have a cesarean delivery because of obstetric problems such as fetal malposition when they have their first child, and many women ask for a cesarean delivery despite the doctor’s objection because they are psychologically afraid of pain. Whether you passively accept the doctor’s recommendation or actively request a C-section, you will face a difficult medical problem when you get pregnant again: scarred uterus pregnancy.
The scar on your body is not only the long scar on your stomach, but also the scar on your uterus, which is medically called “scarred uterus”. There was a time when the cesarean rate in our country was as high as 50% for various reasons, and in recent years obstetricians and gynecologists have had to deal with more and more pregnancies with scarred uterus.
2. What are the risks of having another pregnancy with a scarred uterus?
(1) Early pregnancy risk: the tiny embryo cannot artificially choose its location when it is implanted, it can be planted anywhere in the uterine cavity, and if the embryo is planted in the uterine scar, then it is a scar pregnancy, which is a very dangerous situation. Due to the lack of elasticity of the scar tissue, as the embryo grows and the scar cannot grow and provide nutrition with it, the uterus may rupture and hemorrhage endangering the mother’s life. At this time, early detection is needed to go to the hospital and terminate the pregnancy with the help of a gynecologist.
(2) Risk in middle pregnancy: If your small embryo is smart enough to avoid the place of uterine scar for implantation, as the fetus and placenta grow up, some placenta may grow to the place of uterine scar, also because the scar tissue is weak and inelastic, at this time the placenta with vascular proliferation ability may implant in the myometrium of the scar or even penetrate the uterine wall. If the placenta cannot be delivered after the fetus is delivered, the uterus will not be able to contract and bleeding will continue, and the uterus may need to be removed to save the mother’s life.
(3) Risks in late pregnancy and delivery: Luckily your embryo and placenta are smart enough to be planted in the fertile soil of the uterus instead of the scar, so is it safe? Not necessarily! If you choose to try to deliver vaginally again, the strong uterine contractions after labor will put the weak scar of the uterus at risk of rupture; after the delivery is over the risk of postpartum bleeding will also be higher due to the poor contraction of the scarred uterus. Of course, in the hospital, doctors will avoid serious risks through professional examination and assessment and treatment, and most pregnant women will deliver safely.
Therefore, in order to reduce the risk of a second pregnancy with a scarred uterus, a singleton pregnancy is recommended. If assisted reproduction is necessary to help you conceive, your doctor will also recommend transferring one embryo to avoid multiple pregnancies.
3. What is the safer time to have a second pregnancy?
Many studies have shown that the elasticity of the scar tissue of the uterus is best two to three years after delivery, so it is recommended that mothers who have had a cesarean section with their first child and have plans for a second child can choose this time frame to get pregnant.
4.If I had a cesarean with my first child, do I have to have a cesarean with my second child?
Not necessarily! If you have not had a trial of labor with your first child, it is recommended that you have a regular checkup when you get pregnant again, and if your obstetrician fully evaluates your pelvis and fetal condition, you can consider a trial of labor if your situation allows it (no pelvis deformity, not a large fetus, and a huge baby of 8 pounds or more is an indication for a C-section). However, such a trial of labor for the second child is equivalent to the first child, and the duration of labor is the same as that for the first child.
If the first child has already had a trial of labor and the opening of the uterus has been opened wide, due to the slow fetal heartbeat, baby oxygen deficiency and other reasons to accept the doctor’s recommendation for cesarean delivery, then the birth can also be a trial of labor if the birth is normal; but if the first child is due to the failure of the trial of labor, pelvic narrow and other problems cesarean delivery, then the second child is recommended or cesarean delivery.
5.How can I try to conceive as soon as possible?
Under normal circumstances, women have one chance to ovulate in each menstrual cycle, and the fertilization ability of the egg can be maintained for 12 hours after ovulation. Normally, the sperm discharged by men after intercourse can survive outside the body for 72 hours. Therefore, the period from 3-4 days before to 1 day after ovulation is the fertile period. Some people can refer to this theory to arrange the time to try to conceive due to busy work or separation.
So is it easy to get pregnant if you don’t have intercourse for the whole month and wait for ovulation? Haha, you are wrong again. In fact, men’s sperm is produced continuously, if they do not ejaculate for a long time, then the sperm ejaculated will be mostly dead, which is often called “low viability”. This is why men are asked to go to the hospital for sperm checkups when they don’t discharge sperm for 3-5 days.
The best frequency of intercourse is 2-3 times a week, and it is not recommended to calculate ovulation intercourse because: first, the sperm viability is low if you do not have intercourse for a long time; second, many couples will be nervous when calculating ovulation, which is also not conducive to conception.
6.What do I need to pay attention to when I get older and get pregnant?
Both men and women, as age increases, fertility is declining, and women are more obvious. The women’s liberation movement gave women the same job opportunities as men, but did not free women from the task of producing offspring, although if science develops in the future, men can have children or have artificial wombs, then women will be completely free (haha, purely joking).
Age is an important factor related to fertility, and is a problem that no medical means can solve. (Haha, of course, if human fertility could be extended indefinitely, it would not be conducive to the replacement of the old with the new in society and would not be in line with evolutionary theory). Many data show that women’s fertility decreases significantly after the age of 35, and pregnant women after the age of 35 are also called “senior” pregnant women by obstetricians, and China’s maternal and child health law requires that pregnant women after the age of 35 be recommended to undergo prenatal amniocentesis to rule out fetal chromosomal abnormalities. Of course, many research data do not support this regulation, but at least it shows that as women get older, the chance of fetal chromosomal abnormalities increases due to the cumulative effects of exposure to adverse chemicals and radiation in the environment. A woman’s fertility is already low after the age of 40, and her chances of getting pregnant after the age of 45 are extremely slim.