Will there be a pregnancy after a cesarean section? "But on the other hand". The connection between ovulation and lactation

3. They stretch out each problem over time.

For example, “the child does not sleep well.” Yes, it’s terrible, and I’m very tired, but how will my baby sleep in a year? He will already be 1.5, he will run, have dinner at the table, then swim in the bath with toys, fall asleep with a teddy bear in his hands. I will read him his favorite fairy tale, cover him with a warm blanket, stroke his head and kiss him, wishing him sweet dreams.

Or, “the child is constantly fidgeting and I spend half my life trying to collect him and go outside”! Of course, but imagine that in a couple of years, this nimble kid will learn to put on and fasten sandals on his own, go fishing with his father, and go to the hairdresser with his mother.

Sometimes the following thoughts appear: “It’s like I’m on a leash, I can’t go out anywhere, I can’t buy anything for myself, I’m always with my child.” This is true, but you can look at the situation differently, adding the word “yet” to everything. That is, I can’t yet. How long will the period of this dependence last? After 1-2 years, the child will be happy to stay “overnight” with his grandmother. After 3 years, he will be able to go to his family’s dacha and spend 5-7 days there without you. In another 5 years he will be surrounded by friends and you will no longer be the center of the universe for him. Is it really so difficult to give him a piece of yourself now?

4. They understand that everything has its time.

They do not dream that the baby will quickly “sit down”, “go”, “stop eating the breast”, “sleep”, “start talking, otherwise nothing is clear”, etc. Such women watch the baby and do not disturb him natural development and help them master the world around them.

The secret of Mom No. 3’s success is that she is close to the child, realizing that now she is the MOTHER of this small, defenseless baby. And if she devotes the first couple of years to him own life, then as he grows up he will be able to calmly let go and take care of himself. Her simple motto regarding the baby’s needs is: “Necessary? So it’s necessary.”

If you are unbearably tired, still try to accept the fact that now your child needs you like no one else. Ask for help when it's really difficult for you, but don't give up, don't be lazy and don't get angry with your baby. He is just learning to live, and you are his most important life guide. Believe me, very little time will pass and you will see the results of your work in how tightly the baby will hug and kiss you with the words: “You are the most best mom! I love you sooooo much!”

For our wonderful mothers, Mom's Store has prepared a lot of useful and necessary things to help. You can choose and buy:

• bright and ;
• , And ;
• children's room;

What can a woman get sick for 6 months after giving birth?

Half a year after the birth of the baby, most young mothers have practically no postpartum effects. Now this process reminds only a small number of women.

An exception can be considered discomfort in the area or . Bright, strong pain disappeared, leaving a feeling of numbness, periodic stretching, for example during weather changes. These are individual manifestations, more often they completely go away after a year and a half.

Some women suffer greatly. The child has gained weight, he has to be constantly carried in his arms, and often squats and bends over.

• Professional course of restorative massage.
• Therapeutic exercise, including.
• Daily relaxing baths with essential oils and sea salt.
• Sufficient intake of drinking water (30 ml per 1 kg of weight), not subject to reverse osmosis or artificial purification. Water must be natural, qualitatively enriched with minerals and micro/macroelements. Replenishing the reserves of “correct” water in the body is necessary so that the liquid properly “lubricates” the cartilage and bones and prevents their friction.
• Carrying a child in a special backpack that takes into account anatomical features child's body, which reduces pressure on the mother's back muscles.

If the pain is very severe, visit an orthopedic doctor or traumatologist to rule out the formation of intervertebral hernias and other possible deviations in the functioning of the musculoskeletal system.

Playing sports or light jogging are highly recommended. In Mom's Store you can buy:

• for pregnant and lactating women;
• , for every day and for the gym;
• comfortable .

What to think about 6 months after giving birth?

We can say that after the first 6 months of life, the most difficult and incomprehensible stage in caring for a baby is gradually completed. Time will begin next active games and adventures, which means you will need maximum attention to keep track of all the tricks of the young researcher. Make sure that everything that the child can reach, who will sit up or down steadily any minute, does not pose a potential danger to him.

For this:

• Check whether cabinets, shelves, armchairs, chairs, equipment, floor vases and flower pots. It is better to remove the latter altogether. You risk not only losing your favorite plants, but also “feeding” the baby with soil.
• Remove any household chemicals and cosmetics from the floor. If it was downstairs in the bathroom or toilet, raise it higher. You will be surprised at how fast crawling babies move and how they manage to climb into the most inaccessible places.
• Check drawers and cabinets. Are they securely fixed, do they have special “closers” that will not allow the child to nail or crush his fingers.
• Install special plugs on the sockets and remove all electrical wires. Now the baby grabs everything, and by pulling the wire, he can not only throw your laptop or tablet to the floor, but also send the wire into his mouth, and this is extremely dangerous.
• Hide cosmetics, paints, music CDs, pencils and pens, knives and forks, sewing, knitting and embroidery. Anything that pricks or cuts should be kept as far away as possible.
• If you store fresh vegetables outside the refrigerator, remove them too, otherwise your baby will eat raw, dirty potatoes or carrots.
• Put away paper books and magazines, all this rustles and tears very interestingly, and therefore will definitely end up under the close supervision of the baby.
• Hide TV remotes, car keys and, of course, your own phones - these are all your favorite toys. They tend to fall repeatedly onto the floor, hit walls, and “dive” into the toilet.

To further protect you and your baby from possible allergic reactions, you can buy it at Mom’s Store, but you still need to hide it in distant closets.

What can make a mother happy 6 months after giving birth?

If you are mentally ready to get out of the house more often and communicate with other mothers, start attending special courses or classes with your baby. You will both benefit from:

• Swimming in a special children's pool.

As a rule, it is six-month-old babies who can attend such training for the first time. They swim in the company of their mother, master the correct maneuvers through the water, learn to dive and stay on the surface of the water.

We will be happy to help your tiny bather “make friends with water.” You can choose and buy in Mom’s Store. We will provide fast and pleasant service.

IN this issue you can rely on your own taste. Perhaps you like development according to the Montessori, Zaitsev, Walfdor pedagogy, etc.

It has been repeatedly proven that live communication with other young mothers “live” is much more productive than online conversations on forums, which, instead of friendly support, only sow panic, anxiety, and promote.

Therefore, if you need real friends, look for them among women who sincerely smile at the first successes of their babies.

