I had no idea what to expect following my first unplanned cesarean birth. Though my primary concern was my baby’s well-being, I also worried about how recovering from a C-section would impact my body. Today, I’m proud to bear the permanent mark on my abdomen where both of my sons made their entrance into the world, but going through the different C-section scar healing stages was a true learning experience.
How do I know if my C-section scar is healing properly?
Though the timing can vary from person to person, board-certified obstetrician Dr. Cynthia Flynn explains that “a C-section scar takes four-to-eight weeks to heal both internally and externally” and adds that “this incision is in a very forgiving area of the body and tends to heal quickly.”
The proper way to care for a C-section incision will “depend on many factors, such as if you have staples or sutures and whether any infection occurred,” Flynn says. In most cases — regardless of the type of closure that was used — you can expect to be allowed to remove the initial wound dressing or bandage about three days after your C-section. “After it is removed, it is safe to use mild soap and water in the shower,” Flynn says, noting that diluted baby soap is a particularly safe and effective choice for cleaning your incision site. “Keep the area clean and dry,” she continues.
You may experience some pain as your C-section scar heals, but this is a normal and expected part of the recovery process. Numbness, itching, stinging, and pressure can all occur. These sensations come primarily from nerve regeneration and new tissue growth. As always, if you’re uncomfortable or concerned about the way something looks or feels, your first step should be to contact your doctor. Excess pain may be a sign of a C-section scar infection.
What should a healing C-section scar look like?
A C-section incision is a wound from major surgery. As such, it will go through the classic stages of healing as your C-section scar develops. The stages of C-section scar healing can be broken down into four clear steps.
“The first phase, hemostasis, lasts about two days,” says Flynn. “Blood vessels constrict and clotting factors are released.”
2: Inflammatory Stage
The next stage of C-section scar healing lasts about a week. “During this phase, white blood cells and enzymes enter the wound and clear bacteria and debris,” Flynn explains. “This prepares the wound bed for growth of new tissue. The wound might be red, swollen, or painful at this stage.”
3: Proliferative Phase
Now, you’re nearly two weeks postpartum and entering stage three of healing, which will last about three weeks. “The proliferative phase, or stage three, involves healing and filling in of the wound,” Flynn says. “Granulation tissue forms and new blood vessels form. The wound contracts and re-epithelializes. This means that new skin layers form.”
By the time you get to stage four, you should have had a check-up and be well on your way towards real healing. This final phase of healing lasts for months or even years as your body recovers from the major surgery that is a C-section. “Remodeling or maturation... is when scar tissue forms,” says Flynn. “Collagen is produced and the wound becomes stronger and more flexible.”
There is a vast range of “normal” when it comes to the way a C-section scar looks. Some scars will barely be visible once healed, while others may be thick, shiny, or become a keloid scar. Though most scars will appear red or purple in color at first, the majority of C-section scars will fade and become less noticeable with time.
How to minimize scarring of a C-section scar
While proper wound care and post-operative rehabilitation strategies can help minimize the appearance of your C-section scar, it’s worth noting that “much of what goes into healing and scarring is genetic, so it is predetermined and cannot be altered,” Flynn reiterates.
Go easy on yourself as you begin the stages of healing from your C-section, and try to be patient as your body develops a C-section scar. To maximize healing, rest when you can, keep your incision site dry, and attend scheduled post-natal appointments with your healthcare provider.
One popular way to minimize scarring after a C-section is to apply scar-diminishing creams once your C-section scar is fully healed.
How are C-section incisions closed?
C-section incisions are closed using different methods, depending on your doctor’s preference. Externally, your doctor may use one or more of the following methods to close the skin of your abdomen following a C-section:
- Surgical staples
- Surgical glue
- Non-dissolvable stitches
As for the different types of C-section incisions, and how they heal, there are really only two main types — horizontal incisions and vertical incisions. “About 95% of all C-sections are horizontal skin incisions and low transverse uterine incisions.” Flynn says. Though vertical C-section incisions are very rare, it’s worth noting that they typically takes longer to heal than horizontal incisions.
