About 32% of births in the United States happen via Cesarean section, also called a C-section, C-birth, surgical birth, belly birth, or just plain Cesarean. Because this type of birth is a surgery, new parents who have had Cesareans will have an incision on their lower abdomen. If you’ve had a C-section, your incision will go through a period of initial healing before it turns into a scar.
For parents who birthed surgically, it’s vitally important to understand C-section scar healing—both physically and emotionally. Here’s how to care for your Cesarean scar, directly after birth and beyond.
Immediately After Birth
If you’ve had a C-section, your incision will go through a period of initial healing before it turns into a scar. Typically, a C-section incision is about 4-5 inches long, right at the bikini line. Your incision will be closed with either glue, stitches, or staples. Most often, stitches that dissolve on their own are used. Sometimes, doctors will use adhesive strips that will fall off after a few weeks. If you’ve had staples, the staples will need to be removed (most often, they are removed in the hospital before discharge).
Directly after birth, the incision will still be healing, so it will be red and swollen. Keep a close eye on it for signs of infection (like heat, swelling, or liquid leaking from it).
Just water or very mild soap is ok to clean it with, but no vigorous scrubbing. You can simply let the water in the shower run gently over the area for the first few weeks.
Keep pressure off of the incision. The best way to do this is to take it easy—no heavy lifting or strenuous exercise of any kind. Gentle walking is ok, but rest should be your main MO. If you’re breastfeeding, the football hold can be perfect to keep baby’s little legs away from your general pelvic area (and check out our other tips for breastfeeding/chestfeeding after a belly birth).
Let the incision get as much air as possible. Pick high-waisted undies that won’t irritate your incision (we like the postpartum recovery underwear from Nyssa, if you need a recommendation)
Engage your support people in scar care, too. Ask your partner, family member, or doula to look at it regularly to ensure that the scar is healing appropriately.
You can also take a photo as a way to see and track healing over time. Nikki Hunter-Greenaway, nurse practitioner, lactation consultant and curriculum advisor here at Major Care, advises: “For clinical and emotional reasons, I tell all of my clients to take a picture of their scar so they can see if it’s healing, but also to see the progression of their journey.”
Two Weeks After Birth
At about two weeks after birth, you should not be feeling as much pain and tenderness around your scar. It should be well on its way to healing, with much less redness. Collagen is coming into play in the healing process. The scar may thicken and change color.
If you like, you can start gently moisturizing the area with lotion, salves, or oils. Hunter-Greenaway says, “In my opinion, you can start using oils when the strips fall off, which is usually an indicator of external healing. You want to make sure the scar is well-approximated, meaning there are no open gaps or leakage. That means it’s closed.” Coconut oil, vitamin E oil, or castor oil are all appropriate for scar massage. There are products made especially for Cesarean scar healing (like Motherlove’s C-section cream). Whatever you use, take a minute to be mindful and send love to your body when you moisturize your scar.
Remember that you are still healing from major abdominal surgery, so continue to rest and take it easy. Eat well and hydrate!
Six to Eight Weeks After Birth
By this time, your incision should be fully healed. When you go to your six-week postpartum visit with your doctor or midwife, they will check your incision and ensure it’s healed. If it is, you are free to start to move and exercise more (if you feel up to it, of course!).
Although your incision is healed, that doesn’t mean you won’t still have some tenderness (or sometimes, numbness) in the area of your scar. The scar is still integrating into your body. Scar tissue may be continuing to form on the inside of your body, as well.
This is a great time to start some gentle massage of your Cesarean scar. Scar massage has a lot of benefits for scar and skin healing, as it can promote healing, lessen itching, and loosen the skin around the scar. Hunter-Greenway says it can help loosen up the area and allow for increased range of motion. There are many videos on YouTube that will get you started on how to start massaging the scar—here’s a good one to start with!
The First Year and Beyond
Once you’re further out from the surgical birth, be it months or years, your scar will continue to be a part of your body and your experience. The C-section scar itself may still change appearance over time, becoming puffier or fluffier, or changing color to white or the color of your flesh. The scar itself may fade and flatten. It may become hard to see, especially as time passes.
You may find that you still have a bit of pain here and there. Numbness is also common.
Self-massage and moisturizing can continue to be a powerful part of your healing. You may find that, over time, your scar fades more or is less noticeable to you if you are consistent with moisture and massage. Pelvic floor therapy may also be a wonderful way to heal and reconnect with your lower abdomen and pelvis.
You may also want to consider Cesarean scar tissue remediation, which is a hands-on process to continue to heal the body in a holistic way. This is done by a trained practitioner. Zoe Etkin, a motherhood coach and somatic bodyworker/scar tissue practitioner based in Memphis, TN and nationally online, explains: “Scars are an incredibly smart thing the body does when it experiences trauma. However, as they age, they get harder and can also create adhesions elsewhere in the body, impacting the body in a lot of ways: posture, digestion, fertility, lymphatic drainage, circulation, sensation, etc Not to mention that our cells hold memory and even if our minds didn’t feel an experience was traumatic, our nervous system/body may have.”
The physical scar from the Cesarean is just one aspect of healing from this type of birth. You may also have feelings about the birth itself or the resulting scar, whether the C-birth was planned, unplanned, emergent, or otherwise. It’s completely normal to have emotions around your child’s birth and there is nothing wrong with you if you feel nervous about touching or looking at your scar, thinking about it, or if you still need time to process the birth itself and/or how your body has changed.
If you aren’t comfortable being in contact with your scar, it may be helpful to work with a practitioner who can work on it for you. You can find a STREAM practitioner (like Zoe Etkin), pelvic floor therapist, or even a massage therapist (especially if they specialize in abdominal massage).
Some people may find healing in the process of connecting with their scar. Hunter-Greenaway advises: “I encourage journaling about it. I encourage drawing it. Adorn it.”
Etkin adds, “Scars are an invitation to be in close relationship with our bodies. Cesarean scars often hold a lot of emotions, and just as the physical manifestation of the scar can be in need of attention, so can the emotional, even if the person with the scar isn’t overtly aware. Scar care is about more than breaking up the tissue, though that is a very important aspect. It’s about coming back to the site of something big that happened to our entire system, and giving it the love and care we deserve.”