Everything you need to know about C-section overhangs

The impact a C-section has on a woman’s body may be evident long after the incision site has healed. Most women who deliver a baby via C-section will develop a flabby bulge around their lower abdomen.

You might be one of the many new mothers who have a mummy tummy, and although there is nothing wrong with having one, you might find it unflattering. Luckily there are various ways to get rid of a C-section overhang.

WHAT IS A C-SECTION OVERHANG?

A C-section overhang is a bulge that forms in the lower abdomen near the incision site after a C-section. This deposit can also be referred to as a ‘pouch’, ‘mummy tummy’, ‘apron belly’, or ‘pannus stomach’.

During a C-section, an incision is made in the abdomen. As the site heals, a pouch of tissue may form due to weakened abdominal muscles. This pouch consists of a buildup of scar tissue, body fat, and excess skin. A C-section overhang is not abnormal, although it might be unwanted due to its appearance!

Women who did not deliver via C-section may also develop a deposit of tissues around their lower abdomen due to weakened abdominal muscles.

A similar bulge might appear when the abdominal muscles have separated due to increased pressure on the abdominal wall during pregnancy. This is referred to as ‘diastasis recti’.

WHAT CAUSES A C-SECTION OVERHANG?

Let’s take a closer look at C-sections, which involves a doctor making an incision through your abdominal wall and uterus. This is a major surgery that involves cutting through various layers of nerves, muscles, and tissue.

For an elective (planned) C-section, your doctor will make a 10 cm incision horizontally at the bikini line to access the uterus. In an emergency C-section, your doctor may opt for a vertical cut along the midline of the abdomen.

A vertical cut offers quicker access to the baby, but a horizontal cut heals faster and has a lower chance of the wound separating after the procedure.

Once the baby is lifted out of the womb, the umbilical cord will be cut, and the placenta will be removed. The uterus and various layers of skin, muscle, and fat are closed with sutures and the wound is dressed.

As you can imagine, your abdominal muscles are much weaker after such an invasive procedure. A C-section overhang in the form of a stubborn deposit of tissues may appear in the lower abdomen. Your once flat belly may now have a bulge with a flabby or jiggly appearance.

A C-section overhang is mainly caused by the incision through the multiple layers of tissue, but other factors may also play a role in the formation of a pouch.

Pregnancy

The most obvious cause of a C-section overhang (other than the C-section itself), is pregnancy. During pregnancy, the intra-abdominal pressure (pressure inside the abdomen) increases significantly as the baby grows.

During delivery, even more pressure is placed on the abdominal muscles. The increased pressure may cause the abdominal muscles to stretch, weaken, or even separate (called diastasis recti), resulting in a bulge.

Weight gain

It is normal to gain some weight during pregnancy. Weight gain may also lead to increased strain placed on the abdominal muscles which can lead to the formation of a bulge forming in the abdomen.

Hormonal changes

There are a lot of hormonal changes happening during pregnancy which can lead to the body holding on to fatty tissue a bit more than usual.

One of the major role-players in pregnancy is the hormone estrogen. Estrogen also causes connective tissues to soften, which may affect the abdominal muscles’ ability to keep everything together.

Genetics

Genetics may also play a role in the development of a C-section overhang. Genetics may be the cause for weaker abdominal muscles or less connective tissue, which could make a woman more prone to developing a C-section overhang. This may also make getting rid of the pouch harder.

SIGNS AND SYMPTOMS OF A C-SECTION OVERHANG

Pouch after c-section

The most obvious sign of a C-section overhang is a bulging lower abdomen appearing after a C-section.

Abdominal pain

The weakened abdominal muscles may strain during exercise, causing discomfort or pain as it is unable to support the body adequately.

Weak or separated core muscles

The pressure placed on the abdominal muscles may weaken them and even cause them to separate (called diastasis recti).

Discomfort while exercising

Exercises focusing on the core and abdomen (like planks and sit-ups) place strain on the abdominal muscles. The body’s inability to fully support itself may lead to a bulge forming.

