Scarring Associated with Childbirth

Many women are aware of the potential tears and scars that may accompany childbirth, however they are not given much direction on how those scars may affect them weeks to years later in their healing process.  Some women don’t even realize that some of their pain in other areas of the body (back, hips, pelvic floor, etc.) may be directly related to their scars!  The two most common scars we see post-partum are c-section scars and vaginal (perineum and labia) scars, however there can be several different types of each scar based on how your body naturally tore or how the surgeons felt was the most necessary direction to cut based on your individual circumstance.

Vaginal Scar (Perineum and labia): Many women will have some type of vaginal tearing during childbirth that may range from 1st degree minor tearing of the perineal skin that does not require stitches to 4th degree tearing that extends into the anal sphincter and rectum and requires more specialized repair under anesthesia.  Some women may require the surgeon to cut through their perineum, also known as an episiotomy, to help with a difficult delivery.  Scars may occur on one side and not the other, or they may occur right down the middle depending on your individual labor.  Regardless of how extensive the scar and in what direction the scar may be in, any scar can cause painful intercourse, pelvic floor dysfunction, and sometimes even fecal incontinence due to the disruption to skin and underlying tissue or muscles.

C-section Scar: Some women will opt to have a c-section or will be required to have a c-section due to emergency reasons.  Regardless of the reason, c-section scars can heal on their own with minimal to no issues, or they can be quite a nuisance and cause pain or mobility problems throughout the low back, pelvis, and hips.  This is usually caused by scar tissue adhesions that can make it painful to move certain ways due to pulling on tightened skin or underlying muscles.  For those that do have pain, many women report abdominal pain, low back pain, and hip pain, as well as urinary urgency/frequency/incontinence, and difficulty bending or lifting due to pulling in or around their c-section scar. 

Any type of scarring can cause muscle weakness or lack of control, in addition to pain, when it is cut through, so many women will report core weakness following C-section scarring and pelvic floor weakness or incontinence after perineal scarring.  Both are very common however it is not normal for those issues to last longer than 6-12 months following childbirth (varies depending on severity and individual body healing).  If you have tried various home exercises and treatments to try to get rid of your aches and pains from vaginal or abdominal scarring and they just don’t seem to be working, then it may be time to see a Pelvic Health Physical Therapist who can help you minimize the scar restrictions through manual therapy techniques and get you back to pain free movement.

Feel free to contact our specially trained pelvic health physical therapist if you have any questions that were not addressed or would like to schedule an appointment to get back to symptom free life.


Do I need a referral from my physician?

North Carolina is a direct access state for physical therapy services therefore a physician’s referral is not required unless you are using Medicare insurance. We do communicate with your medical providers as needed to improve your care.

What will happen at the initial consultation?

A complete physical evaluation is completed based on your concerns. Often this includes examination of your movement, core and pelvic floor muscles as indicated. Treatment and begin the same day as the initial consultation.

How many sessions will I need?

Together we will develop your treatment plan based on your needs. The exact number of visits is unique to symptoms but on average our patients benefit from 6-8 treatment visits.