The benefits of caesarean scar massage

The benefits of caesarean scar massage

For many women, a caesarean birth brings not only a new baby, but also a scar that needs both physical healing and emotional care. Gentle caesarean scar massage can support the recovery process from the inside out.

The layers of a caesarean section

When a caesarean birth is performed, the obstetrician carefully works through several layers to reach the baby. While it may sound like a lot, the process is precise, and most layers are gently separated rather than cut.

The six main layers:

• Abdominal skin – a small horizontal incision (usually around 10 cm) is made just above the pubic bone.

• Subcutaneous tissue and fat – the soft tissue under the skin is cut to allow access to the fascia.

• Fascia (rectus sheath) – this strong connective tissue layer is cut horizontally.

• Rectus abdominis muscles – these abdominal muscles are not cut, instead, they are gently separated along the midline to create space.

• Peritoneum – a thin, fragile lining of the abdominal cavity is carefully cut. At this point, the surgeon can often see the bowel, and a retractor is used to move tissue downward for a clearer view. Women may feel tugging, pulling, or pressure here.

• Uterus – the uterus has a fine film-like covering. This is opened with a small horizontal cut, followed by an incision into the lower uterine segment. This is the only true muscle layer that is cut in a caesarean. Once the uterus is open, the amniotic sac (if still intact) is broken, fluid is released and suctioned, and the baby is gently lifted out.

 

Why scar massage matters

This healing naturally creates scar tissue, which may feel tight, itchy, or tender. It can even adhere to deeper layers and limit mobility. Once your healthcare provider gives the green light (typically around 6–8 weeks postpartum), regular scar massage can:

• Reduce discomfort, tightness or itching

• Soften and flatten the scar, making it less noticeable

• Help release adhesions, improving mobility in the abdomen and pelvis

• Boost circulation, aiding tissue flexibility and healing

• Support emotional wellbeing by reconnecting you with your body

• Understanding the healing stages of your caesarean scar

Knowing what to expect can empower you and help you time your massage routine more effectively.

Inflammatory phase (days 0 to 7)

A protective clot forms, and white blood cells rush in to fight infection. The incision may look red or swollen and feel tender or sore. This is not the time to massage.

Proliferative phase (weeks 1 to 6)

New blood vessels and collagen form. The scar may thicken, look pinkish, and feel firm or itchy. Around the 4 to 6-week mark, once the skin has fully closed and healing signs are good, many women begin to introduce gentle massage.

Remodelling phase (months 1 through 12+)

The scar gradually softens, flattens, and fades in colour. Tissue strength improves as collagen fibres reorganise. You can safely increase massage pressure during this stage to support mobility and appearance.

 

Here’s a quick summary:

Healing Stage	Timeline	What’s happening	Massage timing
Inflammatory	0 – 7 days	Initial healing, inflammation	Avoid massage
Proliferative	Weeks 1 – 6	Collagen forms, skin closes	Gentle massage when healed
Remodelling	Months 1 – 12+	Scar softens and fades	Increase massage depth / techniques

 

When to start scar massage safely

Your incision must be fully closed, so no scab, bleeding, swelling, or discharge.

Typically, around 4 to 6 weeks postpartum but always check with your GP or midwife before beginning to be sure.

How to massage safely

Basic steps:

• Wash your hands.

• Apply a neutral moisturiser or a good quality natural oil, cream, or gel such as Vitamin E cream, Rosehip oil, Aloe Vera gel, Coconut oil, or Calendula oil or cream. Care providers may also recommend silicone-based creams or gels, which research shows are particularly effective for reducing raised scars. Some women prefer natural or organic products, which can still be soothing and beneficial for skin comfort. The best option is the one that feels safe, comfortable, and right for you.

• Use gentle pressure – massage should feel slightly tugging at most, not painful.

• Try circular motions, side-to-side glides, or gentle skin lifts and rolls.

• Massage for a few minutes once or twice daily, ideally in the remodelling phase, but even during the proliferative stage, light touch around the area (not directly over the scar) can help.

