Childbirth changes our bodies—even our periods can change! While it’s normal for our bellies to be stretched and a little saggy after having a baby, if you continue looking pregnant even many months after giving birth, it might be diastasis recti.
Video: Diastasis Recti – Do You Have It? Plus How to Treat It
What is Diastasis Recti?
Also known as abdominal separation, diastasis recti is defined as having a gap of roughly 2.7 cm between the rectus abdominis muscles. In less technical terms, it means your belly sticks out because the space between your right and left abdominal muscles—which normally holds your belly in its place—has widened, letting the uterus, bowels, and other internal organs hang more forward than they would otherwise be.
The severity of the condition depends on how large or wide the gap is. The wider the gap, the more severe the condition. In more severe cases, the belly, bowels, and organs hang out more, causing more numerous (and more severe) symptoms.
What Causes Diastasis Recti?
Everyone is born with their muscles separated. Around 3 years old, after the development of the nervous system, they come together. (source)
The muscles never completely close where the belly button joins the abdominal muscles, making it possible for the muscles to open when under pressure.
Some reasons abdominal muscles may separate:
- Improper weightlifting and exercise
- Yo-yo dieting
- Cirrhosis of the liver
- Stomach cancer
- HIV
- Being over 35 years old
- Genetics
Though anyone can get diastasis recti for the various reasons outlined above, there is a clear connection to pregnancy.
Diastasis Recti in Pregnancy
Diastasis recti is a very common result of pregnancy—up to two-thirds of pregnant mamas may have it!
(source)
Though not everyone develops this condition as a result of pregnancy, the more pregnancies you have, the higher the likelihood it could affect you. Being pregnant with multiples also makes you more prone.
“There is an increased demand on a woman’s body due to normal pregnancy weight gain, increased curves of the spine and changes in center of mass.” — Solange Ross, licensed Physical Therapist specializing in pelvic floor rehabilitation
It was previously thought that larger babies, maternal age, pregnancy weight gain, and body mass index put someone at a higher risk of developing diastasis recti, but a 2015 study found no connection between these risk factors and the condition.
Diastasis Recti Symptoms
Some symptoms are similar to normal after-birth symptoms, which can lead to confusion.
But if you’re having any of the below issues several months after birth, talk to your healthcare provider:
- Belly bulge (belly hanging forward or sticking out when standing and a dome-like bulge when sitting up)
- Lower back pain
- Constipation
- Bloating
- Other intestinal discomfort that started or worsened after delivery
- Pelvic floor issues
- Poor posture
- Incontinence
- Core weakness
- Pain during sexual intercourse
How Can I Tell if I Have Diastasis Recti?
Though it’s a very common condition, your doctor may not check you for it unless you ask—many doctors aren’t trained to treat or even recognize the condition.
The good news? There’s a simple test you can do at home:
- Lie on your back with your knees bent, feet flat on the floor.
- Slowly lift your head up, as if you’re about to do an abdominal crunch.
- Press two of your fingers into the flesh around your belly button. If you have diastasis recti, you will feel the walls of your abdominal muscles squeezing the sides of your fingers as the muscles contract.
- Try 1, 2, and 3 fingers to see how wide the gap is. The more fingers you can fit in the gap, the wider the gap and the more severe the condition.
Here’s a video demonstration of how to perform the self-test:
If you do this and think you may have an abdominal gap, talk to your doctor to get a referral to a physical therapist who can help you correct the issue with gentle exercises. Since so many doctors aren’t well versed in how to treat the condition, make sure to find a therapist—specifically, a pelvic floor physiotherapist—who specializes in treating the condition.
Since diastasis recti often resembles a hernia, many doctors may suggest surgery. The trouble is, it’s very rare that diastasis recti causes a true hernia.(source)
What Does Diastasis Recti Look Like?
“The split of the abdominals is measured in finger widths and can be anywhere from 1 to 10 fingers wide,” says Lauren Ohayon, founder of the online exercise program Restore Your Core.
It’s also important to note the depth of the abdominal separation—a shallow five finger diastasis recti may actually heal better than a very deep three finger diastasis recti. The split can also occur at different points along the abdominal muscles, which run from the pubic bone to the rib cage.
Diastasis Recti: Do You Have It? How to Treat It. Different Variations of Diastasis Recti
The condition can present differently for each person, as you’ll see in the variation among these photos.
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Physical therapy done consistently and over time is usually enough to correct cases of diastasis recti. Surgical options do exist and may help in very severe cases, but surgery is often unnecessary, and therefore, very rare.
