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April 28, 2021
By Emeline Mugisha, MSN, MPH, RN
A scar is new tissue that develops on and below the skin as part of your body’s natural healing process after an injury or surgery. Scar management is a significant part of recovery for many postpartum moms, including all women who had a perineal tear, episiotomy, or a cesarean birth (c-section). While every woman, delivery, and scar is different, there are a few things to know to help postpartum scars heal, including how to massage a scar safely and effectively.
Most postpartum scars do not cause long-term problems, but some do. For example, studies show that 6 to 18% of women who had a c-section experience chronic scar pain. This pain can lead to difficulties with everyday activities, painful sex, and pain with bowel movements. Similarly, some women recovering from a perineal tear or episiotomy also notice pain during sexual activity and discomfort with bowel movements. These women may also experience soreness between the vagina and rectum and difficulty inserting a diaphragm or tampon.
Related: What to do about painful sex after childbirth
Whether you do it or someone else does it (such as your partner or a physical therapist), massage is an effective way to increase healing and manage the development of physical scars after childbirth. The earlier and more regularly massaging occurs, the faster you will heal (inside and out) and the less likely you are to experience physical restrictions from your scar.
Overall, scar tissue massage can help:
Unless a health care provider advises you to start sooner, wait for your wound to fully heal before beginning massage. Allowing your skin to recover fully can help prevent infection or injury. A fully healed scar will not have open areas or scabs, should not cause severe pain or sensitivity, and should not prevent you from completing your everyday activities. It usually takes about six weeks for a scar to fully heal, depending on the type of scar and your skin's condition.
If you had a perineal tear or episiotomy during vaginal delivery, you will have scar tissue that needs to heal in the area between your vagina and anus. This area is also known as the perineum. The resulting wound—whether natural or surgical—is called a perineal scar.
If you had a c-section, you will have deep-tissue scars that need to heal. Unless there are physical complications such as infection, the scar on your skin’s surface will heal automatically. Deeper physical scarring, however, will require more work and patience for a full recovery.
If you have any questions or concerns about scar massage before you begin, speak to a health care provider. Also, consult a medical provider if you develop any of the problems below:
Kukuchka, K. (2001). Potential dysfunctions occurring in the postpartum years. Physical Therapy Scholarly Projects. https://commons.und.edu/pt-grad/270
National Health Service (UK). (2020, September). Postnatal scar tissue management.
Wasserman, J.B., Abraham, K.S., Massery, M., Chu, J., Farrow, A., & Marcoux, B. (2018). Soft tissue mobilization techniques are effective in treating chronic pain following cesarean section: A multicenter randomized clinical trial. Journal of Women's Health Physical Therapy, 42(3), 111-119. doi: 10.1097/JWH.0000000000000103
Emeline Mugisha, MSN, MPH, RN - Emeline Mugisha is an award-winning, master's-prepared nurse with over a decade of experience in community/public health and clinical health services at the field and management levels. She has co-authored two professional manuscripts in Women's Health Issues and the Journal of Midwifery and Women's Health. She has an M.S. in Public Health Nursing and an M.P.H. from Johns Hopkins University.
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