Second caesarean section: how and at what time the operation is performed. Second caesarean section: what is important to know? Caesarean section: indications, timing, recovery

Each pregnancy in a woman proceeds in a new way, different from the previous one. Childbirth, accordingly, also goes differently. If the baby was born for the first time with the help of gynecological surgeons, this does not mean that now everything will happen according to the same scenario. What to do if you have a second caesarean section? What is important for a woman to know? Is it possible to avoid surgery? Today's article will answer these and some other questions. You will learn about the period at which a planned second caesarean section is performed, how the body recovers after manipulation, whether it is possible to plan a third pregnancy and whether it is actually possible to give birth on your own.

Natural birth and caesarean section

Let's find out how a second caesarean section is performed and what indications it has. What is important to know? The natural birth of a child is a process intended by nature. During childbirth, the baby goes through the appropriate paths, experiences stress and prepares for existence in the new world.

Caesarean section involves the artificial birth of a child. Surgeons make an incision in the woman’s abdomen and uterus, through which they remove the baby. The baby appears abruptly and unexpectedly, he does not have time to adapt. Let us note that the development of such children is more difficult and complex than those born during natural childbirth.

During pregnancy, many expectant mothers are afraid of the cesarean section procedure. After all, preference has always been given to natural childbirth. A few centuries ago, a woman had no chance of survival after a Caesarean section. At an earlier time, manipulation was carried out only in patients who had already died. Now medicine has made a big breakthrough. Caesarean section has become not only a safe intervention, but in some cases necessary to save the life of the child and mother. Now the operation lasts only a few minutes, and the anesthesia capabilities allow the patient to remain conscious.

Second caesarean section: what is important to know about the indications?

What does the doctor pay attention to when choosing this route of delivery? What are the indications for a second intervention in the natural process? Everything is simple here. The indications for the second cesarean section are the same as for the first operation. The manipulation can be planned or emergency. When prescribing a planned caesarean section, doctors rely on the following indications:

poor vision in a woman;
varicose veins of the lower extremities;
heart failure;
chronic diseases;
diabetes mellitus;
asthma and hypertension;
oncology;
traumatic brain injury;
narrow pelvis and large fetus.

All these situations are a reason for the first intervention. If after the birth of the child (the first) the diseases have not been eliminated, then the operation will be performed during the second pregnancy. Some doctors are inclined to this opinion: the first cesarean section does not allow the woman to give birth again on her own. This statement is wrong.

Is it possible to give birth on your own?

So, you are recommended for a second cesarean section. What is important to know about him? What are the real indications for surgery if the woman’s health is fine? Repeated manipulation is recommended in the following cases:

the child has ;
less than two years have passed since the first caesarean section;
the suture on the uterus is incompetent;
During the first operation, a longitudinal incision was made;
abortions between pregnancies;
the presence of connective tissue in the scar area;
location of the placenta on the scar;
pregnancy pathologies (polyhydramnios, oligohydramnios).

An emergency operation is performed in case of unexpected scar divergence, weak labor, a woman’s serious condition, and so on.

You can give birth yourself if a second caesarean section is recommended. What is important to know? Modern medicine not only allows a woman the natural process of childbirth, but also welcomes it. It is important that the expectant mother is thoroughly examined. The conditions for natural childbirth after cesarean section are the following circumstances:

More than three years have passed since the first operation;
the scar is wealthy (muscle tissue predominates, the area stretches and contracts);
thickness in the seam area is more than 2 mm;
no complications during pregnancy;
a woman's desire to give birth on her own.

If you want your second child to appear naturally, then you should take care of this in advance. Find a maternity hospital that specializes in this issue. Discuss your condition with your doctor in advance and get examined. Attend your appointments regularly and follow your gynecologist's recommendations.

