An unexpected byproduct of delivering via cesarean: Whether you call it a C-section pooch or a C-section shelf, the relationship you have with the excess overhang of skin that laps over the top of your C-section scar can be... complicated for some. First off, it held your baby for many months, so it makes sense that you give it a little pat of thanks from time to time. But, let’s just acknowledge the elephant in the room: You didn’t ask for this belly pooch. (I have one, too, so I feel fairly confident in this assertion.) And while you have every intention of embracing your postpartum body in all its beautiful glory, for many, that’s easier said than done. For those who delivered via C-section, knowing more about your C-section shelf or pooch can help you in your healing journey.
What causes a C-section pooch?
The area that hangs over a C-section incision site goes by several names, used interchangeably: C-section shelf, C-section pooch, and C-section overhang. Just as your body changed during pregnancy, it changes during the healing process as well. A C-section pooch that develops above your C-section scar can be part of that change. As your C-section scar heals, the excess skin and tissue that form a C-section shelf can develop.
“Scars are made of stronger, collagen-rich tissue that will bind to the wrong layers of skin if care isn’t taken to massage the scar as it’s healing,” birth educator and doula Sara Lyon tells Romper. “This adhesion can create a line above which the stomach tissue bunches and hangs like a pooch of skin or a shelf above the scar.”
How long does it take for a C-section shelf to go away?
It takes about a year for a C-section scar to complete the remodeling process, and for most people, yes, a C-section shelf or pooch will eventually go away on its own. “A long lasting stomach shelf is actually pretty rare,” explains board-certified obstetrician, Dr. Cynthia Flynn. If you’ve recently given birth, give it time. Most of the time, a C-section shelf “occurs more commonly soon after C-section but dissipates in time,” according to Flynn.
Flynn says there can be a direct correlation between weight gain during pregnancy and C-section shelf development. Though it’s a completely natural part of pregnancy, Flynn notes that sometimes weight gain “can prevent the skin and the anatomy of this area from returning to normal” as your body heals. Of course, every body is different, so while a year may be an average, it’s definitely going to differ from person to person, and in many cases, may never diminish simply on its own.
How does a scar adhesion affect your C-section?
As if coping with post C-section recovery weren’t enough, you might have to deal with scar adhesions, too. This can occur after surgery, following an infection, or due to an inflammatory process in the body, and it can cause tissues to become stuck to each other, says Dr. Greg J. Marchand, M.D., FACS, FACOG, FICS, an OB-GYN and accredited master surgeon. “When you have an invasive surgery, such as a cesarean section, you will have scar formation. Some of this scar can be seen on your skin in the area of the actual incision, and some of it will be within your abdominal wall, and you may be able to feel lumps or hardness within your incision a few months after surgery,” he explains.
But how do you even know if you have scar adhesions? Well, in some instances, you might feel a tugging sensation that might be painful, particularly if you’ve been moving around. “People who have scars or adhesions inside their abdominal or pelvic cavity may experience abdominal and pelvic pain,” Dr. Lauren Demosthenes, M.D., an OB-GYN and senior medical director with Babyscripts explains to Romper. “If they’re severe, the way to diagnose this is to look inside with a laparoscope.”
Dealing with scar adhesions and the discomfort that they might bring isn’t always pleasant. But you’ll want to be mindful about how you handle your wound so that you don’t inadvertently hinder its healing. “After the first six weeks, heat and gentle rubbing or massage to the area can cause relief, sometimes breaking down adhesions that might be causing pain,” says Marchand. “In severe cases, where the bowels might be too stuck to pass their contents along or where pain is interfering with quality of life, you may need to see a general surgeon to see if there are other options to treat your adhesions.”
Even if you do those things there’s no guarantee that your scar adhesion will go away or the pain will pass on its own. Adds Marchand: “One problem with adhesions, however, is that more surgeries tend to cause more adhesions, so surgery can certainly come with some serious disadvantages as well.”
Why does my C-section shelf hurt?
Though this area of overhang isn’t a cause for concern, it can be physically uncomfortable. The area may be sensitive, numb, or even sore, which makes sense because, as Flynn tells Romper, “a new scar that is remodeling itself will cause discomfort for as long as a year,” according to Flynn, and any loose skin can cause discomfort in general.
If you’ve given birth recently and are experiencing abdominal discomfort where your C-section shelf is, Lyon says addressing the issue early on in your recovery can be helpful to avoid discomfort down the line. “The dense scar tissue can be tight and in some cases painful. The rigidity of the scar tissue can create a tugging sensation throughout the abdomen,” she explains.
How do I get rid of my C-section pooch?
It’s normal for your body to change over time, especially after having a baby, and how you process that change is a very personal thing. But, if you’re looking to specifically target your C-section shelf after the first year postpartum, doctors say there are steps you can take to minimize the appearance of your pooch.
Before you run off to see a surgeon, try an extreme diet, or join a gym, though, just give yourself a big postpartum pause. After all, your body has done something pretty miraculous and it’s important to celebrate what that sweet shelf symbolizes. Because when you think about it, a C-section shelf is quite common — and almost expected to occur. “A C-section shelf is a natural response to a major invasive surgery that was needed to deliver your baby,” says Marchand. “This is a ordinary occurrence, and although the bulge may cause distress, it is normal and is not a disease process.”
That’s not to say that you shouldn’t strive to be healthy after Baby is born, though. It’s important to work with your health care provider on your approach so that you can stay healthy and strong as you recover from surgery and care for your child. Reducing or eliminating a C-section pooch, if it is a priority for you, can typically be done by focusing on proper nutrition and exercise over time.
Exercises that target the pelvic floor, which may be weakened as a result of pregnancy and birth, are most effective post-C-section, according to Emily Skye, a personal trainer and mom of two. “The weight of your unborn child, as well all the fluid and the placenta pushes down on the pelvic floor, causing your ligaments to stretch and descend,” Skye says.
Proper execution of exercises like Kegel variations, mini crunches with core activation, and all-fours kickbacks with core activation work by strengthening the pelvic floor muscles. Pelvic floor exercises can also help promote blood flow to encourage healing, according to Skye. It is typically safe to start exercising after your six-week postpartum checkup, but it is always best to check with your health care provider before beginning any new exercise regimen.
If you’ve had a C-section recently, Lyon suggests that you talk to your health care provider about the possibility of early interventions like scar massage during the healing process can help prevent a C-section pooch from forming.
“A C-section cuts through seven layers of abdominal tissue. Each of those layers are build to slide over one another with movement, but scar tissue can bind them all together as the body mends the wound by laying down the strong scar tissue fibers,” Lyon explains. “In order to avoid adhesions between the layers of tissue, specific massage techniques are used to maintain the glide that is so crucial to healthy physiology.” Again, the C-section healing process is a very personal thing and every person’s body is different, so the best approach is to speak directly with your health care provider if you are considering going this route.
Like with so many things, a little bit of prevention can go a long way to keep a C-section shelf at bay. Your body has grown an entire human being inside — that’s something to be so proud of. But if you’re feeling uncomfortable about your C-section shelf long after your little one is past the baby stage, have a conversation with your doctor to discuss the best options for you.
Sara Lyon, birthing expert, doula and author of You’ve Got This: Your Guide to Getting Comfortable with Labor
Dr. Greg J. Marchand, M.D., FACS, FACOG, FICS, an OB-GYN and accredited master surgeon
Dr. Lauren Demosthenes, M.D., an OB-GYN and senior medical director with Babyscripts
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