11 month age gap after EMCS. Any advice?

[snowcake]

I have a 2 year and a 2 1/2 months old dd, both delivered by CS. I have just found out I am pregnant again, after 2 very sozzled shags where we forgot contraception.

I must be 5 weeks along, so very early days but after the last CS I was told to wait 3-4 years to give my scar a break as it was about to rupture and couldn't cope with the contractions (I had tried for a VBAC). The doctor said I will definitely need another CS next time at 37 weeks to make sure I do not go into labour or it could harm me and the baby if the scar tears.

My Dh and I are so happy but also so worried now. Anyone with advice? How do you cope with 3 under 3 and the tiny age gap? How did your body cope after 3 CS? I am worried the doctor will say I shouldn't continue the pregnancy. DD would be end of August.

Massive congratulations - tbh, you're living my dream! :) I think 3-4 years wait is really overly-cautious - yes, you're soon but I'm sure there will be others along who've had the same happen. It would be extremely unethical for your doctors to try and push you towards a termination, even if that is the way they feel! I've read of a woman on mn who's had 5 c-sections - so it is possible! I'm guess this one will definitely be elcs - you might get a "stern talking to" - but the horse has already bolted so "smile & nod, smile & nod".

Again, congratulations! :)

Thanks AlpinePony! We haven't even told our parents yet... (Tries to practice 'smile & nod'.. )

No experience of the cs bit but I can offer support in the three under three bit!
When dd3 was born in July dds 1 and 2 were 2.10 and 1.10. It's a bit hectic but as long as youre fairly organised it's ok.
Found it easier going from 2-3 than 0-1 or 1-2 actually.
Dd3 is 4 months and we are already ttc number 4 so it can't be that bad!
Congratulations

Will the pregnancy itself put pressure on the scar? Or is it only labour that does that?

3-4 years sounds cautious, but presumably that advice was given because they felt the scar was weak last time. Hopefully the new scar is stronger, but I'm not sure it works that way.

In your position I think I would hold off getting too excited about this pregnancy until I had sought medical advice, ideally from the doctor who attended me in the last labour. If the pregnancy presents significant dangers for you and the baby, then you will have to think carefully before proceeding with it.

I think you are nuts. Why oh why would you take any risks after being given that kind of advice?

I believe that the main pressure on the scar and uterus comes from labour rather than the pregnancy itself.

You will probably have to wait until you have seen your obstetrician before you gat any definitive advice, rather than your GP.

Girls, you sound very organized!! I have a bit of help so I hope I can manage.

Spidookly, it was labour (contractions and cervix not dilating) that kept pushing on the scar. Pregnancy was fine and really easy with both.

EYM, thanks, I have an appointment tomorrow to speak to her and seek advice.

snowcake I know that is normally the case, but in your case now the scar has barely finished being a wound, and soon it will be stretched again.

I've mostly heard the advice that you should wait a year after a CS, although after my first (EM) I had no specific advice, and when I asked was told "oh around a year" as though it was no big deal.

After my second CS (EL), which was exactly the same gap as between your DCs :), I was advised to wait a year and that was after a very undramatic and calm elective section.

Thanks spidookly, I knew what you meant re the weight of the baby pushing on it. I will update this thread once I've seen my OB/Gyn...

I had an emcs in July and was told 6 months. There is conflicting advice out there on the internet - there's stuff which says "wait a year" and conversely there's stuff which says "the main healing is done within 2-3 weeks internally".

The uterus is going to be very, very small for a few months yet.

My impression is that there is no standard advice, so you might get some kind of "um, maybe wait a while", or you might not.

I've certainly read on here about women having back to back pregnancies after a CS and it being entirely uncomplicated.

I suppose in this case, given what happened during labour, and the subsequent advice, it's important to revisit that advice in the light of your new pregnancy.

Good luck tomorrow. I really hope they do just give you a "oh, you're a terrible girl giving us all this trouble" thing and there's nothing more serious than that to worry about.

hello, what did the OB/GYN say?

Hi Snowcake. I was in a similar situation. DS was 2 when DD was born at 28 weeks by EMCS.
I got pregnant straight away and was warned that the scar may not hold. DS2 was born at 30 weeks by EMCS, 9 months and 17 days after his sister.
All healthy happy children! It was crazy having 3 under 3yrs old but now that my eldest is 6 and the two little ones are 3, it's much easier.

Wow you even beat me there!
Was your first early too? So stressful my nephew was born at 31 wks that was bad enough

I love the small age gap! It was hard at first, especially because DD was so poorly and being pregnant with DS2! DS1 was born on his due date. I was terrified, just like Snowcake about being pregnant just after a EMCS and did have a labour scare with him at 23 weeks. I managed to carry him until 30 weeks when the weight became too much for my scar.

I had an em section with ds1 and had ds2 11.5 months later (a vbac).

I was worried too but it was all fine. And I love the close age gap!

Yes I also love the small age gap (well most of the time!)
I would much prefer to take a longer block if time off work- luckily I can , and get all the chaos over with in one smaller time frame than have school runs/sleepless nights spread over years and years!

Ooh, thank you so much for your messages!!

Hi AlpinePony, well, I went to the doc and she said she can't see much yet but thinks there is a blob in the uterus but she estimates I'm barely 4 weeks since my last period, so it may simply be too early to tell. We ran blood tests and the HCG count came back as elevated (315) but below the 400 threshold. All my BOOTS pregnancy sticks come back positive. I am very now.

Whysolate, your experience is my biggest worry, that I might not be able to carry the baby full term. May I ask how you/your doctor noticed your scar wasn't coping? I'm glad your babies are all strapping healthy kids!!

Try not to panic. I know it's worrying but everyone is so different. It was me that knew my scar wasn't coping with the pressure. I was in agony. Everytime baby moved it was excruciating. I took myself down to the delivery suite and they kept me in (drugged upto my eyeballs) for three days before having to deliver him. Keep us informed of your progress!

Poor you, i'm glad it ended well. i had severe labour pains running down the insides of my legs and my scar was aching, a ctg revealed the baby wasn't coping and the pain indicated a scar problem so no vbac... i'll post again after my next scan. thank you!

My good friend had 3 under 3. She attempted a vbac with number 2 and ruptured so was under strict instructions not to get pregnant again for 2 years.

Her 3rd baby was born 18 months after 2nd. Pregnancy was very well managed and she was given a c-section at 38 weeks. Everything was ok but she did have to have her tubes tied there and then because the surgeon said her uterus could not tolerate another pregnancy. This was after a rupture with 2nd pregnancy though. Good luck.

Thanks partridge. (gulp) I think this will be my last baby. I didn't rupture but could feel my scar ache and sting. Fingers crossed it will be fine.

Not sure if you are still watchin this but I know someone who delivered twins (one vaginally and one emcs) and was told to wait 3 months before trying to conceive, so you nearly made it

Hi nappyaddict, thanks for the reassurance

AlpinePony: I have actually started a new thread www.mumsnet.com/Talk/pregnancy/1138215-Placenta-attached-to-uterine-wall-post-2-csec-Help