Pregnancy management

If the first birth took place via cesarean section, then the second time everything can be exactly the same or completely different. Expectant mothers after such a procedure should have an individual approach. As soon as you find out about your new situation, you need to contact a gynecologist. A special feature of managing such a pregnancy is additional research. For example, in such cases, ultrasound is done not three times during the entire period, but more. Diagnosis before childbirth is becoming more frequent. The doctor needs to monitor your condition. After all, the entire outcome of the pregnancy depends on this indicator.

Be sure to visit other specialists before delivery. You need to see a therapist, ophthalmologist, cardiologist, neurologist. Make sure there are no restrictions on natural childbirth.

Multiple and regular caesarean section

So, you are still scheduled for a second cesarean section. At what time is such an operation performed, and is it possible to give birth on your own during a multiple pregnancy?

Let's assume that the previous delivery was performed surgically, and after that the woman became pregnant with twins. What are the forecasts? In most cases, the outcome will be a second cesarean section. The doctor will tell you at what time it is done. In each case, the individual characteristics of the patient are taken into account. The manipulation is prescribed for the period from 34 to 37 weeks. In case of multiple pregnancy, do not wait longer, as a rapid natural birth may begin.

So, you are pregnant with one child, and a second cesarean section is scheduled. When is the operation performed? The first manipulation plays a role in determining the deadline. Repeated intervention is scheduled 1-2 weeks earlier. If the first time a cesarean was performed at 39 weeks, now it will happen at 37-38.

Seam

You already know at what time a planned second caesarean section is performed. The cesarean section is repeated using the same suture as the first time. Many expectant mothers are very concerned about aesthetic issues. They worry that their entire stomach will be covered in scars. Don't worry, that won't happen. If the manipulation is planned, then the doctor will make an incision where it was made the first time. Your number of external scars will not increase.

The situation is different with the incision of the reproductive organ. Here, with each repeat operation, a new area for the scar is selected. Therefore, doctors do not recommend giving birth using this method more than three times. For many patients, doctors offer sterilization if a second cesarean section is scheduled. When admitted to the hospital, gynecologists clarify this issue. If the patient wishes, tubal ligation is performed. Don’t worry, doctors will not carry out such a manipulation without your consent.

After surgery: recovery process

You already know when a second caesarean section is indicated and at what time it is done. Reviews from women report that the recovery period is practically no different from what it was after the first operation. A woman can stand up on her own in about a day. A new mother is allowed to breastfeed her baby almost immediately (provided that no illegal drugs were used).

Discharge after the second operation is the same as during natural childbirth. Within one or two months, the discharge of lochia is observed. If you had a caesarean section, it is important to monitor your well-being. Consult a doctor if unusual discharge appears, temperature rises, or general condition worsens. They are discharged from the maternity hospital after the second cesarean section approximately 5-10 days later, the same as the first time.

Possible complications

With repeated surgery, the risk of complications certainly increases. But this does not mean that they will definitely arise. If you give birth on your own after a cesarean section, then there is a possibility of scar dehiscence. Even if the suture is strong, doctors cannot completely exclude this possibility. That is why in such cases artificial stimulation and painkillers are never used. This is important to know.

When performing a second cesarean section, the doctor faces difficulties. The first operation always has consequences in the form of an adhesive process. Thin films between organs make the surgeon's work difficult. The procedure itself takes longer. This could be dangerous for the child. Indeed, at this moment, potent drugs used for anesthesia penetrate into his body.

A complication of a repeat cesarean can be the same as the first time: poor contraction of the uterus, its inflection, inflammation, and so on.

Additionally

Some women are interested: if a second caesarean section is performed, when can they give birth for the third time? Experts cannot answer this question unambiguously. It all depends on the condition of the scar (in this case two). If the suture area is thinned and filled with connective tissue, then pregnancy will be completely contraindicated. With sufficient scars, it is quite possible to give birth again. But, most likely, this will be the third caesarean section. The possibility of natural childbirth decreases with each subsequent operation.

