Caesarean sections, or C-sections, are the most common type of abdominal surgical procedure in the world.
According to the history books, C-sections have been performed since the time of the Ancient Romans — thankfully, medical advancements have come a long way since then!
While common, C-sections are major surgery and can be taxing to the body and the healing process takes time.
In this article, we'll cover all things related to the C-section scar and explore how to make sure your C-section recovery is as smooth as possible.
Types of C-section scars
There are many reasons someone might give birth via C-section, and everyone's story will be different.
For some women, having a caesarean is something they've decided on well before it's time to have the baby.
For others, it might happen because of an emergency, or labour not progressing as it should.
In general, there are two types of C-section scars you might experience.
The type of scar will depend on which uterine incision your obstetrician performs. These are:
- Horizontal incision: The more common type of C-section incision, where you'll have a horizontal scar along your bikini line.
- Vertical incision: Less common, where you'll have a vertical scar just underneath your belly button.
Usually, staples or stitches will be used to close up the abdominal incision and your midwife or doctor will check these at your follow up appointment — about three to seven days later. (3).
But what happens after the stitches are removed?
Why do you scar after a C-section?
A C-section is major surgery — in order for the baby to be born via caesarean, a cut needs to be made through both the uterus and the abdomen.
Scar tissue is made up of cells and collagen, which your body sends to the site of an injury.
So, any time your skin is damaged, like it is in a C-section, your body attempts to heal it by forming a scar.
This is known as a hypertrophic scar, which leaves a raised scar.
As the abdominal incision heals and closes up, it will form a scar that'll probably look a bit red and sore in the beginning.
The good news is that it should fade over time.
Also, depending on your scar type (horizontal or vertical) and what you ask for at your waxing appointments, your C-section scar might eventually be covered by your pubic hair.
How big is a C-section scar?
Most C-section scars are usually about 10 to 20 cm long (4). This can change depending on your body and the size of the baby, as well as what happens during the birth.
If the baby's head needs more space to come out, your scar might turn out to be a little bigger.
This might also happen if there's a medical emergency.
Both vertical incision and horizontal incision scars should be around the same size.
A vertical incision might leave a more noticeable scar, but with the right care, it should eventually fade.
How long does it take for an incision to heal?
After a caesarean delivery, you'll usually stay in the hospital for a few days to make sure everything is healing properly.
The length of your stay will depend on the hospital (and whether you've opted for in-home care), but most women will return home after three to four days.
For the incision site to fully heal, it's a slightly longer haul. Most doctors recommend allowing at least six weeks (4) before you go back to your normal daily activities.
You can definitely hold your baby, go for a gentle walk or catch up on Netflix, but there are some activities you should avoid for those first six weeks.
Ask for support where you can— getting enough rest will help you heal even faster.
There are also essentials you can use to help with the healing process, like Kin's C-Section Recovery Kit, which includes a trio of products that protect and heal your wound while supporting separated abdominal muscles.
The kit includes our postpartum Mesh Panties, which sit above and out of the way of your incision for maximum comfort as you heal, as well as the Belly Band, which gives your abdomen the TLC it needs, targeting compression where you need it most — around your incision and separated abdominal muscles.
Rounding out the kit is the Nourishing Cream, which is formulated to promote wound recovery and reduce scarring.
It helps heal the skin, reduces the appearance of scars and firms up postpartum skin — just what you need if you're worried about your C-section scar.
What's involved in post-op C-section scar care?
Looking after yourself after a caesarean comes down to two main things: wound care and taking things easy.
Here's what the healing process normally looks like:
- Make sure you keep the wound clean and dry
- Don't try to remove any stitches or staples yourself (3)
- Wear loose-fitting clothing that doesn't irritate the incision site
- Keep an eye out for signs of infection
Looking after yourself
- Take a gentle walk or move gently every day— this will help prevent blood clots
- Rest as much and as often as you can!
- Don't lift or carry anything heavier than your baby
- Eat well and stay hydrated, to avoid constipation
- Don't worry about sex until you feel ready — sometimes this can take several weeks or even a few months
- Avoid driving or any motion that can put pressure on your incision. Talk to your GP about when you're clear to drive again (5)
What should you do if you experience pain in the incision?
- Take pain relief when you need it (ask your GP about which pain medication is the best, as some meds aren't suitable for breastfeeding women).
- Warmth can be soothing — use a heat pack or wheat bag to help with pain/cramping. If the pain becomes severe, or nothing is helping, check in with a medical professional as soon as you can.
Is it normal to have a numb or itchy C-section scar?
Now that we've gone through the standard stuff, what about the symptoms that are a little less talked about?
Yes, it's totally normal for your C-section scar to be a little numb or itchy as it heals (5).
You might also notice that as the scar heals, it might either be raised or flat to the touch.
Other things you might notice
Most women will experience vaginal bleeding after C-section births, and this is normal.
Some resources recommend using a pad instead of a tampon to reduce your risk of infection (4).
If your bleeding is heavy (e.g. soaking through your pad every hour) or you're passing large clots, it's time to let your doctor know.
Signs of C-section scar infection: When to see your doctor
Other signs you should see your doctor might be less obvious, but they're definitely important to look out for. These include:
- Urine leaks or pain when you pee
- Severe abdominal pain
- Shortness of breath or coughing
- Swelling or pain in your legs
- Heavy vaginal bleeding or passing large clots
- Redness, swelling, or discharge coming from the wound, or a foul smell (4).
- If you notice any of the above symptoms, you should see your doctor immediately.
When is a C-section scar considered fully healed?
There's no standard timeframe for when a C-section scar is fully healed—everyone's body will recover at a different pace.
According to obstetricians, after the first six weeks, most women can resume their normal daily activities (8).
Usually, after this time, your pain should be lessening, and the wound should be looking mostly healed. The big question though: will it ever go away?
How long does a C-section scar last?
Sorry to be the bearer of bad news but C-section scars rarely go away completely.
They do fade with time, and many women are left with only a thin line where the scar once was.
But if you're feeling uncomfortable about how your scar is healing, there are treatments out there that can help minimise scarring or flatten scars that may be raised.
Scar massage, applying silicone sheets to the scar to soften it, laser therapy, and steroid injections are all options that can help a caesarean scar heal further.
In some circumstances, surgical correction of the scar might also be an option (9).
Before exploring any of these treatments, it's important to check with your doctor about what's best for you.
Does a C-section scar prevent a subsequent vaginal birth?
Having a caesarean doesn't mean you can't give birth vaginally in the future (5).
In fact, in some cases, it might even be less risky to do this instead of having another caesarean delivery. There's even a fancy acronym for it!
VBAC stands for vaginal birth after caesarean section, and like everything, there are risks and benefits to this approach.
The pros of VBAC often include shorter hospital stays and potential shorter recovery times, less pain, and less risk of breathing issues for the baby, among other benefits.
In terms of cons, these include uterine rupture, emergency C-sections and other risks to the baby are all things to consider.
If you're concerned about attempting a vaginal delivery, chat to your midwife or OBGYN.
Does the doctor use the same scar for a second C-section?
If you're having a second C-section, normally your surgeon will attempt to cut through the same scar.
This might not be possible if there's lots of scar tissue in the area, or if the scar tissue is too thick to cut through.
As with giving birth naturally after a caesarean, there are risks and benefits involved in having a second C-section.
It's really important to discuss all your options with your care providers.
Whichever way your baby comes to you, you deserve to heal at your own pace and enjoy your first few weeks together as much as possible.
Remember to check in with your support networks regularly, and reach out for more help if you need to.