Something about dad

Your baby is growing. If a couple of months ago a woman could simply not notice anything that goes beyond “ate, poop, sleep,” now we can notice problems of a different nature. Usually the whole range of these problems is called “tense relations between spouses.” In fact, it can be a whole “bouquet” of everything. Let's consider an important part of relationships - sex. And again, sex is a very broad topic; in this article we will limit ourselves to considering one common complaint.

The woman begins to notice that her husband somehow does not strive for sex. Since the woman notices this only now, she most often makes the conclusion “for today.” She carefully looks at her unsuspecting husband, asks him several “specifically cunning” questions, and concludes with horror: her husband has lost interest in her. That's it, he doesn't want her anymore. He is no longer interested in talking to her or spending time with her. He doesn't love her anymore, and most likely he has another woman.

Usually the wife copes with these conclusions alone for a short time (from several days to a week) and then “brings her husband to face the facts,” most often with tears, etc. Let’s figure out whether everything is really so sad, what reasons could there be for not husband's desire to have sex.

• One of the most common reasons (this is what sexologists say, based on experience) is that when a man wants to resume sexual life (for more early stages after the birth of the child, at 1-2 months), he encounters a too sharp and too categorical refusal from his wife. And often not just a refusal, but a refusal with accusations like: this is all you need, you only think about this, you don’t think about me at all, etc. Or even: you don’t think about the child at all, now you only need think about him.

A man understands that his interest in sex is unpleasant for you personally, and even harmful for the family as a whole (and it makes you and the child feel bad). A man is a concrete creature, and after several such refusals, especially in a sharp form, he will simply stop offering. Why do something yourself that only brings negativity. Therefore, get used to talking to each other, explaining what you want and why.

You can try to increase sexual desire with help .

Get used to talking about your feelings with each other. And then the situation will initially look different. Instead of abruptly refusing her husband, the wife explains how she feels (both physiologically, morally, and emotionally). If he explains it well, then it is completely clear to the husband that the “refusal” is not because he is bad, but for a completely different reason. And joint decisions on how to restore harmony in sex arise precisely during such frank conversations. For example, a wife “doesn’t want to” only because she simply doesn’t have the strength. And the simplest solution here is to just give her a break, sleep for a few days. And believe me, the result will definitely be there.

How a man copes with the fact that he (in his opinion, “is not wanted”) will depend on the man himself. This may be a “switch” to communicating with friends, alcohol consumption may increase, a man may simply become offended and even start to get sick. Maybe, indeed, we should start looking for “understanding” on the side.

Note. It happens that the husband was expecting a child, and seemed to have prepared for everything, but the reality is simply different, that’s all. For example, he could not fully imagine his wife as she would be after giving birth. I couldn’t imagine that every time I left the house would be considered treason, etc.

The man thinks: well, that’s the end of me old life Now. And you don’t meet with friends, and you don’t play on the computer, no matter what you do, it’s still your fault. As a result, the family consists of two convicts chained to the core, and they have no time for sex. No matter how trivial it may sound, the lack of impressions for both husband and wife spoils family life.

The lack of impressions is a trifle only at first glance. Lack of impressions, lack of common activities and interests with her husband leads to the fact that there are no resources at all for good things. And for sex, too. Neither your husband has the resources, nor you. If a woman often thinks that she only needs to communicate with the child and “about the child,” this is not always the case. In fact, there may be a lack of external impressions from other areas of life, and a woman may not even be aware of why she is so irritated by some details of her husband’s behavior.

For example. If the woman herself has not left the house for a long time, on her own business, has not met with friends, has not been engaged in any personal activities (besides the child), then she may be very irritated and offended by the fact that her husband has a “life” besides families.

You need to be very careful about your feelings. Resentment in in this case will be “deciphered” as “why can you, but I can’t.” That is, what makes a woman angry and offended is not that her husband did something (plays his favorite computer game, for example), but the fact that the woman herself is deprived of something (impressions, activities, communication).

Remember, both of you are not convicts, but two free adults. And you can (after thinking) develop a mode of existence when everyone has their own time, and there is time “for two” and there is time “for three.” There are many things you can do with your child, don’t deny yourself. You can travel, watch a movie, and go to barbecue. You just need to prepare and think through everything in advance.

It turns out that the main “cure” for the fact that the husband does not want sex is... frank conversations, and necessarily actions based on these conversations. And everything will definitely work out.

Sometimes you can hear that a dad avoids being “one-on-one” with his child because he doesn’t know “what to do if something goes wrong.” For example, what to do if a child does not sleep during a walk and does not want to sit in a stroller. But mom doesn’t know for sure either, and she’s also learning. If dad lives an adult life, he has to solve all sorts of problems every day. The tasks with a child are no different. Call on your intuition and thinking to help, treat what is happening as a game, a kind of “quest”.

Dad is having more and more difficult questions. When the child was just born, it was also not very clear to dad what exactly to do with him, specifically in actions. And his wife’s example did not really help him at that time. A man usually doesn’t want to coo, hug and lisp like many women (somehow it’s a shame). And in his perception, nothing more can be done.

Remind your husband that everything was not difficult with a newborn: just being there, holding, talking - this is “spending time with the child” at this stage. And when the baby is six months old, the dad begins to worry about the idea that just “being close” may not be enough. It is necessary to take some actions already aimed at the development of the child. How to raise him? To allow - to prohibit, to pick up - not to pick up? How to find out?

The easiest way is to develop an “action plan” based on what the child already knows at this stage and what he is learning.

For example, a child aged 5 full months holds toys tightly, transferring them from hand to hand. This means that you can “slip” objects of different textures and shapes “for familiarization” with the child. Don’t be afraid to “overdo it”; when the child gets bored, he will simply let go of the object.

A good activity for dad during this period is exercise and gymnastics with the child. At 5 months the baby is already “heavy” for mother's hands. Therefore, dad will do a variety of swinging, tossing, etc. perfectly. Therefore, you can simply distribute responsibilities and roles for the child between husband and wife.

Many of my friends did the so-called dynamic gymnastics from birth to about a year (when the child is swung by the legs, arms, turns, etc.). And most often it was the dads who did this, since it required a fair amount of strength.

The article was written jointly with practicing psychologist Valeria Onisko.

Many women are very scared about pregnancy after caesarean section. There is nothing surprising here, because psychologically it can be difficult to carry a fetus again in a uterus that already has a scar. And it always remains after the last operation. However, there are no contraindications to pregnancy after a caesarean section. Moreover, if the girl has no complications, she can give birth to her baby without the intervention of a surgeon. Doctors always consider this possibility.

