It is natural that childbirth changes a woman’s body. While it is normal for bellies to look stretched or feel a little saggