Definition
Pain at the scar of the caesarean section is an unpleasant sensation in the area of the scar tissue after the surgical birth. As the skin, abdominal layers and the uterus are surgically opened and sutured again during a caesarean section, the pain is normal up to a certain duration and intensity, as the aforementioned tissues have to heal again. The pain can be pulling, dull, pressing or, in the case of a fresh wound and only beginning scarring, shooting. These sensations can occur during exertion, but also at rest and can vary in intensity.
Causes of pain at the caesarean scar
Numerous factors are involved in the pain sensation of a caesarean scar. During the procedure, several layers of the body are penetrated, which must heal at great expense and cause discomfort during this process. These include above all the uterus and the skin, but other tissues, such as the abdominal muscles or internal organs, can also be irritated or injured and thus lead to pain.
These are mediated by tiny nerve fibers, which are injured during the incisions. So-called nociceptors, receptors of pain perception, transmit the pain stimulus and reach the pain center in the brain via complex signal cascades. Individual pain tolerance also plays a role in processing; similar pain impulses lead to different pain reactions in each person.
Therefore, scar pain can be classified as severe by some patients and tolerable by others. Another reason for a painful caesarean scar can be poorly or incorrectly healing tissue, a so-called hypertrophic scar can be the cause. This causes the scar tissue to proliferate and thicken, which can exert tension on the adjacent skin and restrict normal mobility. In the case of a fresh scar, increased pain in combination with local redness can be an indication of an inflammatory process.
Complaints in the area of the caesarean scar in case of a new pregnancy
In case of a new pregnancy after a caesarean section has already been performed, there may be complaints in the area of the scar. Due to the increase in the circumference of the abdomen as the pregnancy progresses, the skin and thus the scar will stretch more, which can lead to discomfort. As with any scar, an insufficiency can occur, which means that the scar can no longer satisfactorily perform its function of holding tissue together.
This can also manifest itself through increasing pain and sometimes visible changes in the scar. Pain can also occur when the caesarean scar has grown together with underlying tissue layers and exerts a pull on these layers by the increase in size of the abdomen. It should not be forgotten that the visible skin scar is not the only scar resulting from the caesarean section; the uterus was also sutured.
Here, too, pain can be caused by stretching processes. In addition, scar pregnancy, i.e. the implantation of the embryo in the scar tissue, can occur and thus become symptomatic. A scar rupture, i.e. a tear in the area of the scar, can also lead to pain. Although the probability of this is very low at 1%, it is a serious complication.