Pregnancy Three children consultation
anesthesia after childbirth
9 months

The birth of another baby is a big event for the family and the most wonderful thing that can happen in life. It’s just important to follow all the doctor’s instructions, and also remember that no matter how much you want to conceive a child immediately after the operation, there is no need to rush into a new pregnancy.

When can you plan to conceive?

Some mothers are planning a pregnancy 3-6 months after a cesarean section. This is very dangerous for both mother and baby. The fetus may simply not survive because the uterus is still too weak. The scar on the uterus should get stronger and heal completely. If this does not happen before the next conception, there is a risk of uterine rupture.

Planning another pregnancy after a cesarean section is allowed after at least one year. Or better yet, it should take a couple of years.

It is worth knowing that you cannot have an abortion at this time, since the scar may rupture due to the mechanical effect on the uterine wall. Therefore, it is worth taking care of contraception in order to allow the body to recover and prevent pregnancy 6-7 months after the previous caesarean section.

Before planning another child, a woman will need to undergo an ultrasound examination of the uterus to determine the thickness and consistency of the scar. The uterine cavity is also examined and its walls are examined (hysterography, hysteroscopy). The doctor checks from which tissues the scar was formed. Ideally, it should be formed from muscle tissue. Information about this is necessary in order to determine the method of delivery in the event of a repeat singleton or multiple pregnancy after surgery.

A second pregnancy that occurs after birth by cesarean section has several features. Eg.

1. The scar on the uterus can disperse during pregnancy as early as 4-5 months after surgery, since it heals only after 2 years.
2. An abortion cannot be done because the uterus may rupture or become inflamed.
3. The placenta can attach to the scar, as a result of which the fetus will not receive enough substances necessary for its development and growth.

It is worth planning at least a year after surgery

During the second pregnancy, which occurs 9 months or a year and a half after the caesarean section, the mother is under the closest attention of the doctor. She is prescribed regular palpation of the uterus and ultrasound examinations. These measures will allow you to promptly detect possible seam divergence and take action. necessary measures. Often the operation is followed by not only a second conception, but also a third. There is no need to worry, but you need to unquestioningly follow the recommendations of the gynecologist, especially if the previous birth did not occur. naturally.

Each operation traumatizes and greatly thins the walls of the uterus. The features of the third pregnancy, which occurred after two cesarean operations, include:

• high fetal weight;
• risk of premature labor pains;
• the fetus begins to move earlier.

The estimated day of birth is calculated in the same way as before. By 1 day last menstrual period you need to add 40 weeks. If the day of conception is known exactly, you need to add 38 weeks to it, which will allow you to obtain more accurate data on the birth of a child during pregnancy after 2 cesarean sections. However, the peculiarity is that only 5% of babies are born on the set date. The rest are born either a week early or wait another week. But healthy pregnancy always lasts approximately 38-42 weeks.

During the second and third pregnancies after a caesarean section, the woman feels the baby’s movements much earlier. This is also due to the fact that she knows these sensations, so she will not confuse them with intestinal gas. Most often, with the first child, the mother notices movements at 23-24 weeks, and with subsequent ones already at 16 weeks.

When a third pregnancy occurs after two previous operations, the condition of the fetus and the formed scar must be regularly assessed. To do this, an ultrasound examination and CTG are performed at 35-38 weeks. The doctor usually prescribes these procedures before childbirth, but if necessary, he does them at other times.

How many times can you have surgery?

All women who become pregnant after a cesarean section are interested in how often the operation can be performed. Doctors do not recommend more than three times, because with each operation the walls of the uterus become thinner. At the same time, today a woman is allowed to give birth in this way an unlimited number of times, especially abroad. Much depends on
materials used, instruments, method of operation.

Three children were born by caesarean section

And, of course, the question of the number of possible surgical interventions should be decided taking into account the health status of the mother and her individual characteristics, because in some cases surgery can lead to the development of immunodeficiency. A third of girls experience inflammatory processes and urinary tract infections after the second cesarean section.

Even today, vaginal birth is always the priority. Therefore, if the process of bearing a child goes without complications, and doctors recommend natural delivery, you should not refuse it. This is safer for both you and your baby, especially if you have had a caesarean section before. Vaginal delivery is recommended in the following cases.

1. The scar does not hurt and does not bother the woman.
2. Fetal weight maximum 3.5 kg.
3. The woman has only one transverse scar.
4. The placenta is located outside the scar.
5. There is no danger of scar divergence; it is in good condition.

However, if there are certain pathologies, the operation will have to be performed again. Contraindications include:

1. Availability cardiovascular diseases, diabetes mellitus, traumatic brain injury, severe myopia.
2. Multiple pregnancy.
3. Deformation of the pelvic bones and spine.
4. Insufficient pelvic width.
5. Cicatricial fixation of the placenta.
6. Scar after longitudinal section and made of connective tissue.

Also, many doctors recommend surgical intervention if the woman giving birth is over 35 years old. In this case, she needs close medical supervision latest dates, therefore, obstetricians-gynecologists usually play it safe and put the expectant mother in storage. A new pregnancy after a cesarean section will have a natural outcome and proceed without complications if the woman’s health and her reproductive condition are not alarming and are normal. But even in this case, you need to be constantly monitored by a doctor to prevent suture divergence. This could have fatal consequences.

Many girls are simply afraid to give birth on their own and, in order not to experience pain during this process, choose a caesarean section. Yes, the operation always takes place under strong anesthesia, but as soon as it wears off, the pain can be much stronger than during natural childbirth. In addition, even one operation is stressful for the human body, let alone two or more.

Despite advances in medicine, it is very difficult to foresee all the consequences. Again, you will have to recover for a very long time, the suture on the uterus will be very painful, and the wound on the abdomen will cause some inconvenience. Also, this operation is always accompanied by greater blood loss than during natural childbirth. Therefore, you need to weigh the pros and cons and then make a decision.

Risk of conception after surgery

After abdominal surgery, you need to allow the body to fully recover and only then plan a pregnancy after a cesarean section. During the entire recovery period, you need to limit yourself from serious physical activity and stress. The main risk of bearing a child after surgery is the condition of the postoperative scar on the uterus. It is formed due to the fact that during the operation the wall of the uterus is dissected, so during subsequent conceptions its strength and low extensibility can become a serious risk. This is why early pregnancy after a cesarean section is so dangerous.

