Scar tissue and pain after caesarean section

A caesarean section is a surgical procedure in which the abdominal wall and the uterine wall are opened and the baby is delivered. The incision is about 15 centimetres and is made transversely, just above the pubic hairline. The scar is often small [1]. Two types of incision are mentioned, the bikini incision and the vertical incision [2].

After the operation the wound should not be loaded for the first six weeks [2]. Signs of infection in the wound are redness and irritation around it, swelling, fluid from the wound, fever or pain [2].

A scar adapts over time. In its description of excessive scarring, NHI writes that scars mature over one to two years, and that only after this period can one say what the final result will be [5]. It also describes that a scar sometimes forms excessively, and it can then cause itching and discomfort [5].

During the first days you feel pain in the wound and afterpains. The pain should gradually ease, and the need for painkillers is usually under five to seven days [2]. Gas pains are common, and movement, changing position and deep breaths can ease them [2][3]. Support the wound when you cough or sneeze [3].

If you are unsure whether the pain is within what is usual, you can contact your GP, midwife or the hospital where you gave birth.

Early movement is recommended. The day after the operation you can sit on the edge of the bed and walk around a little, and you can take short walks and increase gradually [3]. Heavy lifting and heavy housework should be avoided for six weeks [1][2][3]. Sit-ups should wait for ten to twelve weeks [2][3].

The pelvic floor muscles are weakened after pregnancy, and training them is recommended after a caesarean section as well. You can start right away [3]. After the birth you will need more help and time than after a vaginal delivery [2].

We have read one randomised study of chronic pain after caesarean section. It included 28 women and compared two forms of soft tissue treatment over four treatments. One group received superficial massage of the abdomen and lower back and skin rolling over the scar. The other group received the same treatment, plus myofascial release of the abdomen and direct mobilisation of deep scar tissue [4].

Pain, pressure pain threshold, level of function and mobility of the scar improved in both groups. There was no difference between the groups [4]. Since both groups were treated, and the study is small, it says little about which part of the treatment, if any, made the difference. The study scores 5 out of 10 on the PEDro quality scale [4].

We have not read studies showing how many have pain in the scar over time, or which treatment gives the best results. Research on this is so far limited.

Contact a doctor if you get signs of infection in the surgical wound, such as redness and irritation around the wound, swelling, fluid from the wound, fever or pain [2]. You should also get in touch if you cannot empty your bladder properly after leaving the hospital [2].

If the scar feels tight, stiff or painful, an osteopath can examine the area and see it in connection with the pelvis, back and abdomen. Dr.Dropin offers scar tissue treatment after caesarean section. You can read more about osteopathy and about the pelvic floor muscles.

How long does it hurt after a caesarean section?

The pain should gradually ease after the operation, and the need for painkillers is usually under five to seven days [2]. If you have pain for longer than this, you can raise it with a doctor or midwife.

How long does it take for a caesarean scar to fully mature?

NHI writes that scars mature over one to two years [5]. The page concerns excessive scarring in general and not caesarean scars specifically.

When can I start exercising after a caesarean section?

Short walks can be started early and increased gradually. Heavy lifting should be avoided for six weeks, and sit-ups should wait for ten to twelve weeks. Pelvic floor training can be started right away [2][3].

What are signs of infection in the caesarean wound?

Redness and irritation around the wound, swelling, fluid from the wound, fever or pain. Contact a doctor if you notice such signs [2].

The page about pelvic girdle pain describes problems in the pelvis that can arise during and after pregnancy. You can find more articles in the overview of articles.

This article was written by Dr.Dropin Fysikalske and is based on the sources listed below. It gives general information and does not replace an examination by a healthcare professional.

The websites were accessed and read on 22 October 2026.

1. Keisersnitt (Caesarean section). NHI.no. Last updated 17 June 2024. Link

2. Keisersnitt (Caesarean section). Oslo University Hospital. Last professionally updated 12 February 2025. Link

3. Råd etter keisersnitt (Advice after caesarean section). Physiotherapists at KK, Helse Bergen. No date given. Link

4. Wasserman JB, Abraham K, Massery M, Chu J, Farrow A, Marcoux BC. Soft tissue mobilization techniques are effective in treating chronic pain following cesarean section: a multicenter randomized clinical trial. J Womens Health Phys Ther. 2018;42(3):111-119. Read as a record and summary in PEDro. Link

5. Overdreven arrdanning (keloid) (Excessive scarring (keloid)). NHI.no. Last updated 19 April 2022. Link