The Physical Long-Term Effects of a Caesarean Birth

The picture shows work I had done over 3 months to release stuck connective tissue above a scar and softening and releasing the scar beneath it. The appearance has improved but more importantly, Alicia does not experience pain anymore. Alicia’s testimonial:

“Having had three C-sections in 5 years, I had been left a pouch where my scar lay, and also a ‘ledge’ a few inches above my scar. It was noticeable through clothing and I was getting more and more self conscious of it. After a bit of googling I found that it was quite possible myofascial massage I needed to help break down scar tissue. I found that this was something Nina offered and having already met her, didn’t hesitate to book an appointment.

The first appointment was quite uncomfortable, but it made me realise there was a lot more going on in all the layers under my skin than I had thought. Nina identified areas of tissue adhesions and has been working on these over a number of sessions and gave me ways of massaging myself in between sessions.

Although it might not be hugely noticeable to some, I can feel a big difference and can now wear clothes I wouldn’t have previously, including a bikini!

I’ve also noticed that since having myofascial massage, when I’m ovulating on one particular side, I no longer experience the excruciating pain that I was previously, which is something I hadn’t even thought would be down to the scar tissue.

I would definitely recommend this treatment to anyone that feels their scar doesn’t feel right, or suffers with pain in that area”. Alicia – mum of three who were all birthed by Caesarean Section.


Due to the high turnaround of women experiencing a caesarean section birth in our busy NHS hospitals, it is no surprise that c-section aftercare and recovery advice can often be limited. Whether making the decision for medical, personal or emergency reasons, the basic information given to mothers is to prepare for a six-week recovery, stay away from lifting anything heavier than your baby and don’t drive. This downplays the huge abdominal surgery you have been through, suggesting it as something you will fully recover from within a matter of weeks, leaving you only with a lifelong scar. Yet this scar has a much bigger impact than you may realise. With one in every four women having a caesarean, it’s time to bring awareness to the prolonged physical impact this scar can have on your body.


During a caesarean delivery, a 10-20cm cut/tear is made through six layers of tissue, beginning with the skin and fat and ending with the uterus. After bringing your baby into the world, the cut is stitched back together and covered for a short time before dressings are removed and your scar slowly begins to heal itself. But has it really healed? Because scars can look nice and neat on the surface, we don’t consider the irregularly fixed layers underneath that form scar tissue, strengthening the vulnerable area, but also exerting a three-dimensional pull inside your body. This scar tissue becomes an internal adhesion that can bind together formerly, separating structures in your body and can reach far away from the site of the scar, potentially restricting movement between bones and joints.


The consequences of this adhesion can include pain during intercourse, a weakened core, pain when ovulating, difficulty in restoring abdominal separation as because of pregnancy and poor bladder and bowel control. But because you can’t see these things externally, it can be hard to know they’re happening. It’s often only with a focused deep massage on your scar that you can feel the tightness caused by internal pulling.


Whatever method you gave birth by, it will take time for your body to recover from the immediate stress it’s been through and start to think about rebalancing your hormones. The first six weeks post-birth, your uterus contracts and your internal organs slowly start to move back into place. Bleeding can continue for up to 6 weeks too so it’s important to keep iron levels up now to avoid anaemia. Breastfeeding and your eventual decision for this to come to an end also impact your body: it takes four months after you finish breastfeeding for pregnancy hormones such as relaxin to leave your body and you’ll still have an unstable pelvis in this time. It can take two years and beyond for your pelvic floor and abdominal muscles and connective tissue to go back to normal after stretching during pregnancy. All these things take longer to recover from following a C-section, especially the final point as internal scarring can delay your abdominals from getting back to normal.


Because your scar is located within the pelvic area, it can have a greater impact on the rest of your body than you realise, affecting your core and therefore your posture as well as cause back, hip and neck pain. Your pelvis and core are closely connected so working on one helps release pain or difficulties in another part: therefore, we are also able to work on diastasis recti (abdominal separation) through massage too.

After surgery, scar releases through massage and mobilisation techniques can continue to restore the incision area and the layers beneath for optimum recovery and function. All scars need this type of treatment to reduce the risk of adhesions building up and causing long term concerns. This treatment is recommended from as early as 10 weeks post caesarean, if the area is healed and there are no scabs, open areas, or signs of infection.

Nina Parnham has trained with top therapists to be able to offer scar massage and release treatments for women who have scars on their abdomen. This treatment is also suitable for women with hysterectomy and appendix scars. Mama Wellness also offers caesarean scar massage workshops so that women can understand what has happened to their body, and how they can help bring long term improvements to their health and wellbeing.