What Do You Do If Your C-Section Incision Is Opening? - Healthline

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Parenthood

Signs That Your C-Section Incision Is Reopening and Needs Medical Attention

Medically reviewed by Carolyn Kay, M.D. — Written by Noreen Iftikhar, MD on December 15, 2020

Get immediate medical attention
C-section closures
Causes
Risk factors
Signs and symptoms
Treatment
Prevention
Takeaway

Close-up of c-section scar — Jane Khomi/Getty Images

Congratulations — you’ve delivered your new little miracle by cesarean section! This is not an easy feat. Your doctor may have recommended this delivery method as the healthiest — or only — option for you and your baby.

Also known as a C-section, this is the most common surgery in the United States: Nearly 1 in 3 births occurs by C-section. It’s a procedure in which the baby is delivered via two incisions — one in the skin of the lower abdomen and another one in the uterus (womb).

As with any surgery, C-section incisions take time to heal and need the right attention. Most times, the area heals properly without any issues. Still, even if you do everything right, you might experience complications while you’re healing.

In rare cases, your C-section incision might open (or reopen). In medical terms, this is called C-section dehiscence.

Here’s what to look for and what to do if you think your C-section incision is opening — or just not healing well.

When to get immediate medical attention after surgery

Get urgent medical care if there’s any sign that your C-section incision is opening or infected after going home. Call your OB-GYN right away if you have:

bleeding from the incision site
a fever over 100°F
severe or worsening pain
redness or swelling around the incision
heavy vaginal bleeding
large blood clots in vaginal discharge
foul-smelling vaginal discharge
a foul smell from the incision area
leaking or pus around the incision
painful urination
bulging or hardness at the incision site
breast pain and a fever

How are C-section incisions typically closed during surgery?

As is the case with any kind of surgery, the outer C-section incision can be closed in a number of ways, including:

stitches or sutures
absorbable sutures
staples
absorbable staples
skin adhesive (glue)

Meanwhile, the inside incision on your womb is closed with absorbable stitches that dissolve once the site has healed.

Causes of C-section dehiscence

Your outer C-section incision can open or rupture for several reasons:

Strain and stress

Sometimes putting too much pressure on your stomach can cause stitches to loosen or tear. You can put too much strain on the site by picking up something heavy (like your toddler or a heavy bag of groceries), climbing lots of stairs, or trying to exercise too early.

When your OB-GYN says not to lift anything heavier than your newborn during your recovery period, take it to heart and let someone else do the tough stuff. You deserve the break, anyway!

Poor healing

Sometimes your body doesn’t heal the way it should. Poor wound healing can happen because of genetics or an underlying medical condition. For example, diabetes or obesity can affect wound healing.

This can lead to uneven healing or cause the incision to separate and open instead of joining together.

Necrosis

Not getting enough blood and oxygen to the area can also lead to poor wound healing.

In some cases, the skin cells at the edges of the incision site may even die from not getting enough oxygen and nutrition. This is called necrosis. The dead cells can’t grow and join together to heal the wound, leading to the opening of a C-section incision.

Infection

An infection at the C-section incision site will slow or stop it from healing properly. Infections can occur from bacteria or other kinds of germs. While it’s standard care to get antibiotics right before surgery, you don’t usually get antibiotics after a standard, uncomplicated C-section.

When you have an infection, your body is so busy fighting the germs, it might not be able to heal the area properly at the same time.

Risk factors for C-section dehiscence

A C-section cut might be:

vertical (from below the belly button to the pubic hairline)
horizontal (across the pubic hairline)

The type of incision you have depends on what your OB-GYN thought was best for delivering your baby. Horizontal cuts are the most common, as they tend to heal better and cause less bleeding.

Vertical C-section cuts may have a higher risk of opening, as they might not heal as well.

And according to one review, a C-section incision that’s closed with stitches or sutures may be less likely to open than one that’s closed with staples. That said, stitches can sometimes also open or cause complications.

Signs and symptoms of C-section dehiscence

In some cases, a C-section incision might have opened because some or all of the stitches or staples holding it closed came undone or broke through the skin. This can happen if the incision opens due to too much pressure being placed on the area.

If this has happened, you might be able to see some of the stitches or staples that are no longer in place. Your C-section might look like a fresh wound, with redness or bleeding.

If your C-section opening is due to an infection in the area, you’ll see signs of infection, such as redness, swelling, or pus.