Some women manage to give birth to five children by caesarean section and feel great. Much depends on the individual characteristics and technique of the surgeon. With a longitudinal incision, doctors do not recommend giving birth more than twice.

In conclusion

A caesarean section performed during the first pregnancy is not a reason for a repeat procedure. If you want and can give birth on your own, then this is only a plus. Remember that natural childbirth is always a priority. Talk to your gynecologist about this topic and find out all the nuances. Best wishes!

A second pregnancy that ends with a second cesarean section does not always go well. In some women, the scar from a previous operation becomes very thin, as a result of which many are admitted to the maternity hospital 2-3 weeks earlier than the expected date of birth. At what time is the second caesarean section performed and what difficulties await the woman?

Much depends on how the pregnancy went and for what reasons the first operation was performed. For example, if a woman has severe myopia or has fundus disorders, then there are indications for a repeat cesarean section. And doctors will not allow a woman to give birth on her own. And if the first operation was performed due to a long anhydrous interval, then a natural birth is quite possible. But only if the condition of the uterine scar at the time of birth is good and there are no other reasons for surgical delivery.

How is the second caesarean section performed, are there any special features? Almost none. At least for a woman. Although difficulties may arise if, for example, spinal anesthesia was used for the first time, after which women quickly recover. And the second time, general anesthesia was given for some reason. After general anesthesia, the recovery period is slightly longer.

Problems can also arise if a long period of time has passed between operations. That is, the woman is already over 30-35 years old. In this case, due to age, the risk of complications is higher. For example, there may be uterine fibroids, due to which the contractility of the myometrium is reduced and subinvolution of the uterus is likely, followed by an inflammatory process - endometritis. Many women have problems with their veins as they age. And this is a threat of thrombosis. For this reason, doctors recommend not removing compression stockings (bandages, stockings or socks) after surgery and wearing them for a few more days. And if there is pain in your leg, it turns red, or swells, immediately inform your doctor about it.

The good news is that the second cesarean section is performed using the same suture, which means that the woman will not have unnecessary cosmetic defects on the abdominal wall. As long as the suture material is of high quality, and the surgeon carefully stitches everything up. A lot depends on the doctor and his experience. Then the suture after the second caesarean section takes no longer to heal than after the first. Wound care is important. In the maternity hospital, this is done by the medical staff. Treats with antiseptics, makes dressings. And at home everything is in the hands of women. How long it takes for a caesarean section to heal for the second time will depend on how accurately you follow your doctor's recommendations. Doctors often do not advise treating the seam in any way at home. Just don't lift heavy things. And wash the seam itself with soap, but do not rub it with a washcloth. Within a few months, all discomfort in the suture area should disappear.

When will a woman be operated on again? It all depends on the indications for which the operation is performed. If there is nothing urgent, such as very high blood pressure, which cannot be brought down with medication, then the second planned caesarean section is performed at 39-40 weeks, that is, as close as possible to the expected date of birth, calculated by the doctor based on the results of an ultrasound in the early stages and date of the first day of the last menstruation.
If a woman’s pregnancy after a second cesarean section proceeds with the threat of premature termination, and contractions begin, for example, at 35 weeks, then doctors try to help the woman carry the pregnancy to at least another 37-38 weeks, while at the same time giving injections for the rapid maturation of the fetal lungs. But if the amniotic fluid has broken or the condition of the fetus is poor, severe bleeding has begun - the operation is performed as soon as possible.

What is important to know about a second cesarean section to make it easier to survive? There are quite a lot of nuances. But those who have undergone this operation advise the main thing - to try to get up and move faster. This will help you recover faster. And if possible, do not get too carried away with painkillers.

And, of course, remember that this method of childbirth in no way detracts from your feminine qualities and does not indicate your inferiority. You were able to bear a child. And the method of delivery is not so important. The main thing is that doctors act in the interests of you and the child.

