Janine Gard: Is it normal for my C-section scar to itch?

Parenting and birth educator Janine Gard.

Janine Gard is a diploma-qualified birth educator (2005) and founder of Bellies to Babies antenatal and postnatal classes. She has helped more than 3700 parents prepare themselves mentally, emotionally and physically for their journey to parenthood and loves what she does. This week she speaks about healing after a C-section.

Having a Caesarean section can be hard enough at the time, and the healing process afterwards, including the Caesarean section scar, can be just as challenging. It takes time to recover physically and emotionally, coupled with the tremendous changes a newborn brings into your life.

Thousands of women deliver their babies by Caesarean section, also known as C-section. Sometimes, these surgeries are planned ahead of time. In other cases, a medical emergency arises during birth that necessitates a C-section delivery.

The skin incision for a C-section is about 12-17 centimetres long and generally sits just below your pubic hairline. The obstetrician must go through several layers, separating muscles to reach your uterus. A cut is made into the uterus and your baby is brought out through this incision.

Once the C-section is finished, the obstetrician will close the incision, using dissolvable stitches on the interior layers and either stitches or staples on the external incision.

How long does it take for a C-section scar to heal?

There are several layers to heal after having a C-section. The obstetrician will cut through skin tissue, move aside muscles, and then make an incision through three layers of the uterus: the inner lining (endometrium); the middle muscular layer (myometrium); and the outer layer (perimetrium).

The skin or external incision will usually heal within the first two weeks of birth. The incision that was made into the uterus takes between 6 to 12 weeks to heal completely. It's important to follow the instructions of your LMC to ensure your incision heals properly and minimise the chance of any complications.

How do you know if the C-section scar is healing?

It's not uncommon to feel some soreness and bruising in the weeks following a C-section. You should take the appropriate pain medication if needed.

As the incision heals, good care management will promote healing and lessen any complications. It's not uncommon to lose some feeling at the incision site but this should come back over time.

You should gently wash your incision with warm water (soap may irritate) and then gently pat the area dry with a clean towel. Allow the wound site to air-dry after washing. Avoid wearing clothes that will rub against the incision site and irritate the area.

How do you know if your C-section scar is infected?

Infection usually occurs due to a bacterial infection in the incision site.

Warning signs that your incision isn't healing and may be infected include:

- Redness or swelling around the incision
- Pain at the incision site that worsens or becomes extreme
- Oozing or weeping from the incision
- Fever
- Severe abdominal pain
- Pain when urinating
- Foul-smelling discharge
- Excessive vaginal bleeding (more than one pad an hour)
- Large clots

If you experience any of these symptoms after a C-section contact your LMC or healthcare provider immediately.

Why is my C-section scar itching?

It's very common for your C-section scar to be itching as it heals. This happens for a number of reasons. The nerves at the incision site were damaged and as a result, become very sensitive.

As the nerves and the surrounding tissue begin to heal, this causes the sensation of itching to happen. If you had any pubic hair shaved at the time of the C-section, the hair regrowth can also cause itching.

However, it's important to resist itching your C-section scar, as you can cause damage or even infection. If you are also experiencing numbness around the incision, you may scratch too hard and hurt yourself.

What can I put on my C-section scar to stop itching?

Itching is often a part of the healing process after a C-section but you can try and minimise the severity of the itchiness. Promote healthy skin healing by keeping to a nutrient-dense diet and drinking plenty of water too. Keep the incision site clean to reduce the chance of inflammation and infection. Avoid wearing clothes that may irritate the area such as nylon or polyester.

There are mixed thoughts on whether you should use topical creams or gels on c-section incisions for itching. Some medical professionals think it doesn't hurt, others firmly believe it's better to leave the wound alone. Always check with your LMC or healthcare provider before using anything directly on your healing incision.

Reducing the appearance of your C-section scar

Your incision will heal within a few months, and over the years, your scar will naturally fade. Some scars are fine lines while others are wide and raised. On darker skin tones, scars will appear as pale or dark lines. On lighter skin tones, scars will appear as pale or red lines.

Healthcare professionals have the opportunity to talk to women about what is healthy and normal after having a baby. More images and narratives about pregnancy, birth, and the postpartum period are needed to dispel myths about perfection and help women reclaim their bodies and their experiences.

If your C-section scar is bothering you, know that you are not alone-thousands of other women have C-section scars. In fact, around 30 per cent of births today are Cesarean deliveries. Having a baby isn't easy for anyone. Likewise, adapting to changes in your body is never easy.

Why does my C-section scar itch two years later (or longer)?

Some women report their scar is itchy years after they have a C-section. This can happen for a number of reasons.

Sometimes the scar can make the skin feel very tight, which increases the sensation of itching. Changes in your weight or skin can also make your scar itch more, especially if you have dry skin.

Keloid scars can be the cause of an itchy C-section scar years after surgery. The body produces more collagen after a cut or damage to build up and help the wound seal and heal. The scar usually fades and becomes smoother after time.

While your C-section scar might be something you prefer to keep under wraps, remember your scar is unique to you. If you have any concerns or questions, check in with your healthcare provider.

■ Bellies to Babies Antenatal & Postnatal classes, baby massage courses and baby and infant first aid courses, 2087 Pakowhai Rd, Hawke's Bay, 022 637 0624. https://www.hbantenatal-classes.co.nz/

Medical disclaimer: This page is for educational and informational purposes only and may not be construed as medical advice. The information is not intended to replace medical advice offered by physicians.