Mandatory consultation with a specialist

Scar failure can cause uterine rupture, as the fetus causes stress on its walls. In addition, it is possible that the fetus will be attached close to the scar. Because of this, he will not receive enough blood, which will affect his development. Repeated pregnancy, both after 8 months and 2 years after one or two cesarean sections, is complicated high risk development of respiratory tract diseases and the unborn child.

Also, as already described above, surgical childbirth is accompanied by severe blood loss, and this causes the development of anemia in girls. Therefore, a lack of iron in the mother’s body can cause developmental defects in the baby, and abortion is not recommended, since this is an even greater risk than early conception child. Every effort must be made to ensure this occurs in a timely and planned manner.

Attention!

The information published on the website is for informational purposes only and is intended for informational purposes only. Site visitors should not use them as medical recommendations! The site editors do not recommend self-medication. Determining the diagnosis and choosing a treatment method remains the exclusive prerogative of your attending physician! Remember that only complete diagnosis and therapy under the supervision of a doctor will help you completely get rid of the disease!

How will the pregnancy proceed in this case and what problems may the woman encounter?

Second pregnancy: reasons

Repeated pregnancy immediately after the first occurs quite often. This is due to the fact that young mothers begin sexual activity 1-2 months after giving birth, but do not think about contraception, because they mistakenly believe that if there is no menstruation and breastfeeding, one cannot get pregnant. However, the frequency of such cases is 16–18?% among young mothers during the first year after childbirth.

The recommended interval between pregnancies is 2–3 years. This is the time needed for a woman’s body to fully recover after a previous birth. If the first birth ended with a cesarean section, this interval is needed not only to restore the body after pregnancy, but also to form a full-fledged scar on the uterus.

The postpartum period lasts about 2 months after birth. At this time, restoration processes occur in the woman’s body, as well as involution (reverse development) of those organs and systems that have undergone major changes during pregnancy.

The most pronounced changes occur in the genital organs, especially in the uterus. Over the course of 6–8 weeks after birth, the uterus gradually contracts and decreases in size, and its internal wound surface heals—the place where the placenta was attached during pregnancy. In the ovaries, the regression (reverse development) of the corpus luteum, which is formed after the release of a mature egg from the ovary, ends. The corpus luteum functions during pregnancy, producing the main pregnancy hormone, progesterone. At the same time, the maturation of follicles - vesicles from which eggs mature - begins.

Besides, in postpartum period restoration processes occur in all organs and systems of the woman’s body: the central nervous system, cardiovascular, respiratory, digestive, urinary, endocrine systems.

Women who do not breastfeed begin menstruation within 6–8 weeks after giving birth. The first menstrual cycle after childbirth usually occurs without ovulation (the release of a mature egg from the ovary). Subsequently, ovarian function is restored and ovulation occurs.

The first 2–3 menstruation after childbirth may be irregular, heavier and longer than before pregnancy. Subsequently, the duration and intensity of bleeding during menstruation, as a rule, decreases. The menstrual cycle becomes regular. Thus, the ability to have a new pregnancy is restored. Therefore, before resuming sexual activity (6–8 weeks after childbirth), it is recommended to consult with an obstetrician-gynecologist on issues of postpartum contraception.

Breastfeeding mothers usually do not have periods for 8–9 months or, rarely, for the entire period of breastfeeding. In some cases, they may appear earlier - 4-6 months after birth during breastfeeding. As a rule, such menstruation is short and more scanty than before pregnancy. In this regard, many women do not pay enough attention to postpartum contraception, relying on the so-called “method” lactational amenorrhea» – absence of menstruation during lactation. However this method contraception is reliable only if the baby is completely on breastfeeding, breastfeeding is regular (every 3–3.5 hours) and at night the baby is also put to the breast. When introducing complementary feeding or supplementary feeding, or refusing night feedings, the method becomes ineffective.

The essence of the lactational amenorrhea method is that during breastfeeding, a woman’s body produces the hormone prolactin, which blocks the maturation and release of a mature egg from the ovary. And pregnancy for a young mother will become a complete surprise, because it can occur even before the start of menstruation, at the first ovulation. IN similar cases a woman may not suspect a new pregnancy for a long time. Therefore, you should definitely pay attention to the presence of such manifestations as malaise, nausea, vomiting, drowsiness, increased sense of smell, changes in taste preferences, which may indicate a new pregnancy. If such suspicions arise, you can perform an express pregnancy test at home, and if your guess is confirmed, contact an obstetrician-gynecologist for a more accurate diagnosis. Considering the unreliability of the “lactation amenorrhea” method, after childbirth it is recommended to consult a gynecologist about methods of postpartum contraception and selecting the most appropriate method of birth control for you.

Second pregnancy: possible complications

If pregnancy is confirmed, the question of maintaining it arises. Each family decides it individually. When making a decision, you should first assess the woman's general health. This takes into account the number and course of previous pregnancies and births; the presence of complications during childbirth and the postpartum period such as bleeding, inflammatory processes of the genital organs (for example, endometritis - inflammation of the uterine mucosa) is an aggravating factor for carrying a new pregnancy. Be sure to pay attention to the presence of somatic (general) diseases in a woman, especially long-term chronic diseases. Also has important the presence of a scar on the uterus after a cesarean section during a previous birth. Taking into account the totality of all medical and social factors, the woman, together with the obstetrician-gynecologist, decides to continue or terminate the pregnancy. You should know that if a second pregnancy occurs immediately after the first, the following complications may develop:

Development and progression of anemia. Anemia is a condition characterized by a decrease in the content of hemoglobin, a protein that carries oxygen to the cells of the body. As a result, all organs and tissues receive a reduced amount of oxygen. Anemia during a second pregnancy with a short interval after the first is quite common. This is due to the fact that the woman’s body has not yet had time to fully recover from previous pregnancy and childbirth, during which there is an increased need for iron. The risk of developing this condition is especially high if the previous pregnancy was already accompanied by anemia, because the body needs time to recover. If there was bleeding during pregnancy and childbirth, the risk of developing anemia is increased; this also applies to cases where the previous birth ended with a cesarean section, since blood loss after surgery is always greater than after a natural birth. In addition, during lactation, a young mother also experiences an increased need for protein and iron, which can contribute to the development of anemia during a second pregnancy. It is recommended to prevent anemia good nutrition with sufficient protein content (meat, fish, cheese, cottage cheese, milk), as well as taking courses of 2-4 weeks of iron supplements and multivitamins prescribed by a doctor.