Don't rush to check out. Be sure to do an ultrasound before discharge. If doctors see signs of inflammation and lochia accumulation, they may suggest further treatment to avoid further problems with reproductive health.

They have long ceased to be something unusual. It was thanks to Caesarean that many women had the opportunity to become mothers. Of course, this method of delivery has both its advantages and many disadvantages. If for some reason the first birth was by caesarean section, then the question arises of what to expect from subsequent pregnancies and births.

Once a cesarean section, always a cesarean?

For many years the answer to the question asked was exclusively affirmative. It was believed that after the first cesarean, a second similar delivery could not be avoided. Moreover, after the second birth, the woman was offered to either have her tubes tied or have her uterus removed altogether in order to avoid repeated pregnancies. All because the scar on the uterus with each cesarean brought the woman closer to fatal consequences.

Fortunately, today they not only do not suggest removing the uterus (which in itself is monstrous!), but also convince us that it is quite possible to avoid a repeat cesarean section by giving birth to a healthy baby through There are many cases where women gave birth to their second and third child without surgical intervention. . Meanwhile, attitudes towards repeat caesarean sections have changed. With the right approach, experienced gynecologists can “get” even the fourth baby out of the womb. It is only important to fulfill some conditions. The most important thing is that there are no abortions between pregnancies, and at least 3 years must pass after the first cesarean section (this is the time the uterus needs for). Today, every woman should be encouraged by a doctor to have a natural birth, regardless of whether it is her first birth or her tenth. However, our desires do not always coincide with our capabilities, and sometimes a repeat cesarean section cannot be avoided.

Indications for repeat caesarean section

Absolute medical indications for caesarean section are those indications according to which a woman cannot give birth through the natural birth canal either for the first or subsequent times. But there are also relative indications for a repeat cesarean section, which may even occur during natural childbirth.

Anatomically or clinically narrow pelvis. If doctors have given you such a “diagnosis,” then a cesarean section cannot be avoided. However, in many European countries people with a narrow pelvis give birth without surgery.
Deformation of the pelvic bones and discrepancy of the pubic bones.
Oncological diseases of the expectant mother (pelvic or ovarian tumors, for example).
Incorrect presentation of the fetus (transverse or even breech), or (over 4 kg).
Placenta previa (especially in a scar on the uterus), or premature detachment.
Serious diseases of the expectant mother (nervous or cardiovascular systems, vision problems, diabetes, exacerbation of genital herpes, etc.).
Incompetence of the uterine scar after cesarean section (predominance of connective tissue in the scar area rather than muscle).
Problems on the part of the child (fetal hypoxia, for example).
Weak labor.

Possible risks for mother and baby

Almost all doctors talk about the possible risks of natural childbirth after a cesarean section, but very little is said about the consequences of a repeat cesarean section. If they talk about it, it’s only about the risk of uterine rupture, and such information understandably frightens women in earnest, and many do not dare to have repeat pregnancies, depriving themselves of the pleasure of being a mother twice.

Before you decide to become pregnant again and give birth after your first cesarean section, it is important to think carefully about everything and prepare for another pregnancy in advance. As already mentioned, it is safer to carry out a repeat cesarean section (for both mother and baby) no earlier than 3 years after the first operation. Always first consider the possibility of giving birth to a second or even third baby without surgery, because this is quite possible and safer than a repeat cesarean section.

Almost everyone is afraid of a possible rupture of the uterus in the area of the scar, but in the event of a rupture, both the woman and the child can be saved. At the same time, with a repeat caesarean section, the risk of uterine bleeding increases, which is very often the reason for removal of the uterus. Repeated caesarean section is fraught with many complications (this could include injuries to the intestines or bladder, anemia with endometritis, the formation of adhesions and other troubles).

Negative consequences of a repeat cesarean section also await the child. Maternal anesthesia can cause cerebral circulation problems in the baby, and Apgar scores will be very low. With a repeat caesarean section, babies are most often born premature, and the risk of various diseases (including asthma) increases.

