Medical Clearance to Exercise
- A C-section requires that you get medical clearance before you begin postpartum exercises. Assuming that you have clearance (and 4 months post would seem likely that you have) here are some considerations in getting your postpartum belly back in shape:
Weight Loss vs Laxity and Weakness
There are actually 2 concerns in fighting the saggy belly.
Excess body weight
Laxity of muscle, connective tissue and skin from being stretched out.
Losing weight after pregnancy does involve nutrition and exercise just as with any weight loss program (as @Robert has pointed out). However, there are several postpartum specific exercise concerns such as weakness, ligament laxity and postural alignment.
PostPartum Exercise Concerns
- Some ordinary exercises may not be appropriate for you and, in fact, can be counterproductive. For example, routine abdominal exercises like crunches, which target the rectus abdominus, may make the postpartum belly bulge more, not less, especially if they are attempted before restoring the transversus abdominis.
- Another exercise consideration is continued hormonal ligament laxity (looseness) which can last 6 months post delivery requiring you to be protective of your joints during impact type exercises, stretching or resistance training.
Restoring Abdominal Muscle Control
First, you’ll want to assess if you have a separation (called diastasis recti) centrally, between the 2 rectus abdominus muscles. This is important because if your separation remains greater than 2 or 2 ½ finger’s width, you need to be more careful to avoid making the separation and your belly bulge worse. You would need to avoid exercises that cause you to strain, twist as with obliques or triangle pose, or stretch the abdomen as with curl ups over a stability ball, otherwise you will just prolong the weakness.
Next, focus your efforts on the pelvic floor muscles (Kegel’s exercise) and on the transversus abdominis muscle (TvA), which is the deepest layer of abs (the girdle muscle), before you begin with other obliques or rectus abdominal exercises.
The transverse abdominus (TvA) is the muscle you use when draw your belly button towards your spine, flattening your stomach, while exhaling. For an in-depth explanation and demo, see Helene Byrne’s videos. (She also has a book with a nice sequence for getting back in shape after pregnancy.)
Then engage your transversus abdominus and begin with gentle leg slides while maintaining that core control.
Once you can maintain good control of your core with the transverse abdominus while moving your legs lying down, progress towards working your TvA against gravity by pulling your belly button in while on your hands and knees. This video has a nice progression of exercises and includes stabilizing your core with bridging, planks and ball rollouts etc.
Addressing Fat Loss after Pregnancy
You have already been directed to the info that Robert cited so I will just add:
Fat loss is more important than weight loss, so calculate your body fat percentage. (It is easier than you think.) Then track your body fat percentage and waist circumference progress rather than just your weight loss.
Diet is a big factor: Track what you eat (and drink). Take the time to eat sitting down with your attention on your food or snack. Choose smaller portions/smaller plates. Eat well-balanced nutritious meals. Eat less packaged foods and less empty calories foods like sodas. Consume less sugars. Hydrate well. Remember that it takes a 3500 calorie deficit to = 1 pound of weight loss. Walking a mile burns ~ 100 calories. It takes a lot more effort to burn off 3500 calories than it does to consume that amount so eat wisely. Think of creating a healthy lifestyle for you and your family rather than a quick fix diet.
Exercise: Start with simple daily walking and core exercises. Once you have built up some endurance (at least 30 minutes/day) and core control, begin to increase the difficulty of your workouts. Hold off on high impact exercises like running and jumping while your ligaments bounce back.
Efficient workouts are key when you are a busy mom. Compound muscle or whole body, strength training circuit exercises with high intensity intervals will give you effective fat burning workouts in the least amount of time. You can use bodyweight (like squats, planks, push ups etc), resistance bands, free weights or weight machines for resistance training.
Use your target heart rate to guide your intensity. If you can join a postpartum exercise class. It is good for the exercise and support.
Rest - Easier said than done with a new baby, but sleep is also an important factor in losing weight.
If you get your abs working properly and burn off the excess fat, you should see the results you want over time. However, some women do have a problem with overly stretched skin and collagen that just doesn’t return to normal. For them, surgery is a corrective option.
If you have any problems with your scar or with trying to reconnect with your muscles, you may want to consult with women’s health physical therapy specialist.
(Full disclosure of references: We carry Helene Byrne’s book in our amazon store. Our site does affiliate with Holly Rigsby’s Fit Yummy Mummy, despite the name, because it is a good program and we like her membership site.)
I hope this helps you get the flat, taut stomach that you want. Good luck!