Diastasis Recti

First let’s just acknowledge how amazing and adaptable your body is! It just created, nurtured, and birthed new life into this world! That is no small task and every mark, every change, every sensation you are feeling right now is part of your powerful pregnancy and birthing story.

Now let’s talk about something a lot of women experience after pregnancy: diastasis recti abdominis. This is normal and natural, and not anything that you did wrong. You are not broken. You are not behind. This is just a new phase of strength and healing.

So what is Diastasis Recti Abdominis (DRA)?

DRA is the vertical separation of your rectus abdominis muscles, also known as your “six-pack abs.” Your body makes space for your growing baby by gently allowing those muscles to move. The left and right side of the rectus abdominis muscles are separated by a stretchy band of connective tissue called the linea alba. As your abdominal muscles are stretched and to an extent, weakened, the linea alba also thins and pulls apart. Just like a rubber band, the linea alba can stretch and lose its elasticity leading to a separation between your muscles. This is a normal change in pregnancy and the majority of women experience this change in their abdominal muscles.

Symptoms can include:

• Visible bulge that protrudes above or below your belly button

• Soft, jelly-like feeling when you touch near your belly button

• Noticeable ridge down the middle of abdomen particularly when contracting your abdominal muscles or leaning back in a chair

• Difficulty engaging the core muscles such as lifting objects or walking

• Poor posture

• Low back pain

Complications can include:

• Umbilical hernia

• Back pain

• Pelvic and hip pain

• Pain with sex

• Constipation

• Urinary leakage

How do you know if you have diastasis recti abdominis?

1. Lie on your back with knees bent and feet flat on the floor.

2. Keep one hand behind your head and the other hand above your belly button area.

3. Lift your shoulders off the ground and look at your belly.

4. Use the hand on your belly to assess if you can feel a separation between your muscles and see how many fingers you can count between the right and left abdominals.

5. If your abdominal muscles are more than two or three fingers of separation (>2 cm), then discuss with your healthcare provider what the best next steps would be for you.

Remember you haven't done anything wrong. This is how your body has adapted to do something extraordinary. This is treatable and can improve significantly with the right kind of support and core movements.

Diastasis Recti Abdominis Timeline

Expect your DRA to undergo the most significant spontaneous improvement in the first 6-8 weeks postpartum, with continued gradual narrowing through 6-12 months. However it does not fully resolve in a substantial proportion of women, and some degree of separation can persist long-term.

A study looking at 300 first time mothers found the frequency of DRA to be:

• 60% at 6 weeks postpartum

• 45% at 6 months postpartum

• 33% at 12 months postpartum

This indicates that the greatest rate of healing of DRA without treatment occurs between 6 weeks and 6 months.

Risk Factors to Consider for Persistent DRA:

• Multiple births - strongest risk factor

• Cesarean delivery

• Higher BMI

• Twin pregnancy

• Diabetes

What now? How do I manage diastasis recti?

It can often heal on its own, but there are some things to do, and avoid, to assist in its repair.

During the first 6 weeks:

• Avoid lifting anything heavier than your baby

• Avoid abdominal exercises like sit ups, crunches, or full planks that put pressure on your abdominal wall

• Roll to one side when getting up from lying down rather than sitting straight up

You can find more support through rehabilitative exercises with a pelvic floor therapist, postpartum physical therapist, or qualified fitness professional especially if DRA persists beyond 6 months. Combined deep and superficial abdominal muscle training at this later point in your postpartum timeline can be helpful for functional core strength, but may not completely close the gap itself.

Remember, healing is not about immediately bouncing back, it’s about moving forward with the attitude of care and kindness, and intentionally regaining strength.

What are general exercise recommendations for pregnancy and postpartum?

• Abdominal strengthening exercises can be performed during pregnancy to promote good posture, strengthen muscles for labor, and prevent low back pain and diastasis rectus abdominis. If you develop diastasis rectus abdominis, abdominal exercises need to be discontinued.

• During the first few weeks postpartum, abdominal exercises like sit ups or full planks that put pressure on the abdominal wall are not encouraged. It is important to build strength slowly before doing sudden, harsh movements of your abs. Also, if you have had a C-section, there is additional healing that needs to take place within the abdominal layers of your belly and at the wound site so it is advisable to not do any heavy lifting more than the weight of your baby for 6 weeks postoperatively.

• When first starting abdominal exercises, begin at a gentle pace and then gradually progress to more challenging exercises. Guidance with a qualified professional is highly recommended.

Disclaimer: The information on Mone does not replace professional medical assessment, diagnosis, treatment, or advice. Please seek medical advice from your physician or other qualified health care providers.