All these “horrors,” although well-known, do not occur so often. We absolutely do not want to scare you or dissuade you from getting pregnant again. The decision will be made solely by you. No doctor will force you to either give birth on your own or go under the knife again. However, every gynecologist is obliged to give you full information about all possible risks and complications of both a repeat cesarean section and vaginal delivery.

Good luck to you!

Especially for Tanya Kivezhdiy

Contrary to popular belief, if the first birth took place surgically, not every woman is prescribed a second cesarean section for a second pregnancy. I, like any specialist, make a decision on surgical obstetric care only after carefully analyzing many factors.

A second (emergency or planned) caesarean section is prescribed if:

The patient has a history of diseases such as asthma or hypertension, and there are endocrine disorders.
The woman recently suffered a serious injury, she has pathological visual impairment, problems with the heart or blood vessels, and malignant tumors.
The expectant mother has a deformed or too narrow pelvis.
Previously, the woman had a longitudinal incision made; there is a risk of breaking the integrity of the old suture; there are keloids scarring.
After the previous CS, the patient had an artificial one or had a miscarriage.
Pathologies were discovered: a large fetus or its incorrect presentation, postmaturity, poor labor.
The patient is expecting twins.
The mother’s age is 35+ or after the birth of her first child a very short period of time has passed – no more than 24 months.

If nothing from this list is found in the patient, I allow (and even insist) to give birth on her own.

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At what time is a second caesarean section performed?

Here you need to start from the reasons indicating the need for the operation. But in any case, in order to minimize risks, the deadlines are shifted. For example, if a woman in labor has too large a belly, it means that the baby is large and significantly stretches the walls of the uterus. That is, the threat of seam rupture is quite high. In such cases, the operation is performed at 37–38 weeks.

The timing of the second caesarean section even depends on the woman’s blood pressure. If blood pressure is very high and is not controlled by medications, then surgery can take place as early as the 39th week. In any case, we try to schedule the birth for a date that is closer to 40-41 weeks, having discussed this issue in advance with the expectant mother.

In patients with a complicated pregnancy, contractions can begin as early as the 35th week. In such cases, for my part, I make every effort to help the expectant mother carry the baby to at least the 37th week. Of course, during this period therapy is prescribed to stimulate the maturation of the fetal respiratory system.

Every second patient of mine is sure that if she has already undergone surgery once, then her second cesarean will go “like clockwork.” I should note that a positive attitude and calm in this case are already half the success. But such confidence must be supported by the actions of the expectant mother. Excessive negligence and frivolity can lead to disastrous consequences. If you already know that a CS is inevitable, start taking action.

During pregnancy

It is important to provide for absolutely everything that may be associated with a second cesarean section. Here are some recommendations I give to my patients:

Sign up for special courses for expectant mothers who are about to have a CS.
Be prepared for the fact that you may need to stay in the hospital for a long time before and after giving birth. Decide in advance where and with whom your eldest child will be all these days, so that you don’t have to worry about him later, which is extremely undesirable in your situation.
Consider and discuss the option of partner birth with your spouse. If an epidural is administered and you remain awake, you may find it easier and more enjoyable to go through the entire process with a loved one nearby.
Never skip routine examinations prescribed by your doctor.
Don’t be afraid to ask your gynecologist all the questions that concern you (about when the second CS is being done, and why you are scheduled to give birth on this date, what tests you need to take, whether you have complications, why the doctor prescribed you certain medications, etc. .). This will give you the confidence and peace of mind you need.
Purchase in advance the things you and your baby will need in the maternity hospital.

Be sure to find out what blood type your relatives have (this is especially important if you have a rare one). There are situations in which a woman in labor suffers large blood losses during surgery. The reason for this may be coagulopathy , preeclampsia, abnormal placental presentation, etc. In such cases, a donor may be urgently needed.

