Caesarean Section (LSCS)

Medically reviewed by Dr Darshana Ajmera, MBBS (Nair, Mumbai), MS ObGyn (Honours) - Obstetrician, Gynaecologist & Fetal Medicine Specialist

What it is

A caesarean section, which most of us write as LSCS (lower segment caesarean section), is an operation to deliver a baby through a cut in the mother’s lower abdomen and womb. The “lower segment” simply means the cut is made in the thinner, lower part of the uterus, which heals well and lets most women attempt a vaginal birth later.

Let me say one thing plainly: a caesarean is not an easier way to have a baby, and we never present it as better than a vaginal birth. For most healthy women with an ordinary pregnancy, a vaginal birth is the safer and quicker-recovering route. A caesarean is for the situations where, for you or for your baby, it is safer than the alternative. If you want to read how that decision is actually weighed, our post on normal delivery versus caesarean goes through it.

Who needs it

A caesarean may be planned in advance, or decided during labour when something changes. The reasons fall into a few groups.

• Placenta problems. A placenta lying over the cervix (placenta praevia) makes vaginal birth unsafe because of heavy bleeding.
• Baby lying in an unusual position, such as breech or across the womb, when turning the baby has failed or is not suitable. Twins are assessed case by case; some can be born vaginally, some cannot.
• Labour that is not progressing, despite good contractions, or a baby too large to pass through the pelvis.
• Signs of baby’s distress in labour, such as an abnormal heart-rate pattern that does not settle.
• Previous caesarean or uterine surgery, where the scar carries a risk of opening under the strain of labour. Many of these women can still try a vaginal birth, but not all.
• Medical conditions in the mother, for instance severe pre-eclampsia, certain heart conditions, or an active genital herpes infection.
• Conditions in the baby, found on scans, that make labour unsafe for the baby.

“The nurse says my sugar and BP are fine. Why is the doctor still mentioning a caesarean?” Because the decision is rarely about one number. We look at your baby’s size and position, the placenta, any previous scar, how the cervix is behaving and how the baby’s heart is coping. Something can look reassuring on a report and still make labour risky for a particular woman. Ask us to explain the exact reason, in plain words - you are entitled to it, and so is your family.

How it is done

Before the operation, you are checked, your blood group is confirmed, a drip is set up, and a catheter is placed once you are numb. Antibiotics are given just before the cut, because that is when they protect best.

Once the anaesthetic is working, the abdomen is cleaned and covered. A cut of about 10 to 15 cm is made low on the abdomen, usually along the bikini line, through the skin and the layers below. The bladder is gently moved aside, and a small cut is made in the lower part of the uterus. The baby is then delivered, usually within a few minutes of the first incision. The cord is clamped and cut, the baby is checked and handed to you or your partner, and the placenta is removed.

Then comes the part that takes the longest: closing the womb in layers, checking for bleeding, and closing the layers of the abdomen and the skin, with stitches or staples. The whole operation usually takes 45 minutes to an hour, though a repeat caesarean or a difficult case may take longer.

Anaesthesia, duration and hospital stay

Most caesareans are done under spinal anaesthesia, sometimes with an epidural, so you are awake and comfortable, numb from the chest down. General anaesthesia is used in true emergencies or when a spinal cannot be given. Your anaesthetist will explain what suits you.

Expect about 45 to 60 minutes in the theatre, then an hour or two in recovery. The usual hospital stay is 3 to 4 days for an uncomplicated caesarean, and sometimes longer if the baby needs special care or if you do.

Recovery

Day 1. The numbness wears off over a few hours. The wound is sore, and you may feel afterpains as the womb contracts. We give regular painkillers, and you are helped to sit up and take a few steps. Breastfeeding can start. The catheter comes out within 12 to 24 hours.

The first week. Walk a little every few hours; it prevents clots and helps your bowels. Support your wound with a pillow when you cough, laugh or feed. Bleeding from the vagina is normal and heavy at first. The dressing is checked before you go home, and stitches or staples are removed or checked around day 5 to 7, depending on the type used.