The emergence or progression of varicose veins of the lower extremities. This complication is due to the fact that during a new pregnancy after a short break, the load on the woman’s body increases. The volume of circulating blood increases significantly (by about 30–50?%), the speed of blood flow in the vessels of the legs decreases, blood clotting increases, and the tone of the venous wall decreases. As the duration of pregnancy increases, the growing uterus begins to put pressure on the veins located behind it, making it difficult for the outflow of venous blood from the lower extremities. Prevention of such a complication is to wear it from the very beginning of a new pregnancy. compression hosiery(stockings, knee socks, tights), and from 20 weeks of pregnancy - a bandage: it supports the stomach, reduces the load on the back, reduces pressure on the veins behind the uterus. Also recommended is an elevated position of the lower extremities (sitting or lying down with a pillow under your feet), exercises for the legs, and, if possible, following a diet to prevent constipation, which includes vegetables, fruits, dairy products, improving digestion. As prescribed by a doctor, you can use special gels and creams (for example, LYOTON GEL) for preventive and therapeutic purposes.

Exacerbation of existing somatic diseases. During pregnancy, all organs and systems of a woman experience increased stress. The cardiovascular, respiratory, endocrine systems and kidneys work most intensively. It also takes time to restore their functions. Therefore, if a second pregnancy occurs during the first year after the previous one, there may be an exacerbation or progression of existing chronic diseases(chronic pyelonephritis - inflammation of the kidneys, diabetes, hypertonic disease– high blood pressure, etc.). Against the background of these diseases, quite often a complication arises such as combined gestosis (toxicosis of the second half of pregnancy, in which swelling, the appearance of protein in the urine and increased blood pressure). Preventive measures in this case are aimed at timely examination and treatment of women with diseases internal organs which is carried out jointly with a general practitioner.

Isthmic-cervical insufficiency is a violation of the obturator function of the cervix. The causes of this condition may be deep ruptures of the cervix during previous births. Also, isthmic-cervical insufficiency can develop due to disruption of the healing processes after suturing the cervix with the formation of scar tissue. As a result, the full structure of the cervix is ​​not ensured when next pregnancy, which may be accompanied spontaneous interruption pregnancy in the second and third trimesters. To minimize complications, it is recommended to plan a new pregnancy after 2–3 years.

Inconsistency of the uterine scar after a cesarean section. The uterine scar after a cesarean section reaches its optimal condition for carrying a subsequent pregnancy after 2–3 years. It is at this time that it is recommended to plan a second pregnancy. In case of more early onset pregnancy, the scar on the uterus may become thinner (a situation where its thickness is less than 3 mm according to ultrasound), and the formation of large quantity connective tissue, which can lead to scar failure. In such cases, it is possible that such serious complications, as a threat of miscarriage, fetoplacental insufficiency (the placenta attached to the scar area does not sufficiently fulfill its functions of providing the fetus with oxygen and nutrients), the threat of uterine rupture along the scar.

Lactation during pregnancy

Ensuring lactation and simultaneously carrying a pregnancy is a serious test for a woman’s body. To produce complete breast milk you need increased amount nutrients(proteins, fats, carbohydrates), vitamins, microelements, which during a new pregnancy are also necessary for the fetus. During a new pregnancy, the composition of breast milk may change due to the fact that some of the nutrients are spent on the development and gestation of pregnancy. In addition, during pregnancy there is a change hormonal levels(mainly due to the hormone progesterone), which also affects the composition of breast milk. All these changes affect the taste of milk.

As a rule, when pregnancy occurs during lactation, the amount of breast milk decreases or disappears altogether. The child himself may refuse to breastfeed due to a change in the taste of mother's milk.

But even if the baby does not refuse the breast, it is still recommended to stop breastfeeding, because with simultaneous pregnancy and lactation, the woman’s body experiences increased stress. In addition, when a baby is fed, the nipple is stimulated and the hormone oxytocin is produced. This hormone increases the contractile activity of the uterus, which can contribute to the threat of miscarriage.

Question about continuing pregnancy

In some cases, the woman's choice is still to terminate the pregnancy, i.e., medical abortion. The outcome of a medical abortion depends on a number of main factors, which include:

• method of abortion (surgical or medical);
• gestational age;
• general health of the woman;
• qualifications of the specialist performing abortion;
• type of anesthesia used.

The most common complications after medical abortions are:

• Inflammatory processes in the uterus and its appendages (endometritis, salpingoophoritis), which can subsequently lead to the development of adhesions in the pelvic organs and obstruction of patency fallopian tubes and the development of secondary infertility.
• Hematometra is an accumulation of blood clots in the uterine cavity, against which the development of inflammatory process. When treating hematometra, the uterine cavity is emptied using surgical instruments, followed by the prescription of antibacterial and anti-inflammatory therapy.
• Traumatization of the cervix during abortion with surgical dilators, which can subsequently lead to disruption of the obturator function of the cervix and the development of miscarriage. In such cases, during repeated pregnancies, miscarriages in the later stages (18–20 weeks) are quite common.
• Violations menstrual cycle. After an abortion, changes in the frequency and intensity of menstruation are quite often observed. Often there are anovulatory cycles (when the egg does not mature and is released). In some cases, this factor may also contribute to the development of infertility.
• Psychological stress almost always happens after an abortion. Symptoms such as increased nervous excitability, tearfulness, intrusive thoughts, sleep disorders. Depressive states are common.
• Complications surgery. Performing a surgical abortion does not exclude such a technical complication as perforation (rupture) of the uterine wall, since this operation is performed blindly. As a result, massive bleeding and peritonitis (inflammation of the peritoneum) may develop. In such cases it is used surgery– suturing a rupture of the uterine wall; in some cases, removal of the uterus is required.
• Endocrine disorders due to dramatically changing hormonal levels after termination of pregnancy.
• The development of endometriosis as a result of endometrium entering the vagina during surgery.
• As we see, termination of pregnancy in this situation is a very serious step, which may have whole line negative consequences, including infertility. That is why, when making a decision, a woman should think carefully and carefully weigh all the pros and cons, because we are talking about her future and the fate of her child.