A few days before surgery

As a rule, in the last stages of pregnancy the patient is in the hospital. For at least two days prior to surgery, you must abstain from solid foods and foods that cause gas. 12 hours before birth, it is generally forbidden to drink or eat, since the anesthesia used during a CS can cause vomiting. And most importantly, the expectant mother must get enough sleep. Keep in mind that recovery this time will be more difficult than after the birth of your first child, so proper rest is a necessary measure.

Stages of the operation

Naturally, experienced mothers who are not giving birth for the first time with the help of surgeons already know how to perform a planned caesarean section. The operations are truly identical and follow the same scenario. Therefore, you should not expect surprises. So, let's look at how a second caesarean section is done step by step.

Preparing for surgery

Even if the caesarean section is for the second time, I still give detailed consultation to each patient. I answer all questions, talk about the advantages and disadvantages of surgical intervention, and possible complications.

Immediately before the birth itself, a nurse also helps the patient prepare for the operation, who:

Checks the basic indicators of a woman’s health: temperature, cardiac activity (pulse), blood pressure.
Gives an enema to empty the stomach and thus prevent regurgitation during the birth process.
Shaves the pubic area so that hair getting into an open wound does not cause inflammation.
Installs a dropper with, the action of which is aimed at preventing infection, and with a special composition that prevents dehydration.
Inserts a catheter into the urethra of the woman in labor.

Surgical stage

If the birth is performed surgically, it does not matter whether it is the first or the second, be prepared for the fact that there will be quite a lot of doctors in the operating room. As a rule, a “team” works in the delivery room, consisting of:

two surgeons;
anesthesiologist;
nurse anesthetist;
neonatologist;
two operating room nurses.

First of all, the anesthesiologist administers anesthesia - local or general. When the anesthesia takes effect, surgeons begin work - they perform a longitudinal or transverse incision (depending on the indications). After gaining access to the uterus, doctors use special equipment to suck out the amniotic fluid and remove the baby from the womb. After this, the child is taken by a neonatologist or nurse for initial care (clearing the mouth and nose of mucus and fluid, Apgar measurements, examination and medical care, if required).

All these manipulations take no more than 10 minutes. After which the surgeon removes the placenta, checks the uterus and applies sutures. The organs are sewn together for quite a long time – about an hour. After which the patient is administered medications that promote uterine contractions.

Dangers of a second caesarean section

The risks associated with a second cesarean section vary from person to person. Here everything depends both on the characteristics of the pregnancy and on the general health of the mother in labor. In a mother who gave birth again through surgical manipulations, the suture may become damaged or inflamed. Rarely, complications such as anemia and thrombophlebitis occur.

For a child, the consequences can also be different, ranging from circulatory disorders to hypoxia caused by prolonged exposure to anesthesia (since a repeat CS always lasts longer than the previous one).

But any complications are very easy to avoid if you properly prepare for the operation and follow all the recommendations of your doctor.

Second caesarean section: what is important to know

As I said above, any operation is individual, and childbirth cannot take place in the same way. But these differences should not cause anxiety and panic in the woman in labor. The main thing is to familiarize yourself with them and set yourself up correctly before the operation.

So, second cesarean section: what is important to know:

How many weeks? Most often - at 37-39, but if there are indications for this, the doctor may insist on an earlier delivery.
When are they sent to the hospital? If the pregnant woman and the fetus are absolutely healthy - a couple of days before the appointed date. But it’s better - in a week or two.
What anesthesia is used? Both local and general, but the dose is stronger than for the first CS, since repeated births last longer.
How is it cut? According to the old scar, so a new scar will not appear.
How long does the process take? A little longer than the first birth, approximately 1–1.5 hours.

It is also worth considering that the recovery process in this case will be longer and more complex. This is due to the fact that skin that is excised repeatedly takes longer to heal. The involution of the uterus also occurs more slowly, causing discomfort. But if you follow all the rules of the rehabilitation period, it will pass as soon as possible.

