Ask An Expert: Conception After C-section

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Ask An Expert: Conception After C-section

Question:

I am 25 years old and have been pregnant twice. I had a C-section with my 19-month-old son. My husband and I have been trying to get pregnant for a year now with no success. I am healthier now then I was with my previous pregnancies. Could the C-section be affecting my ability to conceive? I know I have been ovulating regularly.

Answer:

Having had a first Caesarean section may affect future health, including future reproductive health, in many ways. Some potential effects are bad, others good. For example, some studies argue that women who have had a first Caesarean delivery may be at slightly higher risk for ectopic (tubal) pregnancies or miscarriage when they next conceive. Other studies suggest that Caesarean delivery may be protective against incontinence later in life.

Whether having had a C-section delivery is associated with difficulty becoming pregnant is uncertain, as different studies have produced different results. What is clear is that if cesarean delivery has such effects, the magnitude of the risk is small. Most women who have had Caesarean deliveries will not have trouble becoming pregnant, and when they become pregnant, they will have a healthy outcome.

Some evidence suggests that it is safest to wait nine to 12 months before conceiving after having had a C-section. If you have now been actively trying to become pregnant for 12 months, you should consider seeking the advice of a gynecologist or infertility specialist. Actively trying means you are timing sex to the midpoint of your menstrual cycle. This is when you are ovulating.

The fertility work-up will include evaluation of your partner's semen to check for sperm count and other features, your ovulation, and the health of your fallopian tubes and the lining of your uterus. Many couples find that as they are undergoing this evaluation, they get pregnant on their own. In some cases, more time and patience are all that is needed.

Jeffrey Ecker, M.D. is an Associate Professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics and Gynecology at Massachusetts General Hospital, where he practices maternal-fetal medicine.

Last updated:	April 11, 2007
Reviewed By:	Faculty of Harvard Medical School