#101: The Truth About the C-Section 'Belly Pouch' – and Why It’s Not Your Fault

“What looks like a pouch is often a pattern — of healing, compensation, and protection. Your body isn’t failing. It’s asking for a better approach”

— Karo, Tired Mum Fitness

You’ve done the core workouts. You’ve tried Pilates. Maybe you’ve even had your diastasis checked and been told it’s “fine.”

But no matter how much effort you put in — there’s still that stubborn softness or bulge across your lower belly. That pouch that doesn’t seem to budge.

It’s not just about appearance. It’s how it feels:

• Your jeans pinch or slide under it.

• You feel disconnected when you move or brace.

• It’s like your lower abs never fully switched back on.

And despite what the internet says — about “healing your gap” or “flattening your mum tummy” — you’re not lazy, and you’re certainly not broken.

You’ve just never been told what’s actually going on inside your body post-C-section.

In this post, we’ll break it down clearly and calmly — what causes the C-section pouch, why common advice rarely works, and what actually helps (especially years later).

What Is the C-Section 'Pouch' Really?

Let’s start with some facts.

That lower belly bulge so many women notice after a C-section isn’t just extra skin or leftover baby weight. And it certainly isn’t something you can crunch away.

The so-called “pouch” is often a result of three overlapping layers of post-surgical changes:

1. Fascial disruption and tension
   The abdominal wall — including the fascia (connective tissue) — is cut during surgery. The way it heals affects how tissues move, stretch, and hold shape. Scar tissue can create tightness in one area and compensations in others, leading to a bulge, fold, or flat spot that doesn’t “bounce back.”

2. Changes in intra-abdominal pressure
   After birth, the balance between the diaphragm, pelvic floor, and deep abdominals is altered. If the core can’t regulate pressure well — especially while standing, moving, or lifting — the belly may push outward instead of drawing in.

3. Delayed or interrupted core coordination
   Surgery affects the nervous system as much as the tissue. Even if your muscles are “firing” in a clinical test, they may not be working in the right sequence or at the right time during real movement. This contributes to that sense of weakness, bulging, or disconnection.

In short: what you’re feeling is real. And it’s mechanical, neurological, and structural — not cosmetic.

Why Most Core Work Doesn’t Help

If you've followed a postnatal programme and didn’t see much change, you're not alone. Most of them are built on generic progressions — with little consideration for:

• Whether the mother had a C-section or vaginal birth

• Whether scar tissue was addressed at all

• How the nervous system is responding to the stress of surgery, sleep loss, and recovery

• Whether deep abdominal coordination has been restored in real-world movement (not just on the mat)

Even targeted exercises like bridges, bird dogs, or modified planks can fall short when they don’t address breath, tension, and postural patterns.

And if your system is still in “guard” mode — physically or neurologically — more reps can reinforce dysfunction rather than resolve it.

This isn’t to say those exercises are wrong. They just need to come after foundational work that:

• Releases fascial tension (especially around the scar)

• Rebuilds breathing mechanics

• Reactivates deep abdominal control — gently, and in motion

• And honours the role of the nervous system in healing

What Actually Helps (and Why It’s Not Too Late)

Even years after your C-section, it’s possible to shift this pattern — but the body needs the right sequence and safety signals.

Here’s where to start:

• Work with your breath. Your diaphragm is the gateway to pressure control, core activation, and nervous system balance. Deep, slow, expansive breathing is more powerful than it looks.

• Release tension around the scar. This doesn’t have to be aggressive. Even light, daily hand contact around the scar and lower belly (not just on the scar itself) can help soften adhesions, improve blood flow, and restore connection.

• Reconnect your deep core in standing and movement. The goal isn’t flat abs. It’s functional support — during walking, lifting, cleaning, carrying your child. Floor work is a start, but your abs need to wake up during real life.

• Respect fatigue. If you’re constantly tired, stressed, or stretched thin, your nervous system will prioritise survival — not repair. Healing takes energy. Recovery is the work.

A Final Word: It’s Not About Perfection — It’s About Function

You don’t need a flawless core or a flat belly to be strong, confident, or well.
But you do deserve to understand your body.
To stop second-guessing yourself.
To rebuild on a foundation that makes sense for your journey.

So if that pouch hasn’t gone away — and nothing you’ve done seems to make a difference — it’s not a reflection of your discipline or worth.
It’s a reflection of the deeper systems that need care, not correction.

You haven’t missed your window.
You’re not behind.
You’re ready for a more complete approach.

Ready to Start Rebuilding — From the Inside?

Download your free guide: C-Section Core Recovery — Your Gentle Start to Rebuilding Strength

Inside, you’ll learn why your core might still feel disconnected — and how to begin restoring deep abdominal coordination, even years after surgery.
Two simple, breath-led exercises you can start at home — no pressure, no fluff.

This is your starting point.
Grounded. Gentle. Smart.
Just like recovery should be.

With Love,

Karo