C-section scars are typically worn as either a vulnerability or a badge of honor. As a woman who recently gave birth via C-section, this Instagram momfluencer chooses inspiration. “A woman’s body is beautiful inside and out, scars and all, capable of so many things”.
32% of women in the United States leave the hospital with cesarean section (C-section) scars, but unfortunately, many moms start their postpartum journey confused about the recovery process. Cesarean section scar mobilization is something that can be life-changing if done properly.
Whether you have a cesarean delivery by choice or necessity, healing your body the right way can make all the difference to your C-section scar, reducing postpartum pain, and increasing your quality of life. Read on for everything you need to know about cesarean section scars and mobilization.
Types of C-section Incisions Used
In order to understand how scars form, we need to start from the beginning—the types of incisions.
It’s standard for doctors to use a low transverse incision when it comes to C-sections. But a lot of people don’t realize there is one other common incision that can also be used. Let’s take a look at each type and how doctors determine which cut to make.
- Transverse Incision: this is known as the most common type of incision used for a C-section surgical procedure. This cut will go from side-to-side horizontally across your lower abdominal wall–about 4 to 6 inches long. Many women and doctors like this incision because it heals easily, has fewer complications, and covers well under pants, underwear and swimwear.
- Vertical Incision: this incision is positioned vertically up-and-down between the pubic area and belly button–also about 4 to 6 inches long. Doctors typically only use this method in cases of an emergency c-section need, such as an unexpected uterine rupture. This incision takes less time and is more convenient for a birthing team under pressure.
What materials are used to close incisions?
Contrary to a vaginal birth, after a C-section birth, doctors have to close up multiple incisions after the baby is out. First, they focus on the inner organ baby called home for 9 months – the uterus. They close this organ back together with dissolvable stitches which eventually go away on their own. Then, the surrounding area: doctors will close up the outer abdomen with staples, stitches, and/or glue strips to heal your skin back together.
Types of C-section Scars
You might be wondering “What do c-section scars look like?” Just like people are all different, so are their scars. While some scars are thin and gradually fade away, other scars might heal much differently and can possibly become large, thick, or grow extra skin on them. Let’s take a look at each type of possible scarring for C-sections.
- Hypertrophic Scar: this type of scar is thick, raised, and usually a pink or red color. It’s common after surgical incisions like C-sections. The scar is formed from an overproduction of collagen (a protein that the body needs to repair skin) during the healing process resulting in thicker and tougher skin than normal. Hypertrophic scars may become less noticeable with time and are easier to treat.
- Keloid Scar: this scar is triggered by a dysfunction of the healing process. Collagen production goes into overdrive and creates extra growth beyond the incision site. The scar can have extra skin growth, appear unusually lumpy, and have a red or purple color. Keloid scars are common in people with brown or black skin and are found to run in families. Unfortunately, it does not go away on its own and is harder to treat.
C-section Healing Stages
Incisions for C-section recovery normally take about 6 weeks to heal. Although in some cases, the scar healing process and flattening can take up to a year. There are 3 healing stages your C-section incision will go through in order to recover correctly. The experts at the Birth Injury Help Center explain how bodies heal, and what to expect during each stage:
1. Inflammatory Stage: this first stage starts immediately after your C-section and lasts only for 2 to 3 days. Bleeding starts to slow down, collagen is produced, and white blood cells pour into your incision site to help protect against any infection from the outside world. Your incision will be swollen and look red or pink. This is when you might experience the most C-section scar pain.
2. Proliferative Stage: during the second stage, your incision starts pulling together to close. New nerve fibers and blood vessels form where the incision site was and the collagen used to heal in the inflammatory stage starts breaking down. This healing stage will last about 3 to 4 weeks. During this phase, the C-section scar will become thicker and lighten in color as it closes up. Moms notice that their C-section scars can actually itch a bit during this stage – but just know that this is completely normal and part of the healing process.
3. Remodeling Stage: this final stage can last for several months up to a year. The thick, swollen scar tissue gradually flattens and loses its prominent pink or red color. The scar will eventually fade and the area should start to look smoother at this point.
Signs of C-section scar infection
C-section infections are possible, and they can be very serious. The Mayo Clinic lists a few infection signs to watch out for:
- Very red or swollen incision site
- Leaking discharge from your wound
- Heavy bleeding
- Worsening abdomen pain
A healthy C-section incision healing site will not include these symptoms. If you have any of these infection signs above, contact your healthcare provider immediately. They will provide you with a C-section infection treatment and the next steps of action in order to prevent further illness.
How To Minimize C-section Scarring
Proactive C-section scar treatment to prevent harsh scarring does exist! Getting ahead of the ball (or scar) is an important factor in healing effectively. Doctors at Dermcare suggest the following to help reduce the prominence of C-section scarring.
- Eat a healthy diet rich in protein
- Drink water to stay hydrated
- Stay away from cigarettes as smoking can cripple the skin’s ability to regenerate
- Work with physical therapists or postnatal specialists
- Skip alcohol and caffeine since dehydrated cells decline the healing process
- Limit sun exposure – sunlight can cause scars to darken
- Start cesarean section scar mobilization
C-Section Scar Mobilization Techniques
Sometimes C-section scars can heal abnormally thick, and stiff, or have unwanted sensations like pain or numbness. Cesarean section scar mobilization is a technique that can help with this. By simply using your hands or small tools to move the skin on and around a C-section scar, you can restore mobility, and minimize the appearance of a scar.
Before trying any of these techniques, you need to be fully healed and should always discuss everything with your provider first.
Cupping hit the mainstream a few years back and is a very popular technique in alternative medicine and massage. But it’s also one of the best ways to mobilize C-sections scars.
Dr. Kaitlyn Kakar, PT, DPT, CSCS, a Doctor of Physical Therapy in Scottsdale, Arizona recommends this method as one of her favorite techniques for mobilizing C-section scars. “It uses suction to lift the skin, muscles and fascia,” Kakar noted. She uses this method in the clinic and sometimes even teaches her patients how to do it at home. “I recommend applying lotion or oil above, below and over the incision. Then, use a small silicone cup to apply suction and glide the cup above, over and below the incision in all directions.” Performing this technique consistently can break down scar tissue and make this area more mobile again.
Skin rolling is a great method that requires no tools. Katie Kelly PT, a Pelvic Floor Physiotherapist recommends this C-section scar mobilization technique on her website.
With this method, you start by using your fingertips to pinch around your scar and lift up the skin. Then begin to roll the skin between your fingertips back and forth essentially massaging your scar. At first, you will feel stiffness and some mild pinching, but the more you do this technique, the easier your scar will relax and become more mobile.
The goal of massaging is to break down that tough scar skin tissue. Dr. Jena Bradley, a Physical Therapist at Live Core Strong, recommends a general massage technique for mobilizing C-section scars on her blog.
Start by using your fingers and pushing down as far as you can tolerate on your scar. Then, move your fingers side-to-side horizontally in small movements. When you get more comfortable, move to bigger side-to-side movements. Next, move your fingers up and down, above and below your scar massaging it once again, but vertically. Moving your scar in these different directions helps break down scar tissue and relax the skin.
Cesarean Section Scar Mobilization FAQ
Have more questions about C-section scar mobilization? Here are some common ones answered by Physical Therapist, Dr. Kaitlyn Kakar.
When can you start scar mobilization after a C-section?
“The first step is desensitization which can be started in the first week postpartum. This includes touching the area around the incision with soft materials like a cotton ball and working toward rougher materials like a towel. This minimizes tenderness and hypersensitivity to the area. Once the incision is fully healed (and you are cleared by your doctor), usually between 6 to 10 weeks, then, I recommend massage and mobilization to the area above, below, and directly over the incision.”
When is it too late to mobilize a C-section scar?
“It’s never too late. Changes can still be made years later.”
Can you break down C-section scar tissue?
Yes, you can! “When scar tissue is massaged and mobilized, it allows all the layers–skin, muscles, and fascia–to move and glide properly.”
Why doesn’t my C-section scar move?
“Sometimes adhesions (think of these as sticky spots) form which prevents the scar from moving well. The good news is with some mobilization techniques we can get the scar moving again.”
Is it normal for my C-section scar to hurt when massaging it?
“It is normal for the scar to feel tender when massaging it, but it shouldn’t be painful.”
Recovering from a C-section, or any major surgery, isn’t easy. And unfortunately, moms often aren’t provided the postpartum care they need to heal properly. In order to get back to optimal health, it’s crucial to understand the full picture: C-section incisions, healing from chronic pain, scarring treatment, and mobilization.
Ultimately, every mom’s recovery will be unique. You need to listen to your body and seek medical attention if you experience any complications or concerns. By taking a proactive approach to your C-section scar care and mobilization, you can feel confident and enjoy a full and healthy life after childbirth.
If you need more help with your recovery, take a look at Pelvicrehab.com to find a specialist near you.
Contributing experts in this article:
Dr. Kaitlyn Kakar, PT, DPT, CSCS, is a Doctor of Physical Therapy in Scottsdale, Arizona, with 10 years of clinical experience under her belt. She received her degree from Marquette University and is an active Pelvic Health Specialist, Certified Strength and Conditioning Specialist, Yoga Teacher, and certified Nutrition Coach. She helps women during their pregnancy, birth, and postpartum journeys via her website thrivingmommas.com and on Instagram.