Tummy Not Going Back to Normal After Pregnancy? You May Have Postpartum Diastasis Recti
What is Diastasis Recti?
Diastasis recti is the condition that results when your abdominal muscles on either side no longer meet in the middle, creating a space or “pooch” that bulges outward. The normal space between abdominal muscles is two centimeters or less. During pregnancy, your abdominal muscles stretch and move, and some degree of diastasis or separation is normal during that time. Once the baby is born, these muscles should ideally close the gap, returning to their pre-pregnancy positions, but this is not always the case. Especially in second, third, and subsequent pregnancies, these muscles have been stretched and overworked, and a gap may remain.
To test for diastasis recti, lie down flat on your back with your knees bent and feet flat on the floor. Bring your chin to your chest, as if you were doing crunches. Take your pointer and middle finger together, and feel close to your navel. You will feel two distinct muscle masses, one on the right and one on the left. These are the rectus abdominis muscles. There will be a hollow gap in between them. How many fingers can you fit in the gap? A width of more than 2 fingers (approximately 2 centimeters) is considered to be diastasis recti.
Why does diastasis recti occur?
Diastasis happens because our abdominal muscles lose some of their elasticity and are not able to spring back in to place as they should. The muscles are stretched and heavily stressed during pregnancy. Even though you may not have experienced diastasis recti in your first pregnancy, the added stress of subsequent pregnancies on already-damaged tissue make it more likely to occur the more pregnancies you have.
If you already have a gap, certain movements and exercises can make it worse. Avoid the following:
- Heavy lifting or straining
- Exercises that put pressure on your ab muscles, such as planks or crunches
- Twisting from side to side
- Balancing too much weight on one side, and leaning to the other
Excessive coughing can also exacerbate or worsen existing diastasis recti.
How about you?
Have you experienced diastasis recti?
What can I do to prevent diastasis recti?
As with most problems, prevention is preferable to treatment. One of the earliest steps you can take to prevent diastasis recti is to be in shape with strong core muscles BEFORE pregnancy. The stronger they are beforehand, the more stress they will be able to sustain during and after pregnancy, and the more likely they will properly realign postpartum. Other suggestions to prevent diastasis recti include:
What can I do to treat diastasis recti?
We mentioned above that many exercises can make diastasis recti worse. However, many exercises exist that specifically focus on closing the gap between the abdominal muscles. Some systems exist, such as Wendy’s MuTu System, that follow a researched pattern and sequence of exercises, but there are also many free videos and resources available to find appropriate post-partum exercises.
Diastasis recti can look even worse if it is accompanied by bloating or constipation. Unfortunately, diastasis can also cause constipation. It is important to eat a diet high in fiber to maintain a clean colon. Avoid foods that cause bloating, such as beans, fried foods, or high salt/high carb snacks. Eat a diet full of good fats and protein to aid in muscle repair from a cellular level.
Although there is some controversy around the subject, many claim that collagen or gelatin supplements can restore elasticity to abdominal muscles, thus repairing diastasis recti more quickly. Homemade bone broth is believed by some to also accomplish this.
Do not slouch while sitting, and while standing do not lock your knees and lean backwards, which puts great pressure on your ab muscles. When standing or sitting, try to be conscious of your mid-section, and practice belly breathing, which naturally brings the abdominal muscles closer to the center.
Breastfeeding does not cure diastasis recti, but it does encourage contractions that help return the uterus to its pre-pregnancy size. This can cause your tummy to appear flatter more quickly after pregnancy. Breastfeeding also factors in to sustained weight loss postpartum.
In rare cases, surgery
If no conventional method is able to successfully manage diastasis recti, a procedure called an abdominoplasty (tummy tuck) can be done, which corrects the muscles and gets rid of extra skin. However, this should be done only as a last resort and if you don’t plan on becoming pregnant again.
Diastasis Recti Exercises
During healing, how can I cope?
Diastasis recti can be emotionally draining. We want to feel comfortable with ourselves and our bodies, especially after having gone through the physical changes of pregnancy. It can be painful if a woman is five or six months postpartum, and still being asked “When are you due?” Healing unfortunately will not happen overnight, and will take time and effort. There are several things you can do, however, that can help you feel more comfortable and less self-conscious.
- Dress in clothing that flatter your current figure. Avoid form-fitting dresses or tops. Opt for leggings and tunics. Dress in layers of varying lengths to avoid drawing focus to your mid-section.
- Put on your favorite makeup and earrings. If you have time, style your hair. Dressing up in one’s own style increases self confidence. This also can take the focus off of the problem area.
- Try a belly binder or wrap. Although a temporary cosmetic fix, belly wraps can significantly decrease the appearance of the “pooch.” Depending on the type, these can be worn concealed under clothing.
Will diastasis recti disappear on its own?
Technically, diastasis recti is classified as an indefinite condition with no cure—but one that may be helped by treatment. Although the gap may never fully close, many women notice a significant improvement by one year postpartum. With a combination of dedication to postpartum exercises and following some or all of these coping strategies, diastasis recti can be managed.
A belly wrap designed for postpartum support.
This product offers abdominal support postpartum. Unlike many other wraps, which only offer adjustability in the main front velcro closure, this one has two adjustable velcro straps that attach from the back and can be placed anywhere on the front to focus on "problem areas." These adjustable straps can be secured tightly over a specific spot, or can be simply attached loosely if you don't want any tighter support in any one area. I have found it most helpful to adjust then at an angle downwards, securing them just below the navel, in the center of the "pooch." The material for this wrap is stretchy, and after over six months of use mine has not lost its elasticity. It also is covered a breathable material with small holes, which prevents excessive sweating that I've experienced with other belly wraps. This wrap can be worn under your clothing during the day. As long as you are not wearing anything too tight, it is not too noticeable. I have had good results wearing it over night. Although some of the results are temporary and return after a few hours of not wearing the wrap, this product does cause my belly to shrink down a bit every time I wear it. I recommend this one over others because of the added customization, comfort of material, and conceal ability.