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Scar healing and recovery

9-minute read

Key facts

  • During childbirth, you may get wounds from perineal tears, episiotomies or a caesarean section, which can all cause scars.
  • Good hygiene is crucial to caring for your perineal tear and episiotomy wound, involving showering daily, keeping your wound dry, washing your hands and wiping front to back.
  • Appropriate movement, pelvic floor exercises, healthy eating, preventing constipation, rest and pain relief are all important to helping your wounds heal.
  • If you develop a fever, severe pain, tenderness, swelling, redness, heat, discharge, oozing or bleeding from your wound, seek immediate medical advice as this can be a sign of wound infection.
  • If you experience ongoing pain, discomfort, incontinence or sexual dysfunction after a perineal tear, episiotomy or caesarean has healed, seek medical advice.

What can cause scarring after having a baby?

During childbirth, you may get wounds from perineal tears, episiotomies or a caesarean section, which can all cause scars.

Perineal tear

A perineal tear is a tear in the skin and/or muscles of the perineum, which is the tissue that separates your vaginal opening from your anus. There are 4 levels of tears that range from a 1st degree tear, which is a small skin-deep tear that heals without stitches, to a 4th degree tear, that extends downwards from your vagina to deeper muscles near your anus or rectum. Most 3rd or 4th degree tears are repaired with surgery.

Episiotomy

An episiotomy is a cut that your doctor or midwife makes to your perineum with surgical scissors. It enlarges the opening of your vagina to help you give birth. Your healthcare professional will always ask your permission before giving you an episiotomy, and explain why they are recommending it.

Caesarean section

A caesarean section is a surgical operation. Your baby is born via a low cut in your abdomen and uterus. Caesareans may be planned or unplanned (for example, in an emergency).

How do I care for my wound?

Care for perineal tears and episiotomies

While you’re in hospital, the nurses will check your stitches daily. They dissolve by themselves.

Hygiene tips to care for your stitches

  • Keep the area clean, shower daily and pour water over your wound after using the toilet.
  • Change your pad every 2 to 3 hours; avoid touching the part of your pad that touches your wound.
  • Keep your wound dry by gently patting it with a clean towel.
  • Wash your hands with soap before and after showering, using the toilet and changing pads.
  • Wipe front to back.

Tips to reduce wound discomfort or swelling

  • Cold pack: Apply for 10 to 20 minutes every 2 hours, for the first 2 to 3 days.
  • Positioning and movement: Lay on your side as much as possible, avoid sitting for a long time.
  • Pelvic floor exercises: Begin 2 to 3 days after your baby is born, or when your physiotherapist advises you’re ready. Try 4 or 5 squeezes and lifts when feeding your baby.
  • Diet and preventing constipation: A high fibre diet is recommended, drink 2 to 2.5L of fluids daily, go to the toilet when you feel the urge and try not to ‘hold on’ or avoid going.
  • Compression: Apply 2 stacked pads with firm underwear.
  • Pain relief: Take as prescribed.

Tips to support recovery of 3rd and 4th degree tear

  • Stool softeners: Take stool softeners for 10 days after giving birth. It’s best if your stools are soft, as straining can cause stress on your wound.
  • Pain management: Ask your doctor to prescribe medicine for pain relief that is safe for you and safe during breastfeeding.
  • Antibiotics: After birth you will get intravenous (IV) antibiotics, and continue with oral antibiotics (for example, tablets).
  • Hygiene: Keep the area clean, for example, by showering daily.

Caesarean wound

Your wound may be closed with staples or stitches. Staples are removed within 3 to 7 days. Stitches dissolve by themselves.

You may have a waterproof dressing for 2 days. Once the dressing is removed you won’t need another one unless your healthcare professional recommends it.

Tips to care for your caesarean wound

  • Hygiene: Shower daily, keep your wound dry and clean, ‘air dry’ or gently dry with a clean towel. If a skin fold covers your wound, lift the skin fold and dry the area. If your skin fold becomes damp, ask your health team for absorbent padding.
  • Clothing: Wear loose clothing to prevent rubbing. Wear cotton underwear that stretches over your wound. Consider compression shorts that compress your abdomen and pelvis. This promotes blood flow and helps with healing.
  • Infection: Look for signs of infection and show them to your healthcare professional immediately.
  • Products: Avoid creams or powders on your wound.
  • Movement and exertion: Be mindful how you move. Try to roll out of bed, rather than placing strain on your abdomen. Support your wound when you get up by placing your hand over it. Do not lift anything that causes pain or that is heavier than your baby.
  • Rest: Rest as much as possible. If you overexert yourself, your wound may swell, causing pain. Ask for support as you need it.
  • Pain relief: Take pain relief medicines as prescribed.

What are signs my wound may be infected or not healing normally?

