Case Report: Post-Cesarean Section Wound Dehiscence in a Postpartum Woman with Obesity

Abstract

Wound dehiscence is a postoperative complication of cesarean section that may delay wound healing and increase the risk of infection. Obesity is a major contributing risk factor because impaired tissue perfusion reduces oxygen and nutrient delivery to the wound, resulting in slower healing. This case report aimed to describe the implementation of comprehensive midwifery care for a postpartum woman with obesity who developed post-cesarean section wound dehiscence. This study employed a descriptive case report design involving a 41-year-old multiparous postpartum woman (P20002) with Grade II obesity who presented with wound dehiscence on the 20th day following cesarean section. Midwifery care was provided at Taji Community Health Center, Magetan Regency, Indonesia, from January 31 to February 9, 2026. The care consisted of one initial assessment followed by three home visits using Varney’s Midwifery Management Approach, with all findings documented using the SOAP format. The interventions included aseptic wound care, education on self-wound care, a high-protein nutritional plan, gradual mobilization, body mechanics education, non-pharmacological pain management, breastfeeding position counseling, and regular wound assessment using the REEDA scale and the Numeric Rating Scale (NRS). The patient's condition improved progressively throughout the course of care. The REEDA score decreased from 4 to 0, while the pain intensity measured by the NRS decreased from 4 to 0. The wound healed completely without signs of infection. In addition, the patient demonstrated improved adherence to wound care practices, nutritional recommendations, and other self-care instructions provided during the postpartum period. This case suggests that comprehensive midwifery care may contribute to successful healing of post-cesarean section wound dehiscence in women with obesity through appropriate wound management, continuous health education, adequate nutritional support, gradual mobilization, and regular monitoring, thereby promoting optimal recovery during the postpartum period.
Keywords: Cesarean section, Midwifery care, Obesity, Postpartum period, Wound dehiscence