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How soon after a caesarin delivery is it safe to be pregnant again?

Hi Kath,

Thank you for contacting the NCT. 

It is usually suggested to most women to wait a year before becoming pregnant again, however, this doesn't mean that some women don't become pregnant again sooner than this.  It is felt that this time period allows for the incision to heal fully before a subsequent pregnancy.

Our website, http://www.nct.org.uk/info-centre/decisions/view-40 gives information about VBAC (Vaginal Birth After Caesarean) and states "Research seems to show a small decrease in scar separation rates as the gap between pregnancies increases. However, the risks are tiny in all cases and most mothers who go on to have a small gap between pregnancies do not encounter problems."

This website may also be of use : www.caesarean.org.uk

Finally, NCT Shop stocks a book, Vaginal Birth After Caesarean which may be of interest if you are planning a vaginal birth, http://www.nctshop.co.uk/Vaginal-Birth-After-Caesarean-The-VBAC-Handbook-Helen-Churchill_Wendy-Savage/productinfo/1840/

Kath, I hope this is useful information.

Best wishes

Clare Charlton, Antenatal teacher

Hi there, I am breastfeeding my 5 week old and feeding her every four hours during the day and she goes six hours in the nights. Lately she seems to only want to feed every six to seven hours. I try to feed her at four hours but she only latches on for about 5 to 20 minutes and then falls asleep and refused to have any more (clenches mouth or cries when I try any more. I am worried that she won't be getting enough food. Any advice will be greatly appreciated. I have tried calling all the breastfeeding helplines and my health visitor but have had no answer.
Thank you,
Sarah

Hi, Sarah. Thanks for posting to NCT.

I can understand your concern about your baby's changed feeding. 

First thing is to encourage you to call the breastfeeding lines again - NCT's is always answered (bar rare technical hitches) and if you need to leave a message, you will always get a call back within an hour or so (again, bar technical hitches). I encourage  you to call your HV, too.

I'm suggesting you call, because there is more information I'd need to ask you before exploring the situation with you.  Your baby's general health, her weight, her behaviour up until now, and any breastfeeding 'history' you have had - all relevant information that would help you assess what might be going on.

 

I agree with you that this feeding pattern is unusual and concerning - it may be a short phase connected with nothing serious at all, of course, and things may be fine. On the other hand, four hourly feeds and six hours in the night for a 5 week old baby - what she was doing before this change - was unusual in itself. These feeds are quite infrequent - she was probably feeding no more than 5 times in 24 hours, which  can be normal for a baby who's piling on weight and doing well, but for some babies it's just not enough to maintain a good milk supply and a good intake. Feeding only six to seven hourly now could be a result of her trying to conserve energy - it is impossible to tell and I can only urge you to get a real-life opinion on what might be happening. 

 

I hope this helps, Sarah. 

 

Heather Neil

Hi
There seem to be great benefits to baby massage, but I want to know if I am to receive training in such techniques what qualifications should the instructor have? Are there any particular qualifications that are regarded as industry standard? What should I be looking for in the trainer or training? What insurance should they have?

Apologies I couldn't just ask one question. Thanks
Alex

Hi, Alex. We can't answer any of these questions, sorry. We don't run baby massage classes and we don't act as assessors or mediators for training schemes.

 

You could ask the organisation offering training how they assess, insure and otherwise quality control their trainers. 

 

all best wishes

 

Heather Neil

Hi, I have a baby boy who is 6 weeks old. He was breastfed for 5 days but has a mild tongue tie and we had a complete nightmare with latching and resorted to formula (Aptamil). Originally he was feeding quite well, however had lots of wind and often refused to burp, especially at night, resulting in him groaning, moaning and whimpering, usually from his 2/3am feed until his next one unless he was held upright. He also started refusing to take more than 1 or 2oz but still appeared hungry and my HV thought he may have silent reflux. She suggested changing to a comfort milk which was succesful at first then problem re-emerged after a few feeds. GP agreed it was reflux and prescribed Gaviscon, but he then refused to feed altogether until he was given Comfort milk again. Same problems, especially with wind (Infacol etc doesn't seem to help). I've now moved onto Dr Brown's bottles to try and help but after 3 good feeds he has dropped down to 2oz again, refuses more and is crying and obviously still hungry. The HV has been next to useless, saying it's my baby and I know what's best but I don't! He isn't exceptionally sicky and is gaining weight, albeit slowly, and usually has 1 or 2 poos but has never had a solid one like my daughter did. The nights are still just as bad and I have a toddler who is not yet 2. Any advice or pearls of wisdom would be greatly appreciated! Thank you.

