Abdominal separation in pregnancy causes the “Mom Pooch” postpartum. The term is used to describe the slouchy belly most women have after giving birth. It can make a new mom’s belly stick out or bulge for months to years after delivery. We’ll discuss the causes, symptoms, and some strategies for healing these muscles, ensuring your pregnancy is healthier and your recovery is smoother.
What is Diastasis Recti?
How does this belly bulge after pregnancy happen? It is a medical condition called diastasis recti. Diastasis recti occurs due to the separation of the rectus abdominis muscles (six-pack ab muscles) when stretched over your growing uterus. These muscles separate as your belly grows, and the linea alba (the thin band of connective tissue that holds the right and left abdominal muscles together) gets wider.
What Are the Symptoms of Abdominal Separation?
Because your ab muscles and the connective tissues stretch so much over the belly, it is hard to tell if you have diastasis recti. Most women don’t know they have abdominal separation until they are postpartum.
The common signs of abdominal separation are:
- The “pooch” or bulge around the belly button.
- Jelly-like feeling of softness around the belly button.
- Pelvic pain.
- Hip pain.
- Low back pain.
- Poor posture.
- Difficulty doing heavy lifting, walking, and performing everyday tasks
- Urinary incontinence (leaking), especially with coughing or sneezing
- A ridge or dome pushing up your abdominal muscles when you contract them.
- Pain during sex.
- Weak abs.
- Bloating
- Constipation
- Pelvic floor issues.
What Causes Abdominal Separation?
As your abdomen gets larger to accommodate your growing baby, pregnancy puts a lot of pressure on your rectus abdominis, those muscles around your belly button that make up your sleek pre-pregnancy belly.
Hormonal changes during the beginning of your pregnancy relax your tissues and muscles and allow them to stretch. These hormones are relaxin and estrogen. The linea alba becomes thin and stretches as well. This stretching can cause a gap between the left and right abdominal muscles.
Additional factors that may make abdominal separation worse may include:
- The number of pregnancies the new mom has had
- Genetics
- Body type (petite)
- Posture
- Levels of hormones
- Exercise and workout levels done prenatally
- Being over 35 years old
- Having a heavy or big baby
- Having a vaginal delivery, as pushing can increase abdominal pressure.
Those new moms who’ve carried multiples, e.g., twins, triplets, etc., can have increased risk factors or severe cases that may need special exercises or treatments to recover.
How Can I Tell If I Have Diastasis Recti?
The Cleveland Clinic has outlined a self-test you can do to check for diastasis recti. You should not do this test until after your healthcare provider clears you to do it.
The test for diastasis recti:
- Lie flat on your back with your knees slightly bent. Keep your feet flat on the floor.
- Keeping one hand behind your head, lift your shoulders slightly off the ground. Now, look at your belly.
- With your palms down and fingers towards your toes, move your other hand to a position just above your belly button.
- With your fingers, feel the gap between your abs. See how many of your fingers can fit in the gap between the right and left abdominal muscles.
If you feel a gap of two finger widths, consult your OB/GYN or midwife. The ab separation you feel may be considered diastasis recti if more than two fingers fit in that space.
Your healthcare provider will do the same test. They’ll let you know how many fingers they feel. They also may do an ultrasound or use a measuring tape or caliper tool for more accurate measurements.
Should I Work on My Abdominal Muscle Separation During My Pregnancy or Wait Until After Birth?
Anna Ribaudo, PT, DPT, OCS, CApp-OB, physical therapist at Hospital for Special Surgery in New York, says, "Don’t attempt to fix your abdominal separation until after giving birth. If you have it during pregnancy, it’s not going to go away.”
After your delivery, your body needs to heal. Listen to your body to avoid injury. Start with light exercises. Don’t do the exercise if it hurts. Try to stay motivated and get yourself a partner to exercise with you and encourage you. Hydrate, especially when you are breastfeeding. Eat foods that will fuel you, i.e., healthy fats, proteins, and calcium-rich foods.
If you have abdominal separation to work on after your child is born, stick with some diastasis recti exercises. Exercising for the deep core muscles in the abdomen must be done cautiously. Avoid the classic sit-up and try some planking instead.
Don't forget pelvic floor exercises like pelvic tilts. Do some Kegels with your routine to help strengthen the muscles and help relieve any urinary incontinence.
Don’t exercise solely to lose weight. Let your body decide the process by its own clock. You will not lose weight like everyone else. Your body will determine what is best.
Try a new mom exercise class when cleared to do so. Working out with people going through the same issues is great!