• Always stop if there’s sharp pain, heat or bleeding, and report any concerns to your health care provider.

Scar massage during pregnancy after a previous caesarean

While solid evidence supports scar massage postpartum, with benefits in comfort, mobility, scar appearance, and even VBAC readiness, the research on scar massage during pregnancy is minimal, and a conservative approach is recommended: gentle techniques, avoid deep pressure, and always get clearance from a qualified provider.

Potential benefits:

• Improves tissue mobility: Massage may help release adhesions around the old scar, allowing better movement of the abdominal wall and uterus.

• Eases discomfort: Some women experience pulling, tightness, or sensitivity around their old scar during pregnancy. Gentle massage can help reduce this.

• Supports body awareness: Touching and caring for the scar can help women reconnect with that part of their body, which can be very powerful when preparing for a VBAC.

 

Safety considerations

• Uterine scar: keeping in mind that you are not massaging the uterine scar itself as you are not massaging the inside of the uterus, only the external scar and surrounding tissues.

• Gentle pressure only: during pregnancy, avoid deep or aggressive techniques. Stick with light touch, soft circular movements, or gentle stretching of the skin and fascia.

• Medical clearance: it’s always best to check with a midwife, obstetrician, or women’s health physiotherapist before starting, particularly if there are concerns about scar integrity.

• Discontinue if painful: like with any therapy, if massage causes pain, cramping, bleeding, or contractions, it should be stopped immediately.

 

VBAC-specific considerations

The biggest factor for VBAC safety is the strength of the uterine scar, which massage cannot influence directly.

What massage can do is improve the comfort and mobility of the abdominal wall and surrounding tissues, potentially helping with posture, breathing, and overall pelvic alignment – all of which may indirectly support labour progress.

Many women also find that engaging with their scar during pregnancy helps reduce fear and anxiety about it “opening” during labour, by reframing it as part of their body they can care for and trust.

Scar massage during pregnancy is generally safe if it’s gentle, external, and approved by a care provider. While it won’t change the integrity of the uterine scar, it can reduce discomfort, improve tissue mobility, and support emotional readiness for a VBAC.

 

 

In summary – caring for your scar while caring for you

Caesarean scar massage is both a physical practice and a form of nurturing self-care. It helps ease discomfort and tightness by softening and flattening scar tissue, while also reducing the risk of adhesions. Just as importantly, it supports emotional healing and allows you to reconnect with your body after your belly birth, helping to restore confidence and comfort.

By understanding the stages of healing, you can begin massage at the right time and adjust your approach as your body continues to recover. Using a natural oil or a silicone-based product, a few mindful minutes each day can make a noticeable difference in how your scar feels and looks.

Beyond the physical benefits, this simple act invites you to pause and acknowledge the extraordinary work your body has done and create space for nurturing yourself as you move forward in your recovery.

All the very best. 

 

 

Resources:

https://www.royalberkshire.nhs.uk/media/1kzkbb30/physio-scar-tissue-mobilisation-for-perineal-and-cs-scars.pdf

https://www.thevbaclink.com/c-section-scar-massage-before-and-after-vbac/

https://www.verywellhealth.com/c-section-massage-5217455

https://thepositivebirthcompany.com/parenting-blog/how-to-look-after-your-c-section-scar

https://advances.umw.edu.pl/en/article/2024/33/4/387/

https://journals.lww.com/jwphpt/abstract/2018/09000/soft_tissue_mobilization_techniques_are_effective.3.aspx

https://journals.viamedica.pl/ginekologia_polska/article/view/98523

https://pmc.ncbi.nlm.nih.gov/articles/PMC8220509/

https://www.sciencedirect.com/science/article/abs/pii/S136085921600022X

https://www.sciencedirect.com/science/article/abs/pii/S1360859218301657

https://www.kingstonandrichmond.nhs.uk/patients-and-families/patient-leaflets/scar-massage-after-caesarean