Previously, obstetricians and gynecologists almost unanimously opposed repeat surgical births. Pfannenstiel laparotomy (this is the scientific name for this operation) does have its own risks and consequences. But modern medicine has stepped far forward. And today, a CS is perceived as a completely normal option for delivery. Of course, before you decide to give birth to a child in this way, you need to consult in detail with your doctor so that he can determine if there are any indications and/or contraindications. A woman should definitely once again study possible options for the outcome of surgical manipulations, taking into account that she will have to face difficulties not only during childbirth, but also after the baby is born. After all, the recovery period during a repeat operation is more difficult, the suture left after the second cesarean section will take a long time to heal, and the cycle will not normalize immediately. And only after weighing all the pros and cons can the final decision be made.

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A cesarean section is often repeated, since giving birth with a scar on the uterus is not always safe. However, natural childbirth is also possible. True, it is not easy to find such specialists who will agree to accept them. A repeat caesarean section is not technically difficult to perform. However, complications after it are more likely to occur than after the first. But, of course, this does not stop the operated women who want to give birth to a second, third, and sometimes even fourth child.

The dangers and complications of a repeat cesarean section include a high risk of heavy bleeding during and after the operation, slow contraction of the uterus, which can cause acute endometritis (inflammation of the uterus), vein thrombosis (compression stockings need to be worn longer), peritonitis and others. Therefore, to perform a second cesarean section, strict indications are needed, as for the first operation. This is not a whim. And it is not the woman who decides that she will have such a birth, but the doctors, having compared all the benefits and risks of the operation.

A woman must understand that such a delivery is most likely more difficult for her than a natural birth. A difficult postpartum period and very likely problems during the next pregnancy, which is also recommended to be planned no earlier than in 2 years. Most likely, the birth will again not be natural. Although in some cases, in the presence of experienced doctors, the ability to urgently operate if necessary, they may recommend a natural repeat birth after cesarean section, especially if the woman had already had a successful spontaneous birth before the operation.

Here are some situations after which a woman may be allowed to give birth herself:

pelvic or transverse position of the fetus in the uterus (it is not a fact that during the next pregnancy it will also be positioned incorrectly);
premature placental abruption or complete placental presentation;
severe form of gestosis (it often repeats during the next pregnancy, but not always);
loss of umbilical cord loops or other condition that threatens the death of the child;
post-term pregnancy, when induction of labor is impossible or does not produce results;
weakness of labor;
long water-free period.

At what time is a repeat planned caesarean section performed and what are the absolute indications for it? The operation is performed as close as possible to the expected date of birth if:

the woman has an anatomically narrowed pelvis (the operation will be performed regardless of the weight of the child estimated by ultrasound and the size of the uterus);
there is a large uterine fibroid;
have severe cardiovascular diseases;
very poor vision, etc.

A caesarean section is performed for the second time at less than 40 weeks of pregnancy or urgently if the woman has begun spontaneous labor. On the one hand, this situation is good, since the child is born at his “own” time, determined by the body and nature. But emergency operations always involve greater risk than planned ones. And the consequences of a repeat cesarean are usually more severe if it is an emergency. It is better if a woman enters the maternity hospital as planned. 1-2 weeks before the expected date of birth. There she undergoes all the necessary tests, undergoes an ultrasound, an ECG, and consults with an anesthesiologist and doctors of other specialties if she has any diseases.

But even if doctors consider a second operation safer, there is no need to worry about cosmetic defects. Most likely, the stitch from the repeat cesarean section will be above the first one, that is, two scars will not remain.

In order for the operation to take place on time and successfully, nothing threatens the mother and child, it is advisable that at least 2 and no more than 5 years have passed after the first operation. Pregnancy after a cesarean section should be planned again only after undergoing an ultrasound, during which the doctor will confirm the consistency of the uterine scar (internal). This serves as a kind of guarantee that it will not separate during pregnancy.