Features of pregnancy

For pregnancy monitoring, it is advisable to consult an obstetrician-gynecologist as early as possible. During the first visit, the duration of pregnancy is determined and a plan for its further management is drawn up. A general clinical examination is performed to determine general condition body expectant mother(blood, urine, vaginal and ultrasound examination). A woman should visit specialists: a therapist, an ENT specialist, an ophthalmologist, a dentist, and, if necessary, other doctors.

From the very beginning of pregnancy, a nutritious diet with a sufficient content of proteins, fats and carbohydrates, vitamins and minerals is recommended (meat, cottage cheese, cheese, dairy products, vegetables, fruits are recommended). It is also advisable to start taking multivitamin preparations for pregnant women; An obstetrician-gynecologist will help you choose them.

If possible, it is necessary to follow a daily routine; the recommended duration of night sleep is at least 8 hours (optimally 9–10 hours). During the day it is also advisable to rest for 1–3 hours; this can be done while the older child is sleeping. It is recommended to walk in the fresh air for at least 2 hours a day, depending on the time of year.

If a woman Rh negative blood, during a visit to the doctor, a test for the content of Rh antibodies in the blood is required, which is subsequently repeated. The fact is that during previous pregnancies, if the born child is Rh-positive and the mother is Rh-negative, an accumulation of Rh antibodies occurs in the woman’s body. These antibodies can destroy fetal red blood cells and lead to the development of a serious complication - hemolytic disease of the fetus and newborns.

To prevent Rh sensitization, prophylactic administration of anti-Rhesus immunoglobulin is used. for Rh negative women during pregnancy. Immunoglobulin is administered at 28 weeks, and for those who were not given it at this time, at 34 weeks of pregnancy. The procedure is repeated within 48 hours after birth.

To monitor the level of hemoglobin in the blood and timely diagnosis of anemia, general analysis blood. As additional method diagnostics, the determination of serum iron and total protein content is used during a biochemical blood test. According to indications (when the hemoglobin level decreases below 110 g?/l), courses of antianemic therapy are carried out using iron supplements.

If a woman has chronic diseases of internal organs (diabetes mellitus, hypertension, pyelonephritis, etc.), pregnancy is carried out jointly with a general practitioner, cardiologist, endocrinologist, etc. If necessary, additional research: biochemical analysis blood (for example, blood sugar levels are monitored), ECG, ultrasound of the heart, coagulogram (study of the blood coagulation system). Assigned as needed drug correction identified complications with drugs approved for use during pregnancy.

If a woman suffers from varicose veins of the lower extremities, it is recommended to consult a phlebologist and wear compression stockings (socks, stockings, tights) with early dates pregnancy. In some cases, to assess the condition of the veins of the lower extremities, an ultrasound examination of the blood flow in them (USDG) is performed. If necessary, the doctor may prescribe medications to increase the tone of the veins, which are approved during pregnancy.

Recommended wearing prenatal bandage after 20 weeks to support the muscles of the anterior abdominal wall, since during repeated pregnancy they experience increased stress and are prone to increased extensibility. In addition, wearing a bandage reduces the load on the spine and prevents the appearance of stretch marks. It is also advisable to use special cosmetics preventing the appearance of stretch marks.

By doing ultrasound examination of the fetus during a second pregnancy that occurs shortly after the first, attention is paid to the correspondence of the size of the fetus to the gestational age. After 20 weeks, the estimated weight of the fetus is calculated, since in such cases there is a high risk of having a child with low body weight. If there is a scar on the uterus after a previous cesarean section, be sure to monitor the condition of this scar and its thickness over time during ultrasound.
The doctor leading the pregnancy pays careful attention to the timely identification of the pregnancy.
These are the threats of interruption and their correction. As with the first pregnancy, there are critical periods for the threat of miscarriage (10–12 weeks, 20–24 weeks, 28–32 weeks).

It is during these periods, even in the absence of alarming symptoms, that it is recommended to rest more, reduce physical activity, and avoid neuropsychic stress. In some cases, sedative (calming) and antispasmodic drugs are prescribed for preventive purposes.

Thus, together with an obstetrician-gynecologist, a woman can always make the best decision, endure a repeat pregnancy with the least number of complications and give birth to a healthy baby.

The site is a medical portal for online consultations of pediatric and adult doctors of all specialties. You can ask a question on the topic "pregnancy after cesarean section after 6 months" and get a free online doctor’s consultation.

Questions and answers on: pregnancy after cesarean section after 6 months

2013-07-05 05:11:33

Love asks:

I am 26 years old. She underwent three operations. Two cesarean sections, one - removal of the left ovary (ovarian torsion due to a cyst). The last caesarean was last year. Were premature birth at 26 weeks of pregnancy. The fundus of the uterus burst. Two months later, a left ovarian cyst was discovered. After this, cramping pain began in the suture area. I am seeing a gynecologist. I heard that my uterus now looks like an hourglass and horizontal position. What does it mean?

Answers Gritsko Marta Igorevna:

This is how your uterus was sutured. If the question is about the possibility of a new pregnancy, then you must resolve this issue with the treating gynecologist; it is difficult to talk virtually. Most likely, another pregnancy is impossible.

2010-12-06 09:14:59

Ekaterina asks:

Dear doctors! Please clarify this situation. Before pregnancy, I had a cyst on the ovary (endometrioid?) measuring about 5x6 cm, CA-125 -23. The pregnancy ended with a caesarean section and I clearly reminded the doctor before the operation that I had a cyst on the ovary. The doctor promised to remove it. After the operation I was told that there was no cyst. 2 months after giving birth, an ultrasound scan again reveals a cyst (endometrioid?) measuring about 2x5 cm, CA-125-13.
How can this be? My menstruation has not yet returned.
Could the doctor have missed the cyst during the operation? or just not remove it?
Or is it possible to confuse a cyst with the ovary itself on an ultrasound?
Thanks in advance for your answer.

2009-04-23 19:01:03

Ira asks:

Tell me where I can get advice on the following issues: first pregnancy - the baby was born 4970 grams, due to natural childbirth she was injured, as a result of which one of the diagnoses was hypoglycemia, died after 2.5 months in Akhmatdyt, her heart could not withstand the long-term use of hydrokartisone; second pregnancy with a threat of pelvic diligence at 30 weeks due to complete placental abruption, the child was born after a cesarean section, weighing 1.5 kg and died in the first 12 hours. In the second trimester of the second pregnancy, glycosuria of the kidneys was detected, there was no sugar in the blood, the sugar curve and glucolized hemoglobin were normal. At the same time, in both the first and second pregnancies, tests were taken for torch infection, which did not reveal anything other than the presence of immunity to rubella. The baby from her first pregnancy is also immune to the vaccine. They recommend contacting a medical genetics center, but I don’t know which one is better.