Other symptoms

The weakened abdominal muscles are unable to provide support for the body and may lead to lower back pain, pelvic instability, and urinary incontinence.

C SECTION OVERHANG VS DIASTASIS RECTI

A C-section overhang is different from diastasis recti, which is also called abdominal separation.

A C-section overhang is caused by a deposit of scar and fatty tissues around the lower abdomen, while diastasis recti is caused by a separation of abdominal muscles. Some women may experience diastasis recti during pregnancy or after childbirth. Diastasis recti describe how the abdominal muscles across the stomach separate from each other.

This is caused by the growing uterus, hormonal changes, and increased pressure of your growing baby.

You are more likely to develop diastasis recti if you have had a pregnancy before, are 35 years or older or are carrying multiples.

Signs and symptoms of diastasis recti include

• A separation (gap) between the two bands of the abdominal muscles.
• A bulge in the middle of your stomach / near your belly button when you activate your core.
• Lower back pain.
  

Although diastasis recti are very common, most women recover within eight weeks after delivery.

HOW TO PREVENT A C-SECTION OVERHANG

Every woman is unique and will recover differently following a C-section. Luckily, there are steps you can follow to reduce your chances of getting a C-section overhang.

Postpartum belly wrap

A postpartum belly wrap is a specially designed supportive band that is placed around the waist after a C-section. It supports your abdominal muscles while allowing the incision site a chance to heal. It has been shown that a postpartum belly wrap reduces pain, bleeding, and inflammation.

Exercise

One of the best ways to prevent a C-section overhang is exercise. Exercise rebuilds your core and abdominal muscle strength as well as tightening your skin. However, it is important to consult with your doctor to be sure when you can start exercising.

Gentle walking is usually a good way to start moving while recovering from a C-section. Other gentle exercises that are great for postpartum workouts include pelvic tilts, Kegels, squats, wall sits, and modified planks.

Another great way to gently ease back into exercising is through yoga and Pilates – just be sure to do a postpartum workout.

Diet

Along with exercise, diet plays a crucial role in preventing a C-section overhang. A healthy and balanced diet full of protein and fiber supports healing of the abdominal muscles and promotes healthy weight loss.

Include lots of nutrient-dense foods in your diet before and after delivery. Decreased weight gain during pregnancy will also prevent a C-section overhang from forming.

A healthy and balanced diet should include fresh fruits and vegetables, lean proteins, and healthy fats. Avoid sugary and highly processed foods.

Collagen-rich foods may also aid your body in repairing connective tissues. Foods rich in collagens include bone broth, fish, chicken, and berries.

If you are breastfeeding, you might experience quite an increase in your appetite. Prepare and keep healthy snacks nearby for those cluster-feeding frenzies!

Also remember to drink enough water, especially if you are breastfeeding. Water plays a vital
role in weight loss and detoxification.

Belly breathing

Belly breathing, also called diaphragmatic or abdominal breathing, is a way of breathing that focuses on your diaphragm.

Belly breathing can help prevent a C-section overhang as it helps retain core muscles during everyday activities and makes core exercises more effective.

How to do basic belly breathing:

• Sit or lie on your back on a flat, comfortable surface.
• Put your hands flat on your belly and relax your shoulders.
• Breathe in through your nose for as long as you can (your hands should feel your belly expanding).
• Slowly breathe out through your mouth while contracting your abdominal muscles (pull your belly button towards your spine).
• Repeat five to ten times, three times a day.

Posture

Poor posture can put more strain on your abdominal muscles and skin, which can contribute to the formation of a C-section overhang.

Keep your back straight, shoulders back, and your core engaged to keep a good posture. Core strengthening exercises may also help you keep a better posture.

Scar massage

Messaging your C-section scar may aid healing, and appearance and may also prevent a C- section overhang by reducing the deposition of scar tissue, promoting collagen formation, and promoting blood flow.

However, scar messaging may be ineffective if your scar is mature (older than a year). Be sure to consult your doctor before attempting to message your C-section scar.

HOW TO TREAT A C-SECTION OVERHANG

The best way to treat a C-section overhang is by maintaining a healthy lifestyle. However, some women may find it extra hard to get rid of a C-section overhang through healthy habits. Unfortunately, genetics also play a role in the formation of a pouch. In such cases, surgical treatments may be the only way to a flat tummy again.

NON-SURGICAL TREATMENTS

Remember to always check with your doctor before incorporating a new diet or exercise routine.

Exercise and physical therapy

One of the most effective ways to treat a C-section overhang is through exercise.

Core strengthening exercises will not only reduce a C-section overhang but will also improve posture (which will in turn also help with a pouch). Healthy weight loss may also reduce the appearance of a C-section overhang.

Supportive undergarments

Supportive undergarments and binders can keep the excess skin and tissues from a C- section overhang together while supporting the abdominal muscles. This is a quick and easy way to hide a pouch but may not address the root of the issue.

Diet and nutrition

A healthy diet filled with nutrient-rich foods can help treat a C-section overhang by promoting healing and weight loss. Include lots of fresh fruits and vegetables, lean proteins, and healthy fats in your diet. Remember to drink water too!

Skincare

Skin care products containing vitamin A may increase your skin’s elasticity and reduce the appearance of scars. A diet rich in antioxidants and staying hydrated may also boost your skin’s ability to heal and repair itself.

SURGICAL TREATMENTS

For some women, diet and exercise will not remove a C-section overhang. In these cases, cosmetic surgeries may be the only way to completely rid of a pouch.

However, to maintain the effect of these surgeries, a healthy lifestyle is crucial. Weight gain after liposuction or a tummy tuck may cause the reappearance of an overhang.

Cosmetic surgeries hold some serious risks, so it may be wise to first try non-surgical treatments for a C-section overhang.

Liposuction

Liposuction is a cosmetic procedure where fat is removed from the abdomen. This may reduce the appearance of a C-section overhang, but if the abdominal muscles have separated, a tummy tuck might be a better option.

Tummy tuck

This cosmetic procedure involves removing excess fat and skin from the lower abdomen and repairing separated abdominal muscles.

Postpartum recovery tips

Recovery after delivery is a marathon, not a sprint. It may require a long-term commitment to healthy habits:

• Self-care
• Doing regular exercise and core strengthening
• Eating a healthy diet
• Drinking enough water
• Stress management

When can I start exercising after a C-section?

In general, it is safe to start with gentle exercises six to eight weeks after delivery. More strenuous exercises are safe from around twelve weeks postpartum.

Every woman is different, so be sure to check with your doctor when it will be safe for you to start exercising again.

Weight gain during pregnancy

Gaining weight is the main culprit when it comes to a C-section overhang. Maintaining healthy weight gain during pregnancy is an effective way to prevent the formation of a C-section overhang.

How to calculate your BMI (body mass index)

You can calculate your BMI by dividing your weight in kilograms by your height in meters squared.

Recommended weight gain during pregnancy

Most women gain between 10 and 12 kg during pregnancy. The recommended weight gain during pregnancy is determined by the person’s BMI:

BMI Recommended weight gain during pregnancy

Important notes on C-section overhangs

A C-section overhang is a bulge formed near a C-section scar. The bulge is caused by a deposit of tissues including scar tissue, fat, and skin.

Diastasis recti is caused by the separation of the abdominal muscles and is different from a C-section overhang. There are various ways to decrease the chance of developing a C-section overhang.

Treatments rely on a healthy lifestyle, but in some cases cosmetic surgery might be the only way to get rid of a pouch.

Additional information and resources

What to Know About C-Section Massages

What is a C-section pouch and how can you treat it?

Belly Overhang after C-Section

Understanding the C Section Pouch: Causes, Treatment, and Prevention