Diastasis recti: How to heal ab separation after pregnancy

Pregnancy

by Noushin Firouzbakht, MD

Feb 16, 2023

Congratulations on your new bundle of joy! As a new mother, you’re probably adjusting to a lot of changes in your life and your body. If you’re feeling a little “poochy” in your belly area, even months after giving birth, you might be experiencing a condition called diastasis recti.

Many new mothers experience diastasis recti after giving birth, but it’s not something to be ashamed of. It’s a common condition that happens as a result of the physical changes your body goes through during pregnancy. However, it’s important to address diastasis recti because it can lead to other problems, such as back pain, poor posture and a weak core.

Here’s everything you need to know about diastasis recti, how to tell if you have it and what to do next.

What is diastasis recti?

Diastasis recti is a condition where the abdominal muscles (aka the “six-pack” muscles or Rectus Abdominis) separate along the midline of the abdomen. This can happen during pregnancy as the muscles expand with a growing uterus. It’s estimated that up to 60% of pregnant women may develop diastasis recti or a gap in the abdomen to some degree.

Diastasis recti usually develops during the third trimester, but most women won’t notice any symptoms until after they’ve delivered their baby.

Preventing diastasis recti

While diastasis recti can happen to anyone, there are certain things you can do to help prevent it from happening or worsening.

  • Exercise during pregnancy: Pregnancy is not the time to start an intense workout program, but staying active and maintaining a healthy weight can help prevent diastasis recti. However, be careful with the types of exercise you do. Avoid exercises that put a lot of pressure on your abdominal muscles, such as crunches and sit-ups. Instead, focus on exercises that strengthen your core, such as pelvic tilts, planks and bridges.
  • Be mindful of your posture: Good posture is important for preventing diastasis recti. Stand up straight, avoid slouching and tuck your baby in toward your spine. When you’re sitting down, make sure to sit back in your chair and use a lumbar roll to support your lower back.
  • Getting out of bed: To get out of bed, do not try to bend at the waist and sit straight up. Roll on your side, then use your arms and legs to push to a sitting position, and plant your feet on the floor to get up.
  • Practice safe lifting: Lifting heavy objects can put a lot of stress on your abdominal muscles. If you need to lift something heavy, make sure to use your legs, not your back, and avoid twisting your torso while you lift.
  • Avoid excessive weight gain during pregnancy: This can put added pressure on the abdominal muscles, making them more likely to separate. Make sure to follow your healthcare provider’s recommendations for healthy weight gain during pregnancy. Sticking to a healthy diet can help, too. Despite the popular myth, you are not eating for two people. Instead, just aim to eat a balanced healthy adult diet.

How to tell if you have diastasis recti

So, how can you tell if you have diastasis recti? The most common sign is a bulging or “poochy” belly, even when you’re no longer pregnant. You might notice that your belly sticks out more when you’re sitting up and that it sinks in when you’re lying down. You might also feel a gap or a bulge when you press down on your belly.

To check for diastasis recti, lie down on your back with your knees bent and your feet on the floor. Place your fingers on your belly, about two finger-widths above your belly button. Slowly lift your head and shoulders off the floor, using your abdominal muscles to press down on your fingers. If you feel a gap of more than two fingers or a bulge in the central line of your abdomen, you might have diastasis recti.

Treatment options for diastasis recti

If you think you have diastasis recti, the first step is to consult with your OBGYN to confirm the diagnosis. They can also give you guidance on exercises and activities that will be safe for you and refer you to a physical therapist if needed.

  • Core exercises: One of the most effective exercises for diastasis recti is called the “transverse abdominal (TVA) muscle squeeze.” This exercise involves lying on your back with your knees bent and your feet flat on the floor. Place one hand on your belly and take a deep breath in. As you exhale, bring your belly button towards your spine, engaging your TVA muscle. Hold the contraction for a few seconds, then release. Repeat this exercise several times a day.
  • Posture: It’s also important to be mindful of your posture and movement during daily activities. Avoid any movements that cause your belly to bulge, such as heavy lifting, or anything that causes your belly to push out.
  • Physical therapy: A physical therapist can work with you to develop an exercise program that targets the abdominal muscles and helps to bring them back together.
  • Surgery: In severe cases, surgery may be necessary to repair the separation. But in most cases, diastasis recti can be treated with exercises and physical therapy.
  • Abdominal support: Use additional abdominal support to decrease separation of the muscles. There are pregnancy belts or bands that can help you do this. The belt can be used in the third trimester and postpartum period for up to six weeks for additional abdominal muscle support.

Diastasis recti usually resolves itself within eight weeks of delivery, but some women experience it for as long as six months postpartum.

Healing from diastasis recti

As a new mother, be sure and take care of yourself both physically and emotionally. It’s important to remember that healing from diastasis recti takes time and patience. It may take one or two months post-delivery, so be patient, and continue your exercises and abdominal support.

Be kind to yourself and don’t expect to see results overnight. With time and consistency, you can strengthen your abdominal muscles.

If you suspect you have diastasis recti or are looking for ways to prevent it during pregnancy, talk to your OBGYN for guidance or find an OBGYN near you.

About the Author

Noushin Firouzbakht, MD, is an OBGYN on the medical staff at Baylor Scott & White All Saints Medical Center – Fort Worth.

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