Hi, Sarah. I can understand why this is upsetting and puzzling - and you've tried a few different routes to help your baby feel more comfortable. It's good he is gaining weight ok, which is an indication there is nothing major wrong with him, but it's miserable for him and for you to have this struggle every day.

We can't give medical advice at all, sorry, and all I can do is suggest you seek out a further, medical, opinion. Perhaps the GP would refer you to a paediatric dietitian? It's possible to prescribe specialist formulas for babies who appear to have trouble coping with standard formula  - perhaps this would be a route worth exploring.

 

I do hope you find some good help soon. 

 

Heather Neil

Hello, just wondering if you have any ideas or information about my current situation.

My son is now 3 weeks old, he is my second child. I have a daughter now 3 and half years.

Following a normal delivery of my son my milk did not come in ( i fed my daughter with no problems for about 5 months after she was born)acutaually no milk at all came that I see, my son went on to produce utrates in his nappies and lose over 10% of birth weight.

after 7 days I went for a scan and it was found that my uterus was still high and I had some small particals in my uterus - I was started on antibiotics. 4days after the antibiotics I started to see drops of milk when expressing. Although I was told to formula feed my boy I carried on putting him to the breast and expressing in hope my milk would start. Following seeing the milk I carried on nursing and having him with me at all times, sleeping with him, hot baths, expessing etc etc... milk supply did not change and I could only see the odd drops of milk. I have now started to use motherlove more milk to see if that would help but nothing.

Have you ever heard of anything like this, it has been such a shock as i had no problems with milk supply for my daughter. I have PCOS which I have read can affect supply but I think if this was a cause it would have affected my first pregnancy??? I had a ok pregnancy - suffered nasty headaches for about 2-3 months nothing came of this my blood pressure remained low and urine clear, i had the swine flu injection and did take clomid to help get pregnant - these are the only things different to my first pregnancy. Any information/advice would be great. Thanks

Hi, Elizabeth. Thanks for posting to NCT. I am sorry to read about the difficulties you've been having - you've done some sterling work keeping up your option to breastfeed, and it sounds as if you will be helped by some further medical input.

When you went for the scan at 7 days, did they see retained fragments of placenta? It's not clear from your post.  Retained fragments interfere with the production of breastmilk, and full production is compromised when this is not dealt with.  Can you speak to your GP or midwife about this?

Maintaining breastfeeding while problems are being sorted out means expressing/direct breastfeeding has to be done many times a day - at least 8 times in 24 hours (inc at night). Hard work and time consuming, but essential, to 'tell' your body to make the milk. 

 

Can you give our breastfeeding line a call 0330 330 0771? The counsellor you speak to will listen and help you work out ways to keep up breastfeeding and see if there is any other aspect that could throw some light on to the issue.... I do think the first thing to explore is the retained fragments, and then if that is ruled out as a problem now to move on to building up and maintaining your milk and concentrating on getting your baby and you to breastfeed 'direct'.

all best wishes

 

Heather Neil

I love breastfeeding my son-it's the best feeling in the world to me but since my son was 9 months old i tried to gradually ween him onto a beaker and now he is 14 months old and still no success! ive tried letting him experiment with the beaker independently to find out how it works for himself(with no pressure), ive tried feeding it to him myself but he will become very distressed very quickly, ive tried holding him closely as i do when i breastfeed, ive even tried putting it in with his toys. I wouldnt care less if i carried on breastfeeding until he is around two years old to be honest but i would like to know the prospect is that he will be able to feed himself too. PLEASE, PLEASE, PLEASE help!!!!!! please may you also subit a reply to jamitaylor89@aol.com as i dont know which one is my correct email address, thankyou.

Hello Jami and thanks for contacting us. You say you enjoy breastfeeding your son and are prepared to do that for as long as it takes. That's great. It sounds, too, as if your son is a happy and contented little toddler and is very happy to have his mum around. That too is great.

