Caring for Cesarean Incisions
How to help yourself heal after a cesarean birth
Whether it’s been your birth plan all along to have a cesarean birth (c-section) or you had emergency surgery, the following guide is for you. After you've given birth, it's important to take care of yourself and your incision. Keeping your sutures clean will help prevent infection, and limiting certain movements may help you recover with less pain.
This article provides general guidelines, but your provider may give different directions depending on your circumstances. Please refer first to the instructions given by your surgeon or provider, as they will be specific to you and your recovery.
Internal vs. External Sutures
There are a few ways your OB or surgeon has closed your incision site. Stitches, or sutures, can be used both internally and externally. Staples or glue are two external options.
For your information
What’s an internal vs external suture? An external suture is anything you can see on or above your skin. Internal sutures go inside your body. You won’t be able to see them.
The most common types of stitches are absorbable, which means they will dissolve on their own over time. This type of suture is used for internal stitches to repair your uterus and other tissues below the skin. Absorbable sutures are becoming more popular for external stitches as well.
Non-absorbable sutures are made of material that won’t dissolve, such as nylon or silk. These are only used for external stitches and are becoming less common.
The most common types of stitches are absorbable, which means they will dissolve on their own over time.
You may have external staples instead of external stitches. Staples need to be removed and can be taken out by your midwife or care provider 1-2 weeks after surgery.
The type of sutures or staples you receive depends on many factors, including the hospital you’re at and what the surgeon is used to using. If you have any questions about your sutures, ask your care provider.
Cleaning your incision site
It’s important to keep your incision site clean to help prevent infection and promote healing. The surgical team most likely placed sterile bandages over your incision right after your incision was closed.
For your information
You’ve probably heard of cesarean births referred to as c-sections. We like to use the term “cesarean birth” to emphasize that having a c-section is still giving birth! Some other validating terms include “belly birth” and “surgical birth.”
After you or a nurse removes your hospital bandages, keep the area clean and dry. Follow the instructions given by your surgeon or care provider. They will give you detailed instructions on how to clean your incision and how often to change your bandages. Your provider may send you home with extra gauze and medical tape. You can purchase those items at a drugstore if you need more. Your surgeon may also recommend keeping the area open to air after the first bandages are removed. It is not uncommon to go home with no bandages on your incision.
You may notice a small amount of drainage from the incision. This is normal and helps to keep the area clean. Don’t put anything on the fresh incision, including ointments, creams, or lotions, unless instructed to do so by a healthcare professional. These can increase your risk of infection.
Caring for your incision
Continue to care for your incision following your surgeon or care provider’s advice. Typically after 24 hours you can shower, but you’ll want to avoid soaking in tubs or pools for a few weeks. Exposing fresh wounds to water can increase your risk of infection. If your provider gives you different advice, follow their instructions.
A small amount of drainage is normal and helps to keep your incision clean.
Check your incision daily for any signs of infection, such as redness, swelling, discharge, pain, or fever. If you have staples or stitches, you may need to have them removed. This is usually done 7–10 days after the surgery. Sometimes, your midwife or primary care provider can do this for you at a clinic or at home instead of at the hospital. Contact your provider if you have any specific concerns about your incision.
Movement
Although it might be tempting to return to your pre-pregnancy movement routines, you’ll need to go slowly; you don't want to put too much stress on your body!
To help prevent your incision from opening, avoid heavy lifting (anything that makes you strain or grunt), twisting, and bending at the waist during the first few weeks of healing. Even common household tasks like taking out the trash might aggravate your incision. Another tip is to cough or sneeze with your mouth open. This helps you avoid putting too much pressure on your incision. You may also find it helpful to place a pillow over your incision when you cough or sneeze.
For your information
It takes about 8 weeks after surgery for your body to recover enough to begin returning to normal activity levels. It’s okay if it takes you longer than that!
As you start to feel better, you can begin adding gentle activities back into your routine. Walking is a great way to help reduce pain and promote healing. Start with short walks and gradually increase the distance.
Helping Your Scar Heal
As your incision heals, it will become a thin, colored line. Underneath that line might feel a bit harder than the rest of your skin. That hardness is scar tissue that forms as your body heals and knits your tissues back together. There are several ways to help your cesarean incision after your stitches are removed, the scab has fallen away, and the incision site is no longer painful to touch.
Massage is one of the best ways to break up scar tissue and improve blood circulation. Gently rub the area around your scar with vitamin E oil, cocoa butter, or turmeric cream that is approved by your midwife or care provider. Most people choose to massage their scars themselves to apply a comfortable amount of pressure and avoid sensitive areas. If you feel comfortable letting someone else touch you, some doulas offer postpartum belly massage and may also massage your cesarean incision.
Avoid any activity that makes you feel worse. Sitting down and getting back up regularly might be enough to cause discomfort.
Although a scar is nothing to be ashamed of, there are a few things you can do to help your scar fade. One option is silicone sheets. These are thin, flexible sheets that you place over your scar. Silicone sheets provide a barrier that helps to keep the area hydrated and protected. Mederma is another hydrating, scar-reducing gel. You can purchase both options at most drugstores.
Laser therapy is a more expensive option, but some people find it helpful. Laser therapy works by stimulating collagen production, which can help to improve the appearance of scars.
Additional Details
You may feel some discomfort around the incision site for the first few days or weeks after surgery. You may also experience numbness or tingling when you touch your incision. Typically, some pain, discomfort, numbness, or tingling are normal and will go away as you heal. Depending on a variety of factors, you may have moderate to high levels of pain. If you experience consistently high pain levels, reach out to your provider.
Additionally, avoid any activity that makes you feel worse. Sitting down and getting back up regularly might be enough to cause discomfort. Don’t be afraid to ask others to help you—you deserve it!
If you have any questions or concerns about caring for yourself after a surgical birth, reach out to your midwife or primary care provider. They’re there to help you through every step of your postpartum journey.
This article was reviewed by Nadia Crane, CNM.