Does Abdominal Separation Go Away By Itself?
Does your body heal diastasis recti itself? Abdominal separation will often go away within the weeks and months after childbirth. However, about one-third of postpartum women still report some ab separation a year or more after delivery.
More specifically, Cleveland Clinic says that diastasis recti abdominis affects 60% of new moms and usually resolves itself within eight weeks of delivery. About 40% of those who have this condition will still have it by six months postpartum.
How To Prevent Diastasis Recti During Pregnancy
Exercise and build strength in your abdominal wall before pregnancy and in its early stages. Better to have healthy and fit core muscles before you even get pregnant.
Here are some things you can do to lower your risk of developing abdominal separation during your pregnancy:
- Maintain a healthy weight gain during pregnancy.
- Eat healthy foods so weight gain stays within a healthy range.
- Good posture and deep breathing exercises
- Safe core exercises, like pelvic tilts and planking, are good, but avoid exercises like traditional sit-ups and crunches.
- No heavy lifting that may put strain on your stomach muscles
- Do a log roll to get out of bed - roll to one side and push with your arms to sit upright and lift yourself from the bed.
How is Abdominal Separation Treated?
It’s never too late to treat and repair your abdominal separation. Even if it's been years since you had your baby, you can fix diastasis recti with proper care.
Treatment plans need to fit the individual needs of the patient and keep in mind the severity of the separation.
Here are some of the treatment options available for your abdominal muscles with diastasis:
Physical Therapy and an Exercise Program:
A physical therapist can recommend and support you through the best exercises for diastasis recti:
- Deep Core Muscle exercise with gentle movements, like planking, pelvic tilts, or the downward dog yoga pose
- Focus on the transverse abdominal (TVA) areas or TVA muscle.
- Bracing exercises - Contracting the ab muscles while exercising is crucial.
- Avoid traditional sit-ups and crunches, which put more pressure on the abs.
- Posture improvement to help support the abs and reduce strain on them.
- Deep diaphragmatic breathing can stabilize your core.
Supportive Devices such as Belly Bands:
Giving birth can change your belly’s appearance, especially if you've had a cesarean section or are experiencing diastasis recti of the abdominal muscles. Even loose skin can cause a "pulling down" sensation. Your post-pregnancy belly may need some support.
The Momcozy Ergowrap Postpartum Belly Wrap is a new product that will launch in late April.
The benefits of this Momcozy Recovery Belly Band effectively promote postpartum recovery, abdominal support, and include the following:
- Relief from postpartum pain: The Advanced Ergonest Support Structure™ delivers support that relieves lower back pain.
- Alleviates discomfort from traditional belly compressing: The 3D abdomen lifting structure gently elevates and pulls in your belly, providing targeted compression.
- Comfortable, supportive, and breathable: The belly wrap is made with soft, skin-friendly fabric with tiny ventilation holes that promote airflow. You can wear it against your skin.
It’s an abdominal binder, only better!
They are tailored for every mom and are available in petite and standard styles. Check out this new recovery belly wrap product on the Momcozy website!
Surgical Intervention
When diastasis recti is severe, surgery may be necessary:
Diastasis Recti Surgery/Repair: Involves suturing the two sides of the rectus abdominis muscle together.
Abdominoplasty (Tummy Tuck): This procedure addresses both diastasis recti and the removal of the excess skin and fat around these muscles.
What Happens if Abdominal Separation Goes Untreated?
As expected, if the ab separation does not go away on its own or is not treated with one of the abovementioned options, it will only make the diastasis recti worse.
When it is untreated, your belly bulge will only get more pronounced. Abdominal exercises for diastasis recti are crucial if your “mom pooch” has not healed on its own.
Consult your healthcare provider and start working with a physical therapist if they feel this is appropriate.
FAQs About Diastasis Recti After Pregnancy:
Q: Can you fix diastasis recti while pregnant?
A: It is best to wait until after your child’s birth to try to fix ab separation so you have time to heal.
Q: What does pregnancy ab separation feel like?
A: Diastasis recti, or abdominal separation, does not hurt. You may feel core weakness when doing tasks like lifting your older child or doing the laundry, but the abdominal separation does not cause pain. Tactile feelings when you touch your belly may be like a jelly-like texture in that space between both sides of your abdomen when you contract the muscles there.
Conclusion
Abdominal separation is not uncommon, and you can treat it after your child’s birth. Just let yourself heal, and then work on getting your six-pack back. Even after years of that “mom pooch,” you can get back to your pre-pregnancy body.