Signs your wound may be infected or not healing include:

  • extreme tenderness or pain (after the initial pain has settled)
  • bleeding, smelly discharge or oozing
  • swelling, redness or warmth on or around your wound
  • fever

Seek medical advice without delay from your midwife or doctor if you think your wound may be infected.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

How long does a wound take to heal?

Perineal tear and episiotomy

It takes 2 to 3 weeks for your perineal tear or episiotomy to heal. You may feel discomfort for up to 6 weeks.

Caesarean

Your incision will heal over a few weeks. While it’s healing you may feel mild cramping, light bleeding, vaginal discharge and pain or numbness around the wound. Most people feel well within 6 weeks.

How do I care for my scar?

You can care for your scars by avoiding the following for 6 weeks:

  • soaking in baths
  • powders
  • creams
  • tampons

Care for a 3rd or 4th degree perineal scar

  • Ask your midwife or physiotherapist for advice on movements or activities that don’t place pressure on your abdomen.
  • Seek physiotherapy to help manage any bowel (poo) or urinary (wee) incontinence.
  • Ask your doctor to check that your anal sphincter has properly healed via ultrasound.
  • If sex is uncomfortable, lubricant may help.

Caring for your caesarean scar

To help manage any pain, numbness or a feeling of pulling or stretching around your scar during the first few months:

  • rest when you feel you need to
  • modify your activities, do not lift anything that causes pain or anything heavier than your baby
  • take pain medicines as your health team directs
  • avoid sex until you are comfortable
  • do not drive a car until you are fully recovered and your wound has healed

Massage can help your caesarean scar heal. Here are some tips:

  • Massage your scar only once your doctor or midwife has checked it and says it’s safe to do so.
  • Use small amounts of oil or cream.
  • Apply light pressure over and around your scar for around 3 minutes daily.

Can I do anything to reduce the appearance of my scar?

When your wound has healed, apply Vitamin E cream to help reduce scarring. The colour of your skin over your wound may fade, but it won’t disappear. Check with your pharmacist or GP before using cream.

When should I see my doctor?

  • Within the first 6 weeks if you experience constipation, urinary or faecal incontinence and pain when urinating.
  • When your baby is 6 weeks old you should have postnatal follow-up where your health provider will assess your wound.
  • After 6 weeks postpartum, if you still suffer from incontinence, pain or sexual discomfort, you may be referred to a specialist.
  • Following a 3rd or 4th degree tear, your doctor will refer you to a perineal care clinic around 12 weeks after you give birth. Specialist doctors will assess your scar and anal sphincter.
  • Following a caesarean, pain and discomfort usually subsides within 3 to 6 months. If pain persists or you have back pain, chronic pelvic pain or sexual dysfunction, seek support from your healthcare professional.

Resources and support

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: November 2023


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Need more information?

Perineal Tear - Birth Trauma

A perineal tear is a laceration of the skin, muscles and other soft tissues that separate the vaginal opening and the anus.

Read more on Australasian Birth Trauma Association website

Vaginal Birth after Caesarean Section

Read more on RANZCOG - Royal Australian and New Zealand College of Obstetricians and Gynaecologists website

Perineal tears

A perineal tear is an injury to the skin and/or muscle between the vagina and anus that can happen during birth. Learn how it's treated and how to reduce your risk.

Read more on Pregnancy, Birth & Baby website

Vaginal birth after caesarean (VBAC)

If you've delivered a baby by caesarean, you can choose to have a vaginal birth after caesarean (VBAC) or a planned (elective) caesarean for your next birth.

Read more on Pregnancy, Birth & Baby website

VBAC: vaginal birth after caesarean | Raising Children Network

For many women, vaginal birth after caesarean – VBAC – is a safe and positive way to have a baby. Our guide explains VBAC’s possible benefits and risks.

Read more on raisingchildren.net.au website

Next birth after a caesarean

How you decide to give birth is your choice and this is not a decision you need to make on your own. Find out more about your options.

Read more on WA Health website

Perineal massage

Perineal massage is a technique that can be used during pregnancy to help to stretch the perineum, to reduce the risk of tears when giving birth.

Read more on Pregnancy, Birth & Baby website

Caesarean birth (C-section)

Caesarean (C-section) is an operation to give birth to a baby, which may be planned or an emergency. Find out why it might be needed.

Read more on Pregnancy, Birth & Baby website

Caesarean Section - Birth Trauma

Being abdominal surgery, pain in the early months is very common after a caesarean section (C-section) and needs to be managed with rest, pain relief, and

Read more on Australasian Birth Trauma Association website

Birth injury (to the mother)

Birth injuries to the mother, such as perineal tears and pelvic floor damage can sometimes occur. Support and treatment is available.

Read more on Pregnancy, Birth & Baby website

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