Lower Segment Cesarean Section (LACS), commonly referred to as Cesarean delivery or C-section, is a surgical procedure used to deliver a baby through an incision made in the lower abdomen and uterus. It is usually recommended when a vaginal birth poses risks to the mother, the baby, or both. LACS is the most widely practiced form of Cesarean delivery because the incision is placed in the lower part of the uterus, where the muscle is thinner and less active, leading to better healing and reduced complications compared to a classical vertical incision.

This procedure may be planned (elective) or performed as an emergency if complications arise during labor. Common reasons for LACS include prolonged labor, fetal distress, placenta previa, breech or abnormal fetal position, multiple pregnancies, previous cesarean deliveries, or certain maternal medical conditions.

Benefits of LACS

• Safety for mother and baby – LACS is often the safest option when vaginal delivery is risky. It can prevent complications such as prolonged obstructed labor, uterine rupture, or fetal hypoxia.
• Reduced maternal complications compared to classical cesarean – The lower uterine incision heals better, has a lower risk of rupture in future pregnancies, and results in less bleeding.
• Predictability – In elective cases, the timing of delivery can be scheduled, which helps in preparedness for both the family and healthcare providers.
• Better healing – The lower segment incision causes less postoperative pain and promotes faster recovery compared to other types of uterine incisions.
• Improved neonatal outcomes – In conditions like fetal distress or placenta previa, LACS significantly reduces the risk of injury or oxygen deprivation to the baby.

Risks and Considerations of LACS

• Surgical risks – As with any surgery, risks include infection, bleeding, injury to surrounding organs (bladder or bowel), and anesthesia-related complications.
• Longer recovery – Recovery after a C-section is generally slower compared to vaginal delivery, with increased discomfort and need for wound care.
• Future pregnancy risks – Although safer than classical cesarean, repeated LACS increases the risk of placenta previa, placenta accreta, and uterine rupture in subsequent pregnancies.
• Breathing difficulties in newborns – Babies delivered by cesarean, especially before 39 weeks, may have a slightly higher chance of respiratory problems.
• Emotional impact – Some mothers may feel disappointed if they hoped for a vaginal birth, and bonding or breastfeeding initiation may be slightly delayed.