Not Just Weight: The Silent Suffering of Indian Mothers

The Invisible Pain Behind the ‘Paunch’

In India, millions of women are told the same thing after childbirth: “Lose weight.”
A protruding belly is dismissed as laziness, lack of discipline, or poor lifestyle. Family members, elders, colleagues, and often even healthcare providers fail to ask a more important question: Is this really just fat?

For many women, especially after multiple pregnancies, this “paunch” is not just cosmetic, It is painful, disabling, and deeply distressing. Yet, their complaints are brushed aside. Indian women are culturally conditioned to tolerate discomfort, prioritise family over self, and ignore their own health until suffering becomes unbearable.

“When a woman says she feels heavy, weak, or unable to function normally, it is not an excuse, it is a symptom,” says Dr. Anmol Chugh, Associate Director, Dept of Plastic & Aesthetic Surgeon, CK Birla hospital, Gurgaon

What Actually Happens After Pregnancy

Pregnancy stretches not just the skin, but the core muscles of the abdomen. Repeated pregnancies, inadequate postpartum recovery, lack of guided physiotherapy, and nutritional deficiencies weaken the abdominal wall.

“Over time, the two vertical abdominal muscles (rectus muscles) drift apart, a condition called diastasis recti. The supporting sheath becomes thin, lax, and almost paper-like. Internal organs begin to bulge forward, creating a prominent belly that cannot be corrected by diet or exercise alone.” Says Dr. Chugh

Many women struggle to sit, stand, or bend comfortably, lift their children, perform household or professional work, maintain posture or balance, or control bowel or bladder function. Yet they are told, repeatedly, to “try harder”.

Because symptoms are ignored for years, women often present very late, when the muscles are too weak to be rehabilitated conservatively. Some develop umbilical or incisional hernias, chronic back pain, pelvic floor dysfunction, and even stress urinary or fecal incontinence. By the time medical attention is sought, simple strengthening is no longer sufficient.

“By the time many women reach us, their abdominal muscles are so thinned out that physiotherapy alone cannot restore function. Surgery isnt a luxury, but becomes a necessity,” explains Dr. Chugh.

This delay is not the woman’s fault. It is a systemic failure of awareness, validation, and postpartum care.

Abdominoplasty: Not Just Cosmetic

In India, abdominoplasty (tummy tuck) is often misunderstood as a purely cosmetic procedure. In reality, modern lipo-abdominoplasty is a functional reconstructive surgery for many women.

The procedure involves repairing and tightening the separated abdominal muscles, restoring the strength of the abdominal wall, removing excess skin and fat that contribute to imbalance, and treating associated hernias when present. Once the core is restored, women often experience dramatic improvement in daily function, posture, pain, and even continence.

Life After Surgery

Post-surgery, many women describe something they had forgotten: normalcy.
They can walk longer, work without exhaustion, lift their children, exercise, and live without constant discomfort. Some patients with long-standing incontinence report significant improvement after abdominal wall reconstruction.

This is not vanity. This is quality of life.

“We are not just reshaping the abdomen, we are restoring the core of a woman’s body, dignity, and independence. For many women, the surgery feels like getting their pre-pregnancy strength back, not their body, but their ability to live fully,” says Dr. Tavishi Kaushik, Associate Consultant, Department of Plastic Surgery, CK Birla Hospital, Gurgaon.

A Call for Change

Indian society must stop equating postpartum suffering with weakness. Women deserve proper evaluation, education, and early intervention after childbirth. Post-pregnancy core assessment and guided rehabilitation should be as routine as antenatal care.

We must listen when women speak.
We must examine before advising.
And we must stop shaming what we do not understand.

Because sometimes, it is not weight.
It is not laziness.
It is not an excuse.

It is a medical condition- long ignored.