Is your baby in an awkward position? Is your labor not progressing? Do you have other health concerns? In any of these situations, you might need a cesarean delivery — commonly known as a cesarean section or C-section — where you deliver the baby via an incision in your abdomen and uterus.
The good news is that C-section scars are usually small and below the bikini line. Once the scar heals, you may only have a faded line that’s barely noticeable. In the meantime, here’s what you should know about types of incisions, types of closures, how to support healing, and how to minimize scarring.
It’s important to know that a C-section isn’t just one incision or cut, but rather two. The surgeon will make an abdominal incision, and then a uterine incision to remove the baby. Both incisions are about 4 to 6 inches—just big enough for your baby’s head and body to fit through.
For the abdominal incision, your surgeon can make either a vertical cut from between your navel to your pubic line (classic cut), or a horizontal side-to-side cut in your lower abdomen (bikini cut).
Bikini cuts are popular and sometimes preferred because they tend to be less painful and less visible after healing — which is great news if you want to minimize scarring.
A classic cut is more painful and leaves a more noticeable scar, but it’s often necessary with an emergency C-section because the surgeon can get to your baby faster.
If you have a bikini cut in your abdomen, your surgeon will also make a bikini cut uterine incision, called a low transverse incision. If you have a classic abdominal incision, you’ll have either a classic uterine incision, or a low vertical incision if your baby is in an awkward position.
Since you’ll receive two incisions — one in your abdomen and one in your uterus — your surgeon will close both incisions.
Dissolvable stitches are used to close your uterus. These stitches are made from materials that the body can easily break down, so they’ll dissolve gradually as the incision heals.
As far as closing skin on the abdomen, surgeons can use one of several methods at their discretion. Some surgeons prefer using surgical staples because it’s a fast and simple method. But others close incisions using surgical needle and thread (non-dissolvable stitches), although this process can take longer, up to 30 minutes.
If you have stitches or staples, you’ll have them removed about a week later, usually in the doctor’s office.
Another option is to close the wound with surgical glue. Surgeons apply glue over the incision, which provides a protective covering. The glue gradually peels off as the wound heals.
If you have a preference for closing the wound, discuss this with your doctor beforehand.
A C-section might be a safe procedure, but it’s still a major surgery, so it’s important to properly care the incision to prevent injury and infection.
- Clean the incision daily. You’ll be sore for a while, but you’ll still need to keep the area clean. Allow water and soap to run down your incision while showering, or gently wash the incision with a cloth, but don’t scrub. Gently pat dry with a towel.
- Wear loose-fitting clothing. Tight clothing can irritate your incision, so skip the skinny jeans and opt for pajamas, baggy shirts, jogging pants, or other loose-fitting clothes. Loose clothes also expose your incision to air, which can help speed the healing process.
- Don’t exercise. You might be ready to shed the baby weight, but don’t exercise until your doctor says it’s okay. Too much activity too soon can cause the incision to reopen. Especially, be careful when bending over or lifting objects. As a general rule of thumb, don’t lift anything heavier than your baby.
- Attend all doctor’s appointments. You’ll have follow-up appointments in the weeks following a C-section, so your doctor can monitor the healing progress. It’s important to keep these appointments. This way, your healthcare provider can detect complications early.
- Apply heat to your abdomen. Heat therapy can ease pain and soreness after a C-section. Apply a heating pad to your abdomen in 15 minute intervals.
- Take pain relievers. Over-the-counter pain medication can also ease pain after a C-section. Your doctor may recommend ibuprofen (Advil), acetaminophen (Tylenol), or a prescription pain reliever.
Along with taking care of your incision, watch for signs of an infection and other problems. An infection can occur if germs spread to the surgical site. Signs of an infection include:
- a fever over 100.4°F (38°C)
- drainage or pus coming from your incision
- increased pain, redness, or swelling
Treatment for an infection may require oral antibiotics or intravenous antibiotics, depending on the severity.
Keep in mind that while it’s normal to have some numbness at the incision site, numbness typically improves within a few weeks. If your numbness doesn’t improve, and you have shooting pain in your pelvis or down your legs, this could indicate a peripheral nerve injury.
Nerve damage after a C-section may improve in the months following delivery, in which case your doctor can recommend a corticosteroid injection to relieve pain. Physical therapy is another potential treatment. But sometimes, surgery is needed to repair the damage.
Some women also form thick, irregular raised scars at the incision site such as hypertrophic scars or keloids. This type of scar is harmless, but you may not like the look of it. If you’re feeling self-conscious, discuss ways to minimize these scars with your doctor.
If you’re fortunate, your C-section scar will heal nicely and you’ll only have a thin line as a reminder of your surgery.
Of course, there’s no way to know how a scar will heal until it actually does. And unfortunately, scars don’t always fade away. How they heal differs among people and the scar size can vary. If you’re left with a visible line, here are a few tips to improve the appearance of a C-section scar.
- Silicone sheets or gel. Silicone can restore skin and strengthen connective tissue. According to
research, it can also soften and flatten scars, as well as reduce scar pain. Apply silicone sheets directly to your incision to minimize the scar, or apply silicone gel over your wound.
- Scar massage. Regularly massaging your scar — after it heals — may also reduce its appearance. Massaging stimulates the skin and encourages blood flow, which encourages cellular growth and gradually fades scars. Massage your scar in a circular motion using your index and middle finger for 5 to 10 minutes a day. If you like, add cream to your skin before massaging such as vitamin E or silicone gel.
- Laser therapy. This type of treatment uses beams of light to improve damaged parts of skin. Laser therapy can soften and improve the appearance of scars, as well as remove raised scar tissue. You may need multiple laser treatments to achieve the desired results.
- Steroid injections. Steroid injections not only reduce inflammation and pain throughout the body, they can also flatten and improve the appearance of larger scars. Again, you may need multiple monthly injections to achieve the desired results.
- Scar revision. If you have a noticeable scar, scar revision can open and re-close the scar, removing damaged skin and making it less noticeable so that it blends with your surrounding skin.
A C-section is necessary when you’re unable to deliver vaginally. Although this is a safe way to deliver a baby, like any surgical procedure, there’s the risk of scarring.
Your scar might be barely noticeable and fade to a thin line. But if it doesn’t, talk to your doctor. You might be able to minimize scarring with home remedies or a minimally invasive procedure.