Answers Loskutova Tatyana Aleksandrovna:

Dear Irina! Medical genetic centers in our country have a territorial affiliation. Almost every region has its own medical genetic center. I recommend being examined for the presence of genetic and acquired thrombophilia. Contact us

2008-08-14 17:26:44

Alena asks:

Good afternoon Please help me figure it out! I am 33 years old. A month ago, at 42 weeks after a caesarean section, my son was born. Indications for surgery – primary weakness labor activity, not amenable to medical correction. The pregnancy proceeded well, without complications. All tests were normal. Based on the date of the last menstruation (09.21.2007), the estimated date of birth was set at 06.28.2008. But according to my calculations, this period could be moved forward by a week, since my cycle is longer than 28 days - namely 30-31 days, there were cases of 35 days. A week after the expected date of birth (06/28/2008), an ultrasound was performed, which showed that all blood flow, fetal heartbeat and echogenicity of amniotic fluid were normal. Despite this, in antenatal clinic insisted on hospitalization and stimulation of labor, a puncture of the bladder was scheduled for July 11, 2008 and, if labor did not occur, a caesarean section. As a result, on 07/09/2008 at 11:00 p.m., I was administered a prostaglandin drug. After about 18 hours, severe chills began, the temperature rose to 37.5 degrees and nagging pain in the lower abdomen. After this, the mucus plug came off. By the morning of July 11, 2008, all symptoms disappeared. The dilatation was 2 cm. At 8-00 the bladder was opened - the waters were not green, but mixed with white flakes - they said that the waters indicated postmaturity. From 12-00 to 15-00 they put on an oxytocin drip. All this time I didn’t feel any contractions or there weren’t any - periodically there was a little tugging in the lower abdomen, an unpleasant sensation and that’s all. At 15-00 the dilation was 4 cm. The doctors insisted on a caesarean section. At 16-12 my son was born - 3870 g, 57 cm, 7-8 points on the Apgar scale, without signs of postmaturity. Yes, there was a double entanglement of the umbilical cord. Question: in my case, how justified was it to induce labor at 41.5 weeks and perform a cesarean section, or was it possible to wait for the start of natural labor at my due date, even if it was longer than 42 weeks. Wouldn't labor have started on its own? It's a shame that I wasn't even allowed to be in labor! What could be the cause of primary weakness of labor? In advance Thanks a lot for answer!

Answers Baksheev Sergey Nikolaevich:

Good afternoon, Alena! Primary weakness ancestral forces usually observed with general and debilitating diseases, infantilism, abnormalities of the genital organs, uterine fibroids, excessive stretching of its walls caused by polyhydramnios or multiple fetuses, premature rupture of water. Unfortunately, it is impossible to determine the validity of labor management tactics remotely, without being present during childbirth. Moreover, you won’t be able to change anything. You have a wonderful baby, enjoy life and don’t get hung up on the little things!

2016-07-29 23:38:59

Tatiana asks:

Hello!
She gave birth 7 months ago through a planned cesarean section (there were no full contractions), the baby was breastfed. Approximately 2 weeks after giving birth, nagging pain began to occur periodically, feeling localized on the right side of the vagina. There is no unusual discharge or itching. The pain occurs mainly at night or in certain body positions, for example, when I sit with my legs crossed. It doesn't hurt much, but it worries me that it's taking so long. There is no increase in temperature. I visited a gynecologist 2 months after giving birth, the doctor said that it was a certain “nerve” that hurt so much because during pregnancy the uterus put pressure on the pelvis. I would like to clarify whether it is normal for the pain to persist for so long. This was the first pregnancy in my life, at the age of 35.

Answers Bosyak Yulia Vasilievna:

Hello Tatiana! Normally, there should not be such pain. It is difficult to draw conclusions virtually; most likely, adhesions have formed, which provoke unpleasant sensations. I advise you to contact a gynecologist for a follow-up examination.

2016-03-12 18:41:37

Ekaterina asks:

Hello. Let me explain my situation. I have a 4th pregnancy, 2 children born by cesarean section. 5 months have passed since the birth. The period is 7 obstetric weeks. According to the penultimate ultrasound results, there are 3 fertilized eggs, with a diameter of 7.6 and 6 mm, respectively. The embryo was visualized only in one egg. The doctor said that this period It’s too early to draw conclusions. I repeated the ultrasound at 7 weeks, that is, a week later. As a result, one egg increased to 14 mm, the baby’s heartbeat can be clearly heard, but the other fertilized eggs remained 7 and 6 mm, the embryo is not visualized. The doctor recommended repeating the ultrasound in 3 weeks. Please tell me how I can understand the result of the examination, can I hope or should I still accept only a singleton pregnancy as valid? Thank you. Best regards.

Answers Palyga Igor Evgenievich:

Hello, Ekaterina! At 6-7 weeks, the fetal heartbeat should be clearly visible. If one heartbeat is visualized, one fetus will develop accordingly, this is only for the better for you. In multiple pregnancies, there are more complications and it is more difficult to bear. In addition, all 5 months have passed since the previous birth, i.e. It is not completely known whether the seam is completely solid or not.