If I've understood you correctly your concern is that your son is not developing independent skills as quickly as you would like him too. I'm not sure if you have a target time when you need to have him feeding from a bottle. In other words I'm not clear if he *must* take a bottle/beaker because you are going back to work. That could alter the picture.

If it is true that your only concern is that he won't develop independent skills if he does not feed himself soon, it's unlikely. If nothing else, most toddlers are mimics and will copy what other people are doing eventually; if he has a cup whene everyone else is drinking from a cup then he may do the same. if he's in the company of other children he will probably want to do what they are doing. He may surprise you one day be demanding it if he has not got it.

 I hope this helps you Jami. If not feel free to ring one of use on the Breastfeeding Line 0300 330 0771.

Good luck.

Eithne Murray ,NCT breastfeeding counsellor

I love breastfeeding my son-it's the best feeling in the world to me but since my son was 9 months old i tried to gradually ween him onto a beaker and now he is 14 months old and still no success! ive tried letting him experiment with the beaker independently to find out how it works for himself(with no pressure), ive tried feeding it to him myself but he will become very distressed very quickly, ive tried holding him closely as i do when i breastfeed, ive even tried putting it in with his toys. I wouldnt care less if i carried on breastfeeding until he is around two years old to be honest but i would like to know the prospect is that he will be able to feed himself too. PLEASE, PLEASE, PLEASE help!!!!!!

Hi, Jami. Thanks for posting. I can understand that this feels frustrating and puzzling to you. You've already had some good ideas about encouraging your baby to have a beaker, and you're right to stop doing anything that causes him distress - that will just put him off more, as you know.

 

One option would be to stop all beaker 'experiments' for a couple of weeks and then try again with something completely different - a plastic cup, even a glass (a tough one), a beaker with a straw, an egg cup...anything novel and unfamiliar! Make a game out of it,  but stop if he looks bored or upset.  Try the same vessel yourself and let him take turns with you in sipping.

I hope some of these ideas will help you, Jami.

 

all best wishes

 

Heather Neil

Hi there,

I have a situation which is causing me some upset, it's to do with going into labour naturally versus induction which I feel I am being pressurised to do.

The first day of my last period was 2nd Sept 2009, my conception date was 23rd Sept 2009, my midwives now consider me to be overdue and want to induce the baby on Wed 23rd June.

I usually get about 6 periods a year so was surprised when I got pregnant so easily and have had a very normal, happy pregnancy to date. I would like to wait and let nature take it's course for inducing the baby into labour. I consider myself to be overdue on June 30th and would be happy to discuss induction if the baby hasn't arrived by that point.

How can I use information to stay calm and relaxed, given the pressure I am getting from the hospital to induce the baby this week?

I was hoping for a homebirth, but the cut-off point for that is June 24th. I went for a membrane sweep yesterday. the midwife said it was unsuccessful as even though she broke the uterine seal, she wasn't able to do the sweep as the cervix was long and closed on the inside (though soft and open on the outer side, which is positive). I wasn't too worried as I have yet to have any contractions which could thin and open the cervix. I was glad that the seal is now broken and was glad that I had cooperated with the midwife, it being Sunday, my cut-off point for homebirth is Thursday so I was keen to do anything to bring on labour, and have also gone for reflexology and craniosacral therapy, vigourous walks and plenty of relaxation and yoga.

However, I do feel disappointed. If I had known that dates would cause such an issue at this point, I would have told the midwives from the beginning that the first day of my last period was Sept 9th, not 2nd. Am feeling despondent, and pressurised, as well by family and friends asking "any sign of the baby yet".

I'm being treated the same as a woman with a regular cycle, when I have an irregular one and am 100% certain of my conception date.

My scan due date is June 11th and my due date according to a regular cycle is June 9th. I believe that my due date is June 16th and that term plus 14 is June 30th.

I'm a first-time mum, so any advice or support that you can provide would be greatly appreciated. I wasn't aware of the dating system when I got pregnant, I knew very little about pregnancy and birth to be honest. I did notice that I seemed to be about two weeks behind the stages as described in the maternity books etc the whole way through.

Now I feel like a failure and have been told by the hospital that I am putting my baby at risk by not going for the induction. Everybody keeps talking about the risks but I feel that no one has listened to me about what I think is happening, which is that my baby is perfectly normal and fine for the stage that he is at, and that I'll go into labour at the right time.

