Prior to delivering my twins by cesarean section, I was worried that I'd end up with a C-section scar that marred my appearance in some obvious way. Luckily, I was totally wrong. Even after bringing 12 pounds, 2 ounces of baby into the world, my scar is small and utterly out of the way, as is typical after cesarean delivery. Sound good? These C-section scar-care tips can help ensure that your incision is a barely noticeable souvenir from bringing your baby into the world.
First, the basics: In almost all cases in the United States, the incision will be a small -- around 4 to 6 inches -- horizontal line that traces well below your belly button, so that only the absolutely skimpiest of bikini bottoms would ever reveal it. My own scar is just about 4 1/2 inches across, and I marvel that two full-term babies came out of it.
In very rare cases -- mostly in emergency situations -- your doctor may make a vertical incision instead.
Before you're discharged from the hospital (typically around four days, depending on your insurance coverage and the specifics of your delivery), your doctor will remove the staples from your incision; if you had sutures, they'll dissolve on their own. Your C-section scar will be covered with a paper tape-like product known as Steri-Strips. These will fall off on their own in about a week -- don't mess with them before that! They're keeping your wound closed and clean.
While your scar is fresh -- usually for the first two weeks -- you'll be instructed not to lift anything heavier than your baby so as not to disturb the healing process.
During this time, you can shower freely using a mild soap and without scrubbing the area; it's fine to get the incision (and the Steri-Strips) wet. But you should avoid submerging your scar in a bathtub (or swimming) in the early days.
At this point, your scar will likely be puffy, and the area around it will be pink. But if you notice bleeding or oozing from your incision site, reddened edges, or have a fever higher than 100.4°, call your doctor right away, as these could be signs of infection.
You may be eager to try vitamin E or over-the-counter creams like cocoa butter in an effort to reduce the appearance of your scar. Go for it -- but manage your expectations.
"There have not been any good scientific studies demonstrating that any of the over-the-counter preparations are better than just proper wound care," says Rajiv B. Gala, M.D., the American College of Obstetricians and Gynecologists' young physician at large. "Most of the expectations presented in online advertisements are best-case scenarios and may not be realistic in typical cases."
You should also be mindful to avoid certain cosmetic creams if you're nursing. "There are things that will work on scars and stretch marks, like Retin-A, but these need to be administered after pregnancy and breastfeeding," says Shawn Tassone, M.D., an Austin, Texas-based ob-gyn and author of the books Hands Off My Belly! and Spiritual Pregnancy.
After about six weeks, your scar will be healed -- meaning you'll likely be able to resume all regular activity without disturbing it. Giving yourself at least six weeks of healing time "allows the incision lines to mature, so that when strenuous activities are performed, the integrity is not compromised," says Dr. Gala.
And although the integrity of the scar may be intact, you may still note that it has turned a reddish-purpleish color. Don't worry -- that's completely normal. The color will persist for about six months before fading to a less noticeable whitish line, says Dr. Tassone.
In less common cases, your scar may have a raised characteristic, known as a keloid. Doctors aren't sure what causes keloids "but there is obviously a hyper reaction to the healing process that causes the scar to grow outside its original boundaries," says Dr. Tassone.
Some physicians attempt to counter the effect by injecting cesarean wounds with a steroid called Kenalog at the time of surgery, but the results are mixed -- as are treatments such as lasers and injections of interferon.
Now that I'm four months postpartum, I have a mild keloid, but no one will ever need to see it. It's also still reddish-purplish, but I expect that will further fade in the coming months.
Overall, I'm comfortable with my scar's progress. And unlike my stretch marks (womp, womp), it's a pregnancy souvenir that actually makes me proud! It's a reminder every day of the healthy kids for whom I'm so grateful -- and the superwoman feat of pregnancy and delivery that brought them into this world.
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