Weeks 2 to 4. The tenderness fades, though you tire easily and the scar may itch or feel numb. Do not lift anything heavier than your baby. Light household work is fine. Drive only when you can brake hard without hesitating.

By 6 weeks. Most women feel much more like themselves. We review you, check the scar and bleeding, and talk about contraception and the spacing of the next pregnancy. We usually advise waiting at least 18 months before conceiving again.

Come in the same day for fever, a wound that is red, hot, leaking or opening, heavy bleeding with clots, a painful swollen leg, or breathlessness.

Risks and complications

Every operation carries risk, and this one is no exception, but serious problems are uncommon in good hands.

• Bleeding, which can occasionally need a blood transfusion.
• Infection of the wound, the womb lining, or the urinary tract.
• Blood clots in the legs or lungs, which is why we ask you to move early and sometimes give a blood thinner.
• Injury to the bladder or bowel, rare, and more likely after earlier abdominal surgery.
• Adhesions (internal scarring), which can make later operations more difficult.
• Scar-related problems in future pregnancies, including placenta praevia, abnormal attachment of the placenta, and rarely the scar opening during labour.
• Breathing problems in the newborn that are slightly more common after a caesarean, especially if it is done before 39 weeks without a medical reason.
• Anaesthetic complications, such as a headache after a spinal, a fall in blood pressure, or, very rarely, a more serious reaction.
• Longer recovery and more pain in the early weeks than after a vaginal birth.

Alternatives

Where there is a genuine choice, the alternative is a vaginal birth, with induction or monitoring if needed. For breech babies, an external cephalic version (gently turning the baby from outside) may be offered at term. For women with one previous lower-segment caesarean, a trial of labour is often reasonable. All of these are weighed against the reasons for the caesarean, and we always explain what is lost and gained by each route.

When the reason is an emergency, such as a distressed baby or heavy bleeding, there is no alternative worth waiting for, and speed is what matters. You can read how pregnancy care is organised in our obstetrics and gynaecology department, see our fetal medicine service for high-risk scans, or see all the procedures we perform.

What it costs

The ranges below are all-inclusive: surgeon’s fee, operation theatre, anaesthesia, room rent for a typical stay, medicines and routine investigations.

Uncomplicated, singleton caesarean: ₹40,000 – ₹70,000

High-risk caesarean (previous LSCS, placenta praevia, twins): ₹45,000 – ₹75,000

Please note: The figures above are indicative estimates for a typical case. The final cost depends on your individual condition, the complexity of the surgery, the room category you choose, how long you stay, and any complications that arise. Deluxe and super-deluxe rooms are charged higher. Emergency admissions and night or holiday surgery attract additional charges. These charges are subject to change without prior intimation. Please call us on +91-8668954915 for a written estimate for your own case before you decide anything.

Preparing for your surgery

• Bring all your antenatal records, scan reports, blood group and any previous operation notes.
• Tell us about your medicines, including iron, calcium, blood thinners, and anything ayurvedic or homeopathic.
• Follow the fasting instructions for a planned operation, usually 6 to 8 hours without food and 2 hours without clear water.
• Pack a hospital bag with loose, front-opening clothes, sanitary pads, a few baby clothes and a soft cotton blanket.
• Arrange help at home for at least the first 2 to 3 weeks, since you should not lift or do heavy housework.
• Ask your questions beforehand, about the anaesthetic, the baby’s care, and who may be with you. Write them down.
• Make sure someone stays with you in hospital, and that your partner knows the plan.
• Save our number and know the route to the hospital for any problems after you go home.

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If you are pregnant and wondering whether a caesarean could be needed, or you have had one before and are planning another baby, come and talk it through early. The obstetric team at Shubham Hi-Tech Hospital and Test Tube Baby Centre, Amravati, will go through your records and explain the safest plan in plain words. Call +91-8668954915 or get in touch here.

Disclaimer: This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor for guidance specific to your situation.