How long should I wait to get pregnant after a C-section?

You will need to give your body time to recover from a C-section, which is major surgery. While it may be tempting to start trying again after you clear your six-week checkup, your doctor or midwife may well advise you to wait. That’s because there can be complications next time around if you don’t give your body time to heal. That’s the case for sure if you want to try for a VBAC (vaginal birth after cesarean) with your second pregnancy (or third, fourth or fifth!). Making sure the scar on your womb is fully healed is a vital part of keeping you safe and healthy.

Pregnancy after C-section

The usual advice is that you should wait a year after a cesarean section, before a second pregnancy. The longer your scar has to heal, the better, especially if you want a vaginal birth next time around. At the very least, you should give your body a rest of six months before trying to conceive again. A VBAC (vaginal birth after cesarean), is not advised if it has been less than 18 months between births (PHAC 2019). The World Health Organization goes so far as to tell people to wait two years between pregnancies, for full recovery, no matter how you deliver your baby (WHO 2006).

In most cesarean sections, a cut is made into your belly and uterus (womb), just along the top of your pubic hair. It's called a bikini cut. It can take four weeks or more after your baby's birth for a C-section cut to heal, and you may have a bit of pain for a year or longer after the surgery (HealthLink BC 2021).

But the longer it's left, the stronger the heal will be. And a strong heal may cause fewer problems over time. This may matter to you most if you want to try for a vaginal birth or VBAC (pronounced veeback) next time around.

Are there risks with having a second pregnancy so close?

There is a very low risk of your cesarean scar tearing with VBAC. This is called uterine rupture. This risk is much higher if you’ve had a high vertical incision, which is where the muscles in the upper part of your uterus are cut up and down through. In fact, if you had this type of cut, you will not be able to have a VBAC. Your doctor will be able to confirm whether this applies to you. It is not something you can tell from the look of your scar. Even though the overall risk of your scar tearing is low, it is slightly more likely if there is a short gap between your pregnancies (PHAC 2019).

A short gap can also increase the chance that you'll have problems with your placenta. These may include placenta previa, or the placenta separating from your uterus wall, known as placental abruption (Hutcheon et al 2019).

This may sound scary, but the risks of rupture and problems with the placenta are still very small (SOGC nd). Most people who have a smaller gap between pregnancies have no problems at all during a VBAC. You may have trouble finding a doctor or midwife who will support this option if there is a short gap between pregnancies.

Are there any benefits to waiting to get pregnant soon after a C-section?

There are other reasons to wait for longer between babies, whether you've had a cesarean or not. Read our article on age gaps between siblings to find out more.

More than a quarter of all births in Canada are by cesarean section (CIHI 2022). Many people don't know how long it takes to recover. You will likely feel tired and very sore afterwards. It can take months to get back to your day-to-day activities. So giving yourself a really good rest after your first cesarean can only be good for you and your next baby.