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Understanding C-Section Overhang: Causes, Solutions, and Support

You’ve just had a c-section and now your tummy is hanging over your scar. Why? We’re going to explore the causes of c-section overhang and how mums can treat their c-section shelf and scar through a variety of methods so you can get back to feeling more yourself postpartum.

What is C-Section Overhang?

C-section overhang is also known as “c-section shelf”, “c-section pouch”, or “c-section shaft”, they all mean the same. These terms refer to the section of the abdomen that ‘hangs’ over the scar where the incision was made. When your incision was stitched back together, it caused the skin to become more taught than before and looks like a piece of string being held against your tummy, which means the skin above, which has been stretched from pregnancy, it hangs over. C-section overhang doesn’t just come because of caesarean delivery but from any abdominal surgery.

Abdominal changes following C-section delivery

With pregnancy and labour, other conditions linked to your abdomen like Diastasis Recti, can look like c-section scar overhang but there is a difference in appearance between the two. With Diastasis Recti, your tummy will “bulge” and look rounded. It appears this way because the muscles have separated, and they cannot support your abdomen correctly.

What Causes a C-Section Shelf?

C-section surgery

When a c-section is performed, the surgeon will make an incision approximately 10cm long horizontally just under your bikini line. If an emergency c-section is carried out, the incision will most likely be vertical instead for speed. So that your baby can be delivered, the surgeon must cut through layers of skin, muscle, fat, and the uterine wall. Once your baby has been delivered, and the placenta and umbilical cord have followed afterwards, the surgeon will stitch each layer back together and cover it with a dressing.

The incision that’s made in this process is the main reason why a c-section shelf appears. The scar tissue causes the skin to become taught and uneven. On top of this, your skin throughout pregnancy has more laxity as it stretches to accommodate a growing baby. Once your baby is born, the skin doesn’t instantly snap back, it takes time for it to heal and adapt.  Sometimes, excess skin that has been stretched can hang over the scar tissue creating a more prominent c-section overhang. You may also notice stretch marks around your c-section scar which is to be expected.

Muscle separation (Diastasis Recti)

Conditions such as Diastasis Recti can lead to c-section shelf because your abdominal muscles have been stretched apart during pregnancy. The muscles that run vertically down each side of your abdomen stretch, leaving a gap in the middle. This gap allows your tummy to “bulge” and protrude out which can also sag over your c-section scarring.

In these cases, the appearance of a c-section scar overhang can be improved by following a healthy diet and exercising. However, this is not always the case and factors such as lifestyle and genetics play a role in recovering from childbirth and reducing a c-section shelf can prove more difficult. If you have been diagnosed with muscle separation such as Diastasis Recti, you will need to follow a bespoke plan by your doctor or physiotherapist to regain support and strength in your abdomen.

Learn more: Diastasis Recti Symptoms And How To Treat It

Physiotherapist assessing postpartum diastasis recti in a woman's abdomen

How Can I Recognise a C-Section Shelf?

There are a few ways to recognise if you have a c-section shelf or other abdominal condition stemming from pregnancy and labour. The main difference that you can look for is the shape of your tummy. Is it rounded like an early pregnancy bump? Is the skin hanging over the top of your C-section scar? If you lay flat on your back, can you feel a gap in the middle of your tummy above your belly button?

Getting the answers to these questions will help you feel more certain about what your potential diagnosis is. In all cases, you should consult with your doctor to get an accurate diagnosis.

How Can I Feel Positive About My C-Section Scar Overhang?

Unfortunately, the way body image is portrayed in the public eye, especially on social media, can be toxic to your self-esteem. We are still in an evolution where different body types are yet to be celebrated and normalised. One of the main reasons new mothers go through postnatal depression is because of how different their body looks and feels following pregnancy and childbirth. The recovery afterwards is more than just a physical healing process, but an emotional one too. This is when you need your support network around you to help you through postpartum recovery to regain confidence in your new body.

One way to accomplish this is to reach out for support from your partner, friends, and family. They say it takes a village to raise a little person, but that village is also there to support you! Your healthcare professional will be able to signpost you to support groups and mental health organisations to access support in various forms.

Learn more: Birth Trauma and C-sections – Managing your emotional and physical pains after a traumatic birth

What are the Management and Treatment Options for C-Section Overhang?

A caesarean is major surgery, and your body will take time to heal. Although most people can begin to resume their normal activities after six weeks such as driving and exercise, the healing process takes much longer than this. When you are exploring treatment options for c-section overhang, bear in mind where you are currently postpartum and what will be best for you. Other factors such as genetics, previous pregnancies, and hormones can affect how your c-section scar heals.

