Diastasis Recti - Do you have it?

Understanding your C-Section Pooch

What is a C-Section Pooch?

Today we’re going to be defining your C-Section Pooch. We’ll cover how you get it, how you can take care of it, and how you can take care of your C-Section scar. Are you ready? Let’s go!

Cesarean section (C-section) is the most common surgery in many countries around the world. It can save women’s and babies’ lives when complications occur during pregnancy or birth. C-section rates in the US vary by state and range from 22-38.7% of all deliveries (CDC 2017).

This procedure requires a surgical cut through all four layers of the abdominals (rectus abdominis, external obliques, internal obliques, and transversus abdominis). As well as through the protective muscle fascia and the uterus itself. The natural healing process involves the body creating scar tissue at the site of the surgery.

This procedure can result in the disruption of the normal length, tension, and tone of the abdominal muscles. This, of course, comes after nine months of pregnancy which causes the abdominal muscles to elongate and stretch outward to accommodate the growing baby, resulting in a separation in the midline of the abdominal muscles. This separation is referred to as Diastasis Rectus Abdominis (DRA).. It occurs in 100% of women in the third trimester (Sperstad 2016).  The resulting effect in many women is the “C-section pooch” or “mommy pooch”.

Why do we get a C-Section Pooch?

The reason for this is mechanical. If the trunk is thought of as a house of our organs, the diaphragm forms the ceiling, the pelvic floor forms the floor, and the abdominals and deep back muscles form the walls. When the abdominals elongate and separate during pregnancy, the walls of our “organ house” become weaker. This provides less stability for the ceiling and floor. This alters our intra-abdominal pressure (IAP) and can affect the piston-like mechanics of the diaphragm and pelvic floor. These work together to create efficient breathing. This is further complicated by the scar tissue that the body naturally creates after C-section surgery.

Understanding Your C-Section Stomach

Furthermore, it is important to note that the abdominal muscles work in symphony with the pelvic floor muscles, diaphragm, and small muscles in the spine called the multifidi to stabilize the trunk, promote effective breathing, and maintain IAP.

The diaphragm and pelvic floor work in a piston-like manner wherein the diaphragm drops drawing breath into the lungs, the pelvic floor also drops. To expel air it is vital that the diaphragm returns to its resting point and the pelvic floor lifts back up. This requires that the muscles maintaining the walls of the trunk are strong and hold firm.

Thus, the abdominal and other core muscles are important in maintaining proper intra-abdominal pressure (IAP) for breathing, posture, and bracing the spine during functional movements as well as when you cough, sneeze, have a bowel movement.

How to Get Rid of C-Section Pooch

It is important to address the core muscles in a comprehensive manner to restore abdominal length and tension and to get rid of the c-section pooch. Here are some steps to take to get rid of the c-section pooch:

  • Soften the C-section scar:

    • for many women, the c-section scar is painful, or difficult to touch. It is important to gently desensitize the scar and provide gentle scar mobilization. No matter how old your scar is, you can do this by:
      • Using a makeup brush or other soft material, gently sweep around the perimeter of the scar. Then when you feel ready, over the scar itself. Once you are able to brush over the scar without discomfort, progress to gently sweeping your fingers on the incision itself.
      • Use gradually more pressure when massaging the area with your fingers in circular motions on the incision. Do not press on the scar with any more pressure than you would use to check a tomato for ripeness.
      • Gently massaging the scar five to ten minutes each day can help to soften the scar tissue. This makes it more pliable, and easier to contract the abdominal muscles around it.
  • Retrain the core muscles to contract in coordination with your breathing:

    • Pelvic Brace exercise:
      • Lie down on your back with knees bent and feet shoulder-width apart.
        Inhale gently.
      • Then exhale and contract the muscles of the core by imagining that you are shutting off the flow of urine while drawing your abdominals slightly inward. Your gluteal muscles should not be contracting, and your pelvis should remain perfectly still, not rocking or tilting.
      • Initially, try to hold the contraction for 3-5 seconds. Rest for 5 seconds. Repeat 10 times, and do 2-3 sets.

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Like I said above, lengthening of the abdominal muscles during the third trimester is something that every woman goes through. Also, having a C-Section will put your stomach in a much different place than you are used to. Don’t feel like you’re alone. You can always reach out to me at [email protected] with any of your questions about Diastasis Recti and your C-Section Pooch. I’m here to help you be the best you can be!

And make sure you read my guide on crunches and situps v.s. your mom pooch!

Once you’ve given these things a try, send me an email or connect with me on Instagram to let me know how it’s going for you. I look forward to connecting.


Center for Disease Control. Cesarean Delivery Rate by State. https://www.cdc.gov/nchs/pressroom/sosmap/cesarean_births/cesareans.htm.

Sperstad, J. B., Tennfjord, M. K., Hilde, G., Ellström-Engh, M., & Bø, K. (2016). Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. Br J Sports Med, 50(17), 1092-1096.

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