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Cesarean births… the impact of that scar!

physical therapy Jul 01, 2018

According to HealthGrades, “almost 1.3 million pregnant women have their babies by C-section in the United States each year.” Another article cited as many as 1 in 3 births are cesarean births.

There are many reasons why a woman would need to have one including: a poorly progressing labor, medical issues that affect mom or baby, emergency intervention to save the life of mom and baby and so on…

That being said it is treated as just ‘another surgery’. If you missed my FB video on cesarean sections, check it out here: The Infamous C-section

What I really want to talk about today though, is the impact of that scar after birth. When you have a cesarean, it’s by no means superficial. An incision is made through the abdominal wall and then through the uterus, cutting through at least 5 different layers of tissue. When these tissues heal, like any other surgery or scar, there is the possibility of several things including: a non – healing wound, infection, keloids, scar tissue, decreased sensitivity to the area or even hypersensitivity or increased sensitivity and impact on surrounding tissues including pelvic floor. WOW!!!!!! Do they tell you any of this after a C-section!?!?!?!?

So what can you do?

1. Once given the all clear at 6-8 weeks by the physician and once the incision has healed where there are no openings, you can go ahead and start some gentle massage to the area. Start firstly with light touch above and below the incision along its length, followed by actually touching on the incision. For some women, there is a huge disconnect as there is trauma, both emotional and physical, associated with a cesarean birth. For some women they have to come to terms with feelings of inadequacy because this was not the way they intended birth to be. As such, some women have a hard time touching or connecting with that scar. So it is truly more than just “a scar”. For some women this could be the beginning of some serious emotionally healing and self love.

2. Once you have reached the point where you can touch the incision, above and below with minimal discomfort, then start making small circles first above the incision, along its length, then below, then on the incision itself.

3. If that works well then progress to gentle mobilization of the incision and surrounding tissue. Hold below the incision with one finger and then gently pull on the opposite side of the incision with another finger (using opposite hand). So what this should look like is lets say we start at the right side of your incision. Take the right thumb and place it under the right side of the end of the incision. Using the left thumb or index finger, place it on the tissue on the opposite side of the incision relative to the right thumb and give a GENTLE pull or stretch in the opposite direction. Move along the length of the incision.

Try these techniques. As always if you need help, the best person you can seek for such issues is a pelvic health physical therapist. I would love to assist you and am available to do video consults as well. I can also connect you with a pelvic health therapist closer to you geographically.

Take care,


Self Magazine (photo)


US National Library of Medicine: Medline Plus

ACOG: American College of Obstetricians and Gynecologists


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