In some cases, you may never be able to make your c-section overhang disappear because you cannot target small parts of your body, even with a healthy diet and exercise. This is why some women choose to explore further surgical procedures to eradicate their c-section overhang. However, even this course of treatment comes with its pros and cons.

Non-surgical treatment for C-Section Shelf

1. Scar Mobilisation

Scar mobilisation is an underrated treatment method for c-section scarring. It means to massage the scar tissue which increases blood flow to the area and helps to gradually break down the surrounding tissues. Over time, the appearance of your c-section scar will reduce and smooth out, and therefore reduce the chance of skin hanging over. The idea is to loosen the scar from the tissue, so it doesn’t get “stuck” to the layers below.

2. Postpartum Exercise Routine

First, you need to be signed off by your doctor so that you are safe to start exercise post-surgery. Rather than going all in with ab workouts and cardio, it’s best to get some advice from a physiotherapist or personal trainer so they can suggest the most effective exercises to reduce your c-section shelf and regain strength in your abdomen.

It’s important to note that if your core muscles have not healed properly, any workout you do will be ineffective and may also cause you pain. Always get advice from a healthcare professional before starting any exercise routine.

Learn more: Managing Back Pain after a C-Section: Tips and Relief

3. Using a Postpartum Support Band

After a c-section, your body can feel sore and achy from the anaesthesia and surgery. When it’s safe to resume exercise and daily activities again, you may want to consider wearing a c-section belly band postpartum. You can even wear them from day one after your surgery if you wanted to.

A postpartum belt stabilizes your core muscles, supports your incision wound and reduces swelling, making it just a tad easier if you’re recovering from a c-section. Lola&Lykke’s Postpartum Core Restore Support Band is specifically designed to support c-section recovery and has two adjustable compression straps which target the abdominal area so you can feel comfortable and supported. To quote one new mum, she said “Sit up, stand and sneeze without feeling like your insides are going to slip out!”.

Mother using Lola&Lykke postpartum support band for c-section recovery

Although you don’t have to wear a c-section belly band postpartum, but some individuals prefer to because they feel more secure and comfortable moving around, especially during exercise. Wearing a c-section abdominal binder during exercise will give you all the benefits above, plus enhancing the effectiveness of core-strengthening exercises to gradually progress your c-section recovery.

Learn more: What postpartum belly binding can do for your post-baby body

4. Weight Loss

In the early weeks postpartum, especially if you have had a trickier labour or surgery, you may not be as mobile as you were before, and this can lead to weight gain. You can reduce your belly overhang by setting a realistic weight loss goal that’s in keeping with your overall health. Getting rid of excess body fat will help reduce the appearance of c-section overhang and will alleviate further pressure on your weakened core muscles.

5. Diet and Nutrition

All treatment methods will work best alongside a healthy balanced diet. The importance of good nutrition is essential in your post-surgery recovery. It can take up to two years for your c-section scar to fully heal and eating a diet that’s rich in protein, whole grains, and healthy fats will aid your recovery.

Surgery options to treat C-Section Shelf

Procedures like an abdominoplasty, also known as a “tummy tuck”, can be carried out to reduce a c-section shelf. A tummy tuck removes excess skin, fat, stretch marks and scars. It can also tighten your tummy muscles, including repairing muscles that have been stretched during pregnancy causing Diastasis Recti.

The downside to having more surgery is that you will need further recovery time after the procedure. It can take up to 2-3 weeks before you can return to normal activities and light exercise again. It will also take several months for you to see the full results from your surgery as the swelling and settling period can take a while. While you will still have a scar from where the incision was made, there are treatments for this that can visibly reduce the appearance and it will fade over time. As this is corrective surgery, weight gain and further pregnancies will require follow-up procedures.

It’s also important to add that surgeries which are not medically necessary are not covered by insurance. So, it’s wise to check when researching this choice how you are covered.

How to Exercise and Strengthen Your Core with a C-Section Scar Overhang

Before you start any exercise program, you must have your doctor’s permission and assurance that it is safe for you to do. Starting too much too soon will cause you pain or further complications in your recovery. You will need to start with slow, controlled stretches and exercises and gradually build it up. The only way you will see results from your exercise routine is if you are consistently doing the exercises and gradually progressing as your fitness improves.