Kathleen Rustici, M.D., is a board-certified obstetrician with SCL Health Medical Group, affiliated with Saint Joseph Hospital in Colorado. She tells Romper that the dissolvable Vicryl sutures are used most often to close C-section incisions internally. “This suture is absorbable, but can take up to 8 to 10 weeks to fully dissolve,” she explains. “This is a good thing, because we want to hold that tissue together long enough for it to fully heal back together before the suture dissolves.”
How long does it take for a C-section incision to heal internally?
Though most experts agree that the main healing stages of a C-section scar can take anywhere from a few weeks to two months after giving birth — with “healing” defined as a closed wound and stitches that have dissolved — the internal healing process can take much longer.
It usually takes an entire six weeks to regain full strength throughout the skin’s internal layers, Rustici tells Romper. This is why physicians advise postpartum patients not to do any heavy lifting until after their six-week checkup. “We really want those internal layers to heal entirely before there is additional strain put on them,” she continues.
Rustici also says that internally, “the incision on the uterus can take even longer to fully heal.” For this reason, she explains that it’s generally recommended to wait a year after having a C-section before getting pregnant again to allow ample time for internal healing. “Getting pregnant too soon can increase the risk of uterine rupture, which is the separation of the prior scar on the uterus,” she says.
As your C-section scar is healing, it’s important to keep an open dialogue with your healthcare provider. Every person’s body heals on its own timeline, and your provider is the best resource for understanding whether or not you are fully healed internally.
How do I know if my C-section incision is open?
If your C-section incision is open, it’ll likely be hard to miss. You may notice oozing or puffiness at the incision site first, followed by gaping. People with open C-section incisions will also usually experience increased pain. A C-section incision that is open can be a warning sign of a potential infection and is definitely a reason call your doctor right away.
Call your doctor right away if you experience anything that might indicate infection, including:
- Heat or burning sensations
- Any type of drainage at your C-section incision site
The best way to avoid your incision opening and keep potential infection at bay is with proper post-operative care. “Avoiding infection by keeping the incision clean and dry is helpful,” says Flynn. “Try to rest and do not do much except caring for yourself and the baby. Extra strain on the area can stretch the incision while it is still healing. Do not pick at scabs or healing areas.” Flynn adds that staying hydrated and consuming a healthy diet can aid in your post-surgical healing as well.
Can a C-section scar reopen after years?
Unfortunately, yes, C-section scars can sometimes reopen. “While this is rare, it can happen,” Flynn tells Romper. “It is more common in women who are overweight or have a seroma [fluid collection] develop.” It is also possible, though still extremely uncommon, for a C-section scar to reopen when stretched during a new pregnancy.
It is important to keep in mind, however, that “all of these possibilities are rare and not likely,” Flynn says. “In nearly 20 years in the field, I’ve never heard of such a thing happening outside of labor, and that itself is extraordinarily rare in a VBAC situation.”
Can you have a C-section scar infection years later?
The most common time for your C-section scar to become infected is within the first few days and weeks following birth. Very rarely, an infection can be so deep inside or lay dormant within the body that the signs and symptoms of a C-section scar infection don’t pop up until months after birth, but in general it is not something to worry about.
If a C-section scar is reopened at any point in time, bacteria on the skin can potentially lead to an infection, but again, this is extremely uncommon. “Often the area that opens leads to infection from the skin bacteria,” says Flynn. “Again, keeping the area clean and dry can prevent most of these issues.”
If the old saying that “knowledge is power” holds any weight at all, knowing what to expect from your C-section scar while it’s healing — both in the short and long term — can be empowering for new moms.
Dr. Cynthia Flynn, board-certified OB-GYN.
Kathleen Rustici, MD, a board-certified OB-GYN with SCL Health Medical Group, affiliated with Saint Joseph Hospital in Colorado.