How to look after a Caesarean Scar

Did you have a Caesarean delivery? Wondering how to look after the Caesarean scar? How to massage the caesarean scar?

This post focuses on looking after the Caesarean scar itself. For general advice about how to get comfortable, moving well, when to start abdominal exercises and why you still need to think about your pelvic floor see this other post:

Let me guide you through the different things you need to do to look after your Caesarean scar at each stage.

What are you dealing with?

It is easy to take a Caesarean section scar lightly because we can only see the surface of it. Surgery and surgeons are so good at this operation, modern stitches are dissolvable, so that you will likely only see a neat 10-15cm thin line on your skin. This starts raised and red but over a few months settles to eventually be a thin silvery line.

However, underneath the surface several layers of tissues, such as fat & fascia were also cut and stitched. Fortunately, the abdominal muscles themselves are not cut – they can be pushed apart side to side to let the baby through.

Nature will heal really well, especially with your help

There are 3 stages to think about to look after a Caesarean scar with different priorities to consider and different ways for you to help at each stage:

Early Days (0-6 weeks)

Initial wound healing and formation of a healed scar

Keep the wound clean & prevent infection

• prevent infection getting into the area by keeping the wound clean & dry
• quickly recognise if there is an infection and seek treatment
• avoid straining the scar which might cause it to breakdown as it is trying to heal – this is why you need to get lots of help with caring for the baby & housework and stick to the simple exercises, which make you Feel Good but don’t make the abdominal muscles pull on the scar

Your maternity hospital will usually have given you advice and a booklet or resource. If you didn’t get one, this NHS article has simple advice on how to keep your stitches clean and cared for in the first 6 weeks.

Start Early days exercises to help the scar stretch naturally:

• introduce Movement to Feel Good
• prevent your body tightening up in a guarding pattern
• walk daily (start with just 10 mins then build up) to encourage your circulation, improve posture, boost your mood & move naturally
• encourage the scar to stretch naturally as it heals so that it is comfortable with simple arm & leg movements
• avoid straining and excess pressure on the belly as the scar heals

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Picking up the Pace (6 weeks +)

promote formation of a flexible, comfortable scar.

After 6 weeks the scar should be fully healed, the scab is gone. Now you can look after a Caesarean scar further by helping the body form flexible, collagen rich scar tissue. This type of tissue will comfortably move with you whatever you want to do! And you will soon be able to forget all about it!

This is when you can start Caesarean scar massage

• use scar massage to encourage the formation of a flexible, comfortable, well formed scar. In the video, below, my colleague, Clare Bourne explains how to massage your scar from 6 weeks.
• you can use a natural oil like olive, almond or coconut or there are several commercial ones available with blends of essential oils included. Be sure to check for allergies & I would recommend keeping the oil only for this massage of this area.

• return to sex. See our Getting back your Mojo series
• seek help from a specialist physiotherapist if you are not happy with the way you are feeling, or not sure how to exercise correctly
• do abdominal exercises with the intention of improving your strength, endurance and co-ordination. As your abdominal wall tones it will support your back, help your pelvic floor work, and help you feel stronger and leaner. Vital preparation before you return to your hobbies and sports around 3 months. Explore the Supported Mums Picking Up the Pace playlist on YouTube or join me full length Postnatal Pilates classes online?

Finding your new normal (12 weeks – 12 years!)

Life and your body are not the same after a baby, and may change again with baby number two or three. What is normal? Perhaps don’t focus on getting “back” to normal as life is a forward journey? Where will your body and your family take you next?

In this phase be sure to sort out any niggly problems

• check in on your scar 1-2 x month to make sure it is happy and to maintain it’s stretchiness. My colleague Clare Bourne demonstrates in the video below how to do a firmer massage from 12 weeks.
• if you didn’t start scar massage earlier definitely give the scar some love and attention now

• Persistent pain needs assessing further. Definitely seek help from a specialist physiotherapist. If the scar is painful or tugging as you move or during sex. Or you suspect it might be causing a problem like back pain, difficulty working your abdominals or pelvic floor.
• give your love-life the time and attention it deserves. Check in with these suggestions if sex is painful or feels a bit flat.
• Join me for regular postnatal or intermediate Pilates classes on BEAM.

If you can’t access a physiotherapist or want to learn more to help yourself first I highly recommend these books:

Please do let me know if this post is helpful?