My BMI was 21 when I got pregnant, I have had normal blood pressure the whole way through, his heart beat has always been fine, I have been healthy and happy up to this point, have had very little swelling or discomfort and physically feel fantastic.

Obviously I am really disappointed by the situations occurring now. How can I accept it or what info can I use to discuss it with the hospital staff so that they will take my point of view on board or even listen to me? I don't have any background in medicine so don't feel very confident discussing it with them, so any statistics or information you could provide about dates would be greatly appreciated. I feel that staff, friends and family see me as a first-timer pregnant lady who's afraid of birth and is putting her baby at unnecessary risk. I need back-up info or reassurance from professionals, that I have a case for waiting to let nature take it's course.

Thanks,

Ruthe

Dear Ruthe,

It sounds as if the situation regarding your due date is causing you lots of anxiety. The NCT has an info page about "going past your due date" here, 
http://www.nct.org.uk/info-centre/information/view-91

It is up to the woman to choose "expectant" management of labour "Allowing labour to develop and progress under supervision without intervention, unless clinically indicated." i.e. a wait and see approach - or "active " management, which involves induction.  The expectant option should include ways to keep a check on the health of you and your baby. At any time during expectant management, you can decide that you wish to follow the path of induction, should you so wish.

You can see the National Institute for Health and Clinical Excellence (NICE)  guidelines for the induction of labour here http://www.nice.org.uk/nicemedia/live/12012/41255/41255.pdf

The www.homebirth.org.uk  website has support and info about homebirth, and a yahoo group for support from women who have been in challenging situations, regarding planning their home birth.

If you are having difficulty getting access to the choices that you want, you can contact a Supervisor of Midwives by phoning your local labour ward and asking to speak to the duty "supervisor of midwives". She should listen to you, and help put a plan in place to support midwives to provide appropriate care for your wishes; their role is described here in this leaflet for parents :

http://www.nmc-uk.org/Documents/Midwifery-booklets/Support-for-parents-2009.pdf

I hope you are soon able to find a plan of care that you are happy with, so that you can relax, and focus on having your new baby.

kind regards

Barbara

NCT antenatal teacher  

My son is 11 months and I have just weaned him off the breast. I have done it very gradually over a period of several weeks and so find I have very little milk left now and have pretty much stopped feeling the sensastion of my milk being "let down". My breasts are slightly full and lumpy however and I'm wondering what I do about that. Do I express a little or does it gradually disappear on its own?Any advice would eb much appreciated. Many thanks.

Hi, Sally. Thanks for posting to NCT.

 Milk in the breasts after stopping breastfeeding can take a while to disappear - unless you are in pain or you think the lumps are getting worse, you can safely allow nature to take its course. I am actually not sure what happens when we say the milk is re-absorbed but I can say pretty confidently that it does just go, it happens to everyone, and there is no need to actually do anything! 

 

all best wishes

 

Heather Neil

My 16 week baby is waking up 1-2 hourly throughout the night and needing to breast feed to settle. This is getting gradually worse and settling her is getting more difficult even after breastfeeding. During the day she's an angel, feeding 3-4hourly and having 2 to 3 hour to 2 hour naps in her cot. I've resorted to trying a bottle of formula last thing, trying water in the night instead (worked initially, not now), sending my husband (she freaked!), and I've now put her in her own room to see if I was waking her accidentally in the night. I'm not sure what to do! I'm finding it more and more difficult not getting any sleep. Do you have any suggestions?

Hello Cate. It sounds as if you’re exhausted with the regular waking and I get the impression  your baby had been settled well enough in the past at night and has become more unsettled recently. You seem to have tried various things. You’ve mentioned some of them.

I’m not sure whether you have tried another look at the daytime routine. If it’s feeding she’s looking for, as opposed to comfort, feeding her more often during the day might help. There are also ways of ensuring she takes fuller feeds in one particular ‘mealtime’. Breast compression is one of them.

As i don’t know what else you have tried, there may be other adjustments you can make, depending on what has happened until now.  You would probably find it helpful to talk to one of us in person on the breastfeeding Line 0300 330 0771

Thanks for contacting us Cate. I hope things sort themselves out for you.

Eithne

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