If you’re not sure where to start, try some of these exercises to strengthen your core muscles:

  • Pelvic tilts: Lay down on your back with your knees bent and feet flat on the floor close to your glutes. Engage your core muscles whilst you draw your belly button inward toward your spine and your pelvis rolls up slightly from the floor. Hold and repeat. This exercise can also be done standing up.
  • Glute bridge: Lay on your back with knees up and feet firmly on the floor, shoulder width apart. With each repetition, you’re going to raise your hips off the floor so only your shoulders and feet are grounded, using your arms either side of you for support. Engage your glutes and try to keep your body straight without sagging in the middle.
  • Wall sit: Imagine you’re sitting in a chair with your back against the wall. At first, start with your hips slightly above your knees. Hold for 10 seconds. You can increase the difficulty by holding the repetitions for longer or bringing your hips in line with the height of your knees.
  • Modified side plank: Kneel and place both arms out to the side. Slowly extend your outer leg to the side. Slowly reach your opposite arm down the floor and feel the stretch along the outer side of your body. Hold and swap sides.
  • Knee squats: Start by kneeling, knees shoulder width apart and extend your arms out in front of you for support. Slowly dip your bum down whilst engaging your core muscles and keeping your shoulders upright. Hold for a few seconds and repeat.
  • Triceps chair dip: Start by sitting on a chair, with your hands next to your hips. Extend your legs out in front of you so that your heels are touching the floor. Slowly dip your bum towards the floor until your arms make a right-angle at your elbow. Raise and repeat. To modify this, you can bring your feet closer to you, putting them flat on the floor to make this stretch easier.
  • Wall push ups: The same as you would do a push up on the floor, but instead, you can do these standing and push against the wall. You can increase the difficulty by placing your hands further apart or moving further away from the wall.
Mother engaging in core-strengthening exercises with her baby, focusing on post-C-section recovery

When you’re doing each exercise, it helps to breathe in rhythm with your movements and you can also practice Kegels, strengthening your pelvic floor muscles at the same time.

Learn more: How to Choose a Right Pelvic Floor Trainer to Improve Your Pelvic Health

Nutrition and Diet Tips to get rid of hanging belly after a C-section

Good quality nutrition goes a long way towards aiding your c-section recovery and your diet needs a range of nutrients such as collagen, vitamins and antioxidants to help your body heal. Post-surgery it’s essential to keep your abdominal health in check, with foods rich in fibre to keep your bowels moving. Your skin will benefit from improved nutrition from where it has been stretched and cut from pregnancy and caesarean. Whilst eating a healthy balanced diet, you can try introducing some of these foods into your diet for their unique nutritional composition:

  • Bone broth: Boiling animal bones such as chicken, beef and pork are rich in collagen and the process of making a broth from the bones makes the collagen easier for your body to absorb.
  • Fish and Shellfish: Including the skin and scales, fish is another excellent source of collagen. It’s also more bioavailable which makes it easier to absorb than other forms of collagen from other sources.
  • Citrus fruit: These types of fruit are high in vitamin C, which helps your body to produce collagen naturally.
  • Berries: Similar to citrus fruits, berries are rich in vitamin C which supports the production of collagen. Berries are also rich in antioxidants and high in fibre, which will help to reduce constipation post-surgery.

Alongside any balanced diet comes hydration. Drink enough water throughout the day is essential to supporting your body to heal as well as your overall health. Without water, your body would struggle to absorb nutrients and vitamins that make it thrive.

Learn more: Lola&Lykke Experts Answer: Top Nutrition Tips For C-section Recovery

Skincare Routine and Self-Care for C-section Scar Overhang Treatment

A consistent skin routine for your c-section pouch and scarring can help to visibly reduce the appearance of the incision scarring, stretch marks, and the laxity of your skin postpartum. During pregnancy, you can put some of these practices into place to reduce the chances of stretch marks and sagging skin. These skincare tips and self-care routines will contribute to your overall wellbeing during your recovery.

  • Gentle Massage: Small circular massages using a moisturiser or oil for your skin can promote blood flow, supports the healing process, and reduce discomfort. You can be practicing this during pregnancy by massaging your bump to reduce the chances of stretch marks.
  • Scar Creams: Some creams are specifically formulated to reduce the visibility of scars and may contain ingredients such as silicone and vitamin E, which are known for helping with this.
  • Silicone Sheets: Readily available online and in high-street shops, silicone strips are used to hydrate and help reduce the appearance of the scar.

There are also surgical procedures that you can have done, such as “scar revision” which improves the appearance and restores the function of the skin by correcting any disfigurement or previous surgeries.

But more importantly, healing from a c-section takes patience. The way you feel about yourself can have a huge effect on your body confidence and self-image. Celebrating and accepting the changes your body has been through to bring new life into the world is part of the healing process which we encourage you to do as part of your daily self-care routine. It can help to address the emotional challenges you are going through and setting time aside to nourish your body and mind will work wonders for your recovery, both physically and mentally.

Throughout your postpartum journey you will face challenges and limitations, but if you’re thinking and acting with a solution-based approach, conditions such as c-section overhang don’t have to drag you down. You can dive further into our library of tips, advice and real-mum stories over on our blog for more support and inspiration.