2015-07-28 14:51:13

Albina asks:

Good afternoon! I am 32 years old, 30 weeks pregnant, and developed acute paraproctitis (ischeorectal). They performed an emergency operation and opened the abscess. They put in a drainage and discharged me on the fifth day. (the operation took place in the department of purulent surgery, not at the proctologist). Three weeks passed, a little pus came out of the wound, and I began to notice that gases were also coming out. I went to the operating surgeon with a suspicion of a fistula. He conducted an external examination, through the vagina and through the rectum. He said that there is a fistula and after childbirth and recovery (in 4-6 months) it needs to be operated on. Painful sensations in sitting position and after walking there is.
Questions: 1) is a cesarean section indicated for such a disease or is it possible to give birth on your own (provided that this is the third birth, and during the previous ones there were ruptures and dissections - accordingly, the tissues are less elastic and dissection will be required during this birth)? I am afraid that purulent masses (although there are not many of them) when the perineum is cut may get into Airways child or into the uterus... (my surgeon said that there is no longer a purulent cavity, and the contents of the fistula are not dangerous)
2) what time period after acute paraproctitis is optimal for surgery to remove the fistula?
3) what is the usual diameter of fistulas and does it increase over time?
4) Have there been any cases of acute paraproctitis and fistulas in pregnant women in your practice? Are there any recommendations in this case?
Thank you!
Best regards, Albina

Answers Tkachenko Fedot Gennadievich:

Hello, Albina. The situation is really not very simple, but in principle the doctors (surgeons) did everything, in my opinion, correctly. Now after opening the abscess the process is underway fistula formation. This process takes about 2-3 months. It is better to operate the fistula after its complete formation, that is, after 2-3 months. Now regarding your questions. 1) The method of delivery will be chosen immediately before birth. It is better to make this decision in consultation with the participation of qualified proctologists and obstetricians-gynecologists. 2) It is better to operate a fistula after opening of acute paraproctitis after its final formation - usually after 2-3 months, however, there are situations when this process takes 4-6 months; in any case, the question of the timing of repeated surgical intervention is decided by the operating surgeon individually . 3) the diameter of the fistula tract varies, usually 1-2mm. It may increase over time, but it may also remain the same. 4) In my practice, there have been cases of acute paraproctitis in pregnant women. Recommendations in such cases are standard - perineal hygiene + normalization of stool. Good luck and good health to you.

2015-01-15 12:45:58

Tatiana asks:

Hello! Please help me with advice... I really want a second child. I am 37 years old, my first birth was at 33 years old - cesarean section at 38 weeks (reason: primary weakness of labor). After giving birth, I lost weight and lost a few more kilos, after which 10 months later it turned out that I had nephroptosis of the right kidney and was already at stage 2-3 (they did excretory urography). There were no further irregularities either in the tests or in the photographs. Some doctors said I needed surgery right away, others convinced me otherwise. I stopped breastfeeding, gained weight and began to feel much better. Today I was planning a pregnancy and for the first time in 4 years I developed cystitis, and then my kidneys got sick. I was hospitalized with a protein of 0.166, red blood cells were high, and white blood cells covered the entire field of view. All other blood parameters were normal, there was no t. They prescribed ceftriaxone and furomag. After 7 days I was discharged because... the pain went away, all biochemistry, Nechiporenko’s urine, and culture were normal. They did a CT scan with contrast and found: The right kidney is located at the level of the upper edge of L3 - the upper edge of S1; size - not increased; the contour is clear, even; structure of the parenchyma with clear differentiation of the medulla and cortex. The calyxes are moderately dilated. The pelvis is located extrarenally, dilated to 18 mm. The concentration and excretory functions of the kidney are not impaired. The ureter forms an inflection in the upper third, can be traced to Bladder, not expanded. The left kidney is normal. CONCLUSION: CT signs of right-sided nephroptosis, hydronephrosis. At the hospital, the final diagnosis was: Right-sided nephroptosis stage 2, right-sided hydronephrosis stage 1, chronic pyelonephritis and cystitis, exacerbation. To date, suturing the kidney has not been recommended. I really need your advice on how long after I should plan my pregnancy and what are my chances of bearing and giving birth to a healthy child with my diagnosis, and also whether I need to have it stitched now and in the future. Thank you very much for your answer.

Answers Ivanov Dmitry Dmitrievich:

Tatyana, good afternoon! It is difficult to make a prognosis for pregnancy; of course, there will be disturbances in urine output and worsening manifestations of hydronephrosis. No one is stitching up a kidney now. The prognosis is determined by its mobility, for which you should do a Doppler ultrasound of the kidneys while lying and standing, to achieve normal tests urine, switch to aflazin 1 tablet twice a day for a long time and repeat the ultrasound to assess the dynamics of changes in the size of the pelvis.

2014-11-16 11:21:01

Lina asks:

Good afternoon. I am 24 years old. For 5 years I have had headaches constantly (5-6 times a week). At that time, my parents asked the local doctor about my condition, but they were told that I would outgrow it. And now I have been suffering with pain for 19 years, and the nature of the pain is different every time. And the strength of the pain and the location also constantly changes: sometimes I have a strong throbbing pain that I can’t even sit, sometimes it’s a constant aching pain. Since I was 14 years old, I have been constantly getting better. Today my weight is 89 kg with a height of 159 cm. In 2012 I gave birth to a child. My weight before pregnancy was 79 kg. I went into labor weighing 86kg, given that I had a very big belly and a baby weighing 4.00kg. Upon discharge from the maternity hospital, the weight was 76 kg and a week later it was already 72 kg. During the birth there was an unplanned cesarean section and I did not breastfeed because the milk never appeared! A month after giving birth, my first period passed and I suddenly began to gain weight! And within a month my weight became 83 kg. And now a year later my weight is 88 kg, although I have been struggling with overweight. I don't eat in the evening, I don't eat sweets and I go to the gym. There are no problems with the thyroid gland; the ultrasound doctor even wrote that it is prone to shrinkage. I took hormone tests, and the doctor also said that everything was fine. at the same time, with everything I feel constant fatigue, drowsiness, attacks of anger! I really want to sleep during the day, I can’t help but at night I just can’t sleep. I go to bed around 1:00 a.m., but then I wake up a couple more times to see the baby. my son is 2 years old. All the doctors I contacted treated only those symptoms that were relevant to them. But this didn’t make it any easier for me. Please tell me if these could be symptoms of a disease that needs to be treated? And which doctor should I contact to accurately make the correct diagnosis? Thanks in advance. Best regards, Lina

Answers Renchkovskaya Natalya Vasilievna:

Hello Lina. The first question needs to be addressed from the survey side. Considering that the problem of headaches has been around for a long time, the first step is to do an MRI of the head (and with an eye to the sella turcica) and Doppler of the vessels of the head and neck. Perhaps weight gain from the age of 14 was accompanied by the appearance of stretch marks (red stretch marks on the hips, abdomen, axillary areas), when the diagnosis is hypothalamic syndrome. At the moment, it makes sense to take bioimpedance measurements of body composition (how much fat, water, energy capacity), to assess whether there is an imbalance in the regulation of sleep and wakefulness (analysis of the hormones melatonin, serotonin). You need to approach the body as a whole and not in parts - this is a metabolic disorder, hormonal imbalance. With uv. Natalya Vasilievna.