A lower segment cesarean section – LSCS, commonly known as a C-section, is one of the most frequently performed surgical procedures in obstetrics. While it is often planned for specific medical reasons, it may also be performed during emergencies to ensure the safety of both mother and baby. In this Q&A, commonly asked questions related to caesarean are discussed, including when it is recommended, different options for anaesthesia, recovery, and future pregnancies, to help expectant mothers feel informed, prepared, and reassured.
What is lower segment caesarean section? (LSCS)
Delivering your baby through a cut or incision is made in the lower part of your womb and abdomen.
What are the common indications of LSCS?
It may be considered when a vaginal delivery may not be safe for the mother or baby. Some of the indications are:
- When the progress of labour is very slow, or it is not progressing
- When the heart rate or rhythm of your baby is abnormal. (fetal distress)
Abnormal position and presentation of your baby, i.e., if your baby is positioned bottom first (posterior position, breech, or transverse presentation) - When the birth canal (bony pelvis) is narrow.
- When there is a disproportion of your pelvis compared to the large head or body of the baby (Cephalopelvic disproportion – CPD)
- Placenta previa – If you have a low lying placenta that covers or lies close to the cervix.
- If the first baby of a twin pregnancy is not presenting by head
Severe fetal growth restriction – If your baby is too small with Doppler changes (blood flow to the baby) - History of previous C-section or uterine surgery.
What is the type of anaesthesia preferred for LSCS
- Spinal anaesthesia (most common)
- Combined spinal and epidural anaesthesia.
- Epidural alone.
- General anaesthesia, typically reserved for emergencies, is less commonly preferred.
Can I have a vaginal delivery after a caesarean section (VBAC)?
Yes,60-70% of patients after LSCS have vaginal birth. It depends on factors like the indication of your previous caesarean section, previous and current pregnancy status.
- What should I expect after surgery?
- You will be given fluids through an IV drip.
- You may start drinking fluids after 6 hours of operation.
- You will be having a urinary catheter for draining urine, which will usually be kept till the next morning.
- You will be started on a soft diet once you pass gas..
- Walking will be encouraged within 24 hours to prevent blood clots and to improve mobility.
How to take care of my wound (LSCS wound)?
You will be in the hospital for 2 days after this. The wound is usually covered with a dressing, which will be removed later. The wound area needs to be kept clean and dry for a few days. Avoid applying anything over the wound unless advised by the doctor. Look out for any changes such as redness, swelling or discharge. In most cases, the stitches are absorbable, and dressings are minimal.
Will there be any bleeding after surgery?
Yes, can have on and off bleeding for 10-14 days. It will be heavy at the start and gradually decrease. It may last upto six weeks for some. However, if there is heavy bleeding up to 12 weeks (late postpartum hemorrhage – PPH) or large blood clots, surely consult with your doctor.
When can I resume normal activities?
- You can resume normal activities like walking in the immediate postoperative period (1 to 2 days after the operation)
- You can start driving after 10-14 days after the caesarean section.
- Avoid abdominal exercise up to 3 months and also heavy weight lifting (> 5kg) upto 3 months.
- You can swim after 6-8 weeks after LSCS.
- You can resume sexual activity preferably after 2 months.
- You can start working after 45 days (depending on the recovery).
How many years do we have to wait when planning for the next pregnancy?
Ideally the interval between two deliveries to be 2 years for optimum integrity of your uterine scar.