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If You Still Look Pregnant Months After Birth, It May Be Diastasis Recti (Abdominal Separation)

FACTS TO KNOW
  • 60%

    are affected by diastasis recti 6 weeks after birth

  • % with diastasis recti 1 year after birth

  • Helpful Tips

    • Avoid abdominal exercises like crunches and planks as these exacerbate the condition
    • Pelvic floor therapy with stabilizing exercises like cat-cow arches and pelvic tilts may help
    • Actively working toward a strong core pre-pregnancy and continuing appropriate exercises during pregnancy is vital to post-delivery recovery
    • Prioritize treating diastasis recti — it often goes hand in hand with other pelvic floor issues like incontinence and pelvic organ prolapse
    • If you believe you might have this condition, you should see a physical therapist

What is it?

Diastasis recti is the name for what happens when the abdominal muscles, which separate during pregnancy to make room for the growing baby, remain separated after delivery. In some, it can look like a visible protrusion or bulge in the middle of the stomach, surrounding the belly button area. In others, it may not be visible at all, or noticeable only when the muscles are tensed.

Common complaints with this condition are a sensation of heavy pressure on the pelvic floor, lower back pain, constipation and/or urinary incontinence. Diastasis recti ultimately weakens ab muscles, which can lead to back pain and make daily activities, such as lifting and standing with good posture, more painful and difficult.

How common is it?

Research suggests that diastasis recti affects 60% of postpartum women six weeks after birth, and 30% a year after birth. That said, it’s an underdiagnosed and poorly studied condition.

How long does it last?

Diastasis recti is most pronounced in the year after birth, with symptoms reversing visibly between six weeks and 12 months postpartum. Ideally, the issue will be diagnosed at the six-week checkup by your doctor or midwife, who will perform a manual examination and ask you to perform specific exercises and then measure the gap above, below and at the navel, usually in units of finger-width. If separation of the abdominals is present, physical therapy and targeted abdominal exercises can be recommended to help reverse it. It can take six weeks or longer for a relatively small (two-finger) diastasis to close and over a year for more severe separation (four-to-five finger) to close.

What can be done to remedy it?

Treating diastasis recti involves strengthening the ab muscles and pelvic floor with stabilizing exercises that bring the muscles back together: think cat-cow arches and pelvic tilts. Abdominal exercises like crunches and planks should be avoided as these can actually exacerbate the condition. Treating diastasis recti should be prioritized because it often goes hand in hand with other pelvic floor issues. A 2007 study found that 66% of women with diastasis recti also had at least one form of pelvic floor dysfunction, like incontinence or pelvic organ prolapse.

What can be done to fix diastasis recti?

While diastasis recti isn’t preventable, research shows that actively working toward a strong core pre-pregnancy and continuing appropriate core exercises during pregnancy is vital to post-delivery recovery.

When should I be worried?

If you believe you might have diastasis recti, you should visit a physical therapist to be assessed and get exercises prescribed specifically for you. Not treating this condition can lead to back pain and a weakening of the abdominal core, along with other pelvic floor issues. This condition is nearly always easily reversed with physical therapy. In the interim, a support belt may also provide relief.

Sources

https://bjsm.bmj.com/content/50/17/1092https://journals.lww.com/greenjournal/Abstract/2014/05001/Postnatal_Exercise_Can_Reverse_Diastasis_Recti.352.aspxhttps://www.ncbi.nlm.nih.gov/pubmed/16868659
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