If necrosis is the cause of C-section opening, you might see gray, yellow, or black discoloration around the area, as opposed to pink or your normal skin color. The area may also smell bad.

What about the internal C-section incision?

The internal C-section incision on the uterus can also open or rupture. You obviously can’t see this, but you’ll likely have signs and symptoms that something isn’t right. These include:

severe abdominal pain
vaginal bleeding
dizziness
low blood pressure
a fever
painful urination
painful bowel movements
severe constipation or the inability to have a bowel movement
a bulge or lump on your lower stomach

Intestinal evisceration

Another rare C-section complication is intestinal evisceration. This happens when parts of the body, such as intestines, gastrointestinal organs, tissue, or muscle just under the skin, poke into or through the C-section site. The pressure from the moving parts under the skin can force the incision to open.

This complication might also present as a fleshy growth or lump coming out of the incision site. Alternatively, the site might feel hard or lumpy in some places. This complication can likewise happen with other kinds of abdominal surgeries.

Note that this is an emergency, and you should seek medical attention immediately.

Treatment for C-section dehiscence

The severity of a C-section opening depends on its location.

If your outer incision is opening, your doctor will probably give you a local injection to numb the area and then remove the skin or tissue just around the site. Then the freshly opened site will be sutured, stapled, or glued again.

If you have an infection or dead skin cells around the area, the C-section site will have to be cleaned up further before it can be closed again.

An internal C-section opening or rupture is rare, but much more serious. You’ll likely need to have surgery to close this. In very rare cases, the uterus might need to be removed if it’s very damaged or infected. This surgery is called a hysterectomy.

If the area is infected, your doctor might give you a stronger dose of antibiotics, or you might be given antibiotics via an injection or intravenous (IV) therapy.

Caring for your incision and preventing reopening

You can’t always prevent a reopening or other complications around your C-section incision, but it can help to take every precaution while you heal and recover. Try these tips:

Get plenty of rest for the first few weeks.
Get proper nutrition, including plenty of fruits and vegetables.
Avoid lifting or pushing anything heavier than your newborn.
Avoid standing for too long.
Avoid strenuous exercise.
Avoid wearing tight clothing.
Use the right posture support for your stomach when you’re sitting or lying down.
Avoid sex for 4 to 6 weeks, or longer if you don’t feel up to it.
Avoid scrubbing or pressing on the area.

If you’re constipated, ask your OB-GYN for a laxative. Straining can worsen pain and put pressure on the C-section site.

Keep the C-section area clean by changing the bandages as needed. Get help or ask your OB to do it if you’re unable to do so.

You can shower after a C-section, and it’s fine to let the soapy water run down the area. Just avoid rubbing, scratching, or scrubbing the C-section site.

Wounds need some moisture to heal properly, so it’s best to keep the bandages on most of the time. It’s also important to let the area breathe by removing the bandages sometimes.

Light exercise like a short stroll or stretching can help keep your blood flowing. More blood and oxygen to the area is great for overall healing after a C-section.

The takeaway

You’re taking great care of your baby, but remember to take care of yourself, too. A C-section is a major surgical procedure. In most cases, you’ll recover easily and quickly (within 6 to 8 weeks) and have just a small scar.

Sometimes, you can do everything right and still have complications. Keep an eye on your C-section incision site and let your OB know right away if you see or feel any sign of an infection or other C-section complications.

Parenthood
Pregnancy
Postpartum Care
Post Delivery

How we reviewed this article:

SourcesHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Bozdag Z, et al. (2016). A rare complication of uterine rupture following C-section: Intestinal obstruction due to internal hernia.http://www.jcasesobstetgynecol.com/Volume-3-Issue-2-April-2016/2-5.pdf
Births — Method of delivery. (2020).https://www.cdc.gov/nchs/fastats/delivery.htm
Mayo Clinic Staff. (2020). C-section.https://www.mayoclinic.org/tests-procedures/c-section/about/pac-20393655
Sung S, et al. (2020). Cesarean section.https://www.ncbi.nlm.nih.gov/books/NBK546707/
Tsai H-F, et al. (2013). Delayed uterine rupture occurred 4 weeks after cesarean section following sexual intercourse: A case report and literature review.https://www.sciencedirect.com/science/article/pii/S1028455913001277

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Medically reviewed by Carolyn Kay, M.D. — Written by Noreen Iftikhar, MD on December 15, 2020

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