A caesarean section is needed in about 10 to 15% of births to save lives.  Your midwife or obstetrician will talk to you after your caesarean birth. You can use this general information about planning for your next pregnancy and birth. For most women a vaginal birth is safe for your next pregnancy. Start a conversation with your family, your doctor (GP), midwife or obstetrician. 

Caesarean section increases risk in future pregnancies: 

These risks can be: 

• Miscarriage 
• Preterm birth
• Your placenta implanting too low (placenta praevia) or to deeply in your uterus (placenta accreta) 
• The scar on your uterus coming apart (uterine rupture) during your next pregnancy or birth

Things that can reduce your risk: 

• Have an 18-month (1 and a half years) gap between your last birth and falling pregnant (conceiving). 
• Work towards a healthy weight for you 

Other things to think about and talk to your midwife or obstetrician about: 

• How many pregnancies you plan on having 
• Your age 
• Your weight 
• The reason for your last caesarean birth 

Next birth after Caesarean section: 

Vaginal birth after caesarean (VBAC): 

• If your labour starts spontaneously a vaginal birth is more achievable 
• a vaginal birth shortens your recovery time 
• Improved long term health of your baby 
• There is a small chance of uterine tear or rupture 
• The induction of labour (IOL) makes the risk of uterine rupture higher and increases the risk of having an emergency caesarean

Elective repeat caesarean section (ERCS):

• Uterine rupture risk is smaller 
• There is an increased risk of infection 
• Anaesthetic risks 
• You will have a longer recovery time 
• There is an increased risk of blood clots in your legs (e.g., DVT - deep vein thrombosis) 
• Increased risk of problems with how your placenta implants (placenta praevia or placenta accreta) in your next pregnancy 
• Babies have an increased risk of breathing problems 

Emergency caesarean section (EmCS): 

• Have the same risks as a planned caesarean section plus 
• Increased blood loss needing a blood transfusion

Support for your next pregnancy and birth after caesarean section: 

• There are many online support groups for your next pregnancy and birth after caesarean birth 
• Ask if there is a group or clinic in your local hospital supporting women for next pregnancy and birth after caesarean birth 

Relevant Articles: 

• Home Page - Every Week Counts
• Contraception | Family Planning NSW
• Placenta praevia, placenta accreta and vasa praevia | RCOG
• VBAC: vaginal birth after caesarean | Raising Children Network
• Caesarean birth: planned & unplanned | Raising Children Network
• birth-after-caesarean-english.PDF
• Pregnancy Risk Assessment Survey - SWS LHD

References: 

• Ahrens, K. A., Nelson, H., Stidd, R. L., Moskosky, S., & Hutcheon, J. A. (2019). Short interpregnancy intervals and adverse perinatal outcomes in high‐resource settings: an updated systematic review. Paediatric and perinatal epidemiology, 33(1), O25-O47. 

• Dekker, G. A., Chan, A., Luke, C. G., Priest, K., Riley, M., Halliday, J., ... & Cornes, S. (2010). Risk of uterine rupture in Australian women attempting vaginal birth after one prior caesarean section: a retrospective population‐based cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 117(11), 1358-1365. 

• Farquhar, C. M., Li, Z., Lensen, S., McLintock, C., Pollock, W., Peek, M. J., ... & Sullivan, E. (2017). Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control study. BMJ open, 7(10), e017713. 

• Hutcheon, J. A., Nelson, H. D., Stidd, R., Moskosky, S., & Ahrens, K. A. (2019). Short interpregnancy intervals and adverse maternal outcomes in high‐resource settings: an updated systematic review. Paediatric and perinatal epidemiology, 33(1), O48-O59. 

• Keag OE, Norman JE, Stock SJ. Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis. PLoS Med. 2018 Jan 23;15(1):e1002494. doi: 10.1371/journal.pmed.1002494. PMID: 29360829; PMCID: PMC5779640. 

• Vandenberghe, G., Bloemenkamp, K., Berlage, S., Colmorn, L., Deneux‐Tharaux, C., Gissler, M., ... & INOSS (the International Network of Obstetric Survey Systems). (2019). The International Network of Obstetric Survey Systems study of uterine rupture: a descriptive multi‐country population‐based study. BJOG: An International Journal of Obstetrics & Gynaecology, 126(3), 370-381. 

• Wendt, A., Gibbs, C. M., Peters, S., & Hogue, C. J. (2012). Impact of increasing inter‐pregnancy interval on maternal and infant health. Paediatric and perinatal epidemiology, 26, 239-258. 

• WHO Statement on caesarean section rates: World Health Organization Human Reproduction Programme, 10 April 2015. (2015). Reproductive Health Matters, 23(45), 149–150. https://doi.org/10.1016/j.rhm.2015.07.007