|Lower Section Caesarean section (LSCS)
What is a Lower Section Caesarean section or an LSCS?
Ans: An LSCS (Lower Section Caesarean section) commonly also known as a Caesarean section (C-section) is a surgical procedure in which a baby is born through an incision made in the mother’s abdominal wall and the wall of the uterus. A caesarean section is usually performed when it is more safe for the mother or the baby as compared to a vaginal birth.
Why is a Caesarian section performed?
Ans: In certain cases, it is more safe (for the mother or baby or both) that the mother undergoes a Caesarian section rather than deliver normally. Some of these conditions are:
- The baby’s head is too large for the mother’s pelvic opening.
- The baby is presenting bottom or feet first (breech) or is lying sideways (transverse) and is not able to be turned.
- The cervix is blocked by the placenta (placenta praevia).
- The placenta is no longer able to meet the baby’s needs and the baby cannot tolerate the stress of labour.
- There are multiple babies.
- The mother has a health condition, for example high blood pressure, that means the mother or baby will not be able to tolerate the stress of labour.
- The umbilical cord has prolapsed (fallen down) through the cervix and into the vagina.
- Labour is not progressing.
- The baby develops stress during labour.
When is the decision for a Caesarian section taken?
Ans: In ‘Elective caesarean section’, the surgery is planned before labour starts because there is a risk of complications.
In ‘Emergency caesarean section’ a decision is made to perform the operation after labour has started, because of complications which occurred during labour.
How is Caesarian section performed?
- The patient may be given spinal or epidural anaesthesia for the procedure or may have a general anaesthetic.
- A horizontal cut is made through the abdomen into the lower end of the uterus, across the ‘bikini line’. These incisions heal better and are less likely to be associated with complications in future pregnancies.
- The baby is born through the incision - head first. Forceps might be used to help lift out the baby’s head.
- Amniotic fluid is wiped from the baby’s nose and mouth before its body is lifted free from the uterus.
- The placenta is then removed.
- The patient is then given an injection of oxytocin to make the uterus contract and minimise blood loss.
- The uterus, tissue layers and overlying skin are then stapled or stitched together.
How does the recovery take place after the Caesarian section?
- If you have a caesarean section, you will probably have an intravenous drip for the first 24 hours or so, until you can eat and drink normally.
- You can start drinking fluids as soon as you feel able, although you must pass wind before you can start eating again (it is a sign that your bowel has begun to work normally again).
- You might also have a catheter to drain urine from your bladder so there will be no need to get out of bed to go to the toilet. This is usually removed after you can walk.
- You may also have a tube to drain fluid from the wound.
- Antibiotics may be given in theatre to lower the risk of infection, but they are not usually needed after that.
- You will be prescribed painkillers, and the midwife and doctor should check regularly to see that they are working.
- As sensation and movement return after surgery, usually within about eight to twelve hours, you should get out of bed and try to walk around. If you start moving soon after the procedure, this will speed up recovery and help to prevent certain complications such as blood clots.
- The wound dressing should be removed after 24 hours and the scar should be kept clean and dry once it is exposed.
Inform your doctor if you develop:
- Increased pain.
- Pain passing urine.
- Leaking urine.
- Increased vaginal blood loss.
- Coughing or shortness of breath.
- Swelling or pain in your calf (lower leg).
- Get as much rest as you can for the first few days.
- Eat a healthy diet and drink plenty of water every day to prevent constipation Take a gentle walk every day to reduce the risk of blood clots.
- Take pain killers as long as you need them.
- Wear loose cotton clothing and keep the wound clean and dry. Look for signs of infection (such as redness, pain and swelling) every day.
- Use warmth on the wound (such as a heating pad), it may be soothing.
- Certain activities such as driving a car, carrying heavy things, exercising or having sex will have to be avoided for some time after a Caesarean section. You should only do those things once you feel you are able to do so and they do not cause pain.