“If there’s a defect in a layer of tissue called the linea alba, then the bowel can poke through,” Dr. Geeta Sharma, OB-GYN at Weill Cornell Medical Center “That’s going to be more dangerous. So I will refer patients to a general surgeon to have a CT scan if there’s really a true concern about a hernia.”
Natural Ways to Prevent Diastasis Recti
There are some things you can do to prevent diastasis recti from happening in the first place, but there is no guarantee. Even women who actively try to prevent the condition will get it after pregnancy. Remember: Some things are out of our control—don’t beat yourself up.
For some mamas, these tips will help prevent diastasis recti or make symptoms less severe, so they’re worth a try.
Before pregnancy:
- Maintain an active lifestyle.
- Practice safe abdominal and pelvic floor strengthening.
- Practice good posture.
During pregnancy:
- Practice pregnancy-safe core and pelvic floor exercises like these or these (avoid heavy weight training, holding your breath, and abdominal exercises).
- Practice good posture. Maintain a neutral posture—try not to walk or stand with your belly pushed out.
- Lift heavy objects—even older children—sparingly and carefully. Bend at your knees rather than at your back. Exhale as you pick up the object. Do not strain or hold your breath.
- Wear a belly band for extra support.
- Eat plenty of protein and healthy fat to support muscle development and skin elasticity.
After pregnancy:
- Get adequate rest immediately following childbirth.
- Avoid heavy lifting.
- Refrain from any exercise that builds abdominal pressure (heavy lifting, crunches, planks).
- If you had a c-section, make sure your incision heals fully before resuming regular activity.
- Practice good posture.
- In some instances, wearing a belly binding device may be helpful. Talk to your physical therapist or doctor about what’s right for you.
How to Fix Diastasis Recti at Home
It is important to do any exercises to correct diastasis recti under the care of a physical therapist to avoid injuring yourself further. You’ll get much better results if you get evaluated personally, since it doesn’t present the same way in every person.
That said, some moms can’t afford or don’t have the time to go to a physical therapist each week. If you want to try some at-home exercises, choose well-respected programs, get your doctor’s approval, and go slowly.
Here are some at-home programs you can trust:
- The Pelvic Floor Piston: Physical therapist Julie Wiebe leads a six-part self-paced series that uses specialized exercise and breathing to help postpartum women begin exercising again. The program is recommended for those with diastasis recti, as well as those with prolapse and pelvic pain.
- Diastasis Recti: The Whole Body Solution to Abdominal Weakness and Separationby Katy Bowman: Biomechanist Katy Bowman explores the causes and treatment of diastasis recti in depth. The book includes whole-body corrective program with over 30 exercises to help heal.
- Fit2B Studio: This online gym has nearly 100 exercise routines to help strengthen. They have specially designed workouts labeled TummySafe that are suitable for women (and men!) with diastasis recti. Look for the “TS” label.
- Tupler Technique:This research-based exercise program treats diastasis recti with an 18-week program to heal the weakened connective tissue that joins the abdominal muscles.
Do Postpartum Belly Binders Help?
Some say a belly binder, like this one or this one can help repair abdominal separation.
According to Dr. Cynthia Robbins, an OB/GYN board specialist. “A recovery garment aides in holding the tissue, ligaments, and bones in place to stabilize the pelvis. This allows a woman to begin exercising earlier in the recovery stage. Therefore, she is able to get active and begin immediately strengthening her pelvis and her musculature.”
Others don’t recommend it, chalking it up to a sort of band-aid for a larger problem.
“Wearing a brace can result in a patient’s over-reliance on the brace reducing the opportunity to retrain the abdominal muscles,” says Rachel Gelman, branch director of the Pelvic Health and Rehabilitation Center in San Francisco.
Talk to your midwife or physical therapist to see if it would be helpful for your individual case.
What Diastasis Recti Means for Future Pregnancies
In most cases, you can absolutely get pregnant again and have a healthy pregnancy without getting diastasis recti again. Taking strides to fix any separation now is the easiest way to ensure that there are no complications later. Continue exercises to help repair and strengthen your core, and as soon as you get a positive pregnancy test, begin pregnancy appropriate pelvic floor exercises to keep your core strong, practice good posture, and limit heavy lifting.
While rare, severe cases of diastasis recti may make it more complicated to have a vaginal delivery in the future, since it can be harder to engage the core muscles needed to push. This is especially true when pregnancies are close together. Talk to your midwife or doctor if you think this may be an issue.
How About You?
Did you have diastasis recti? What helped you heal and correct it? Please share your stories and any tips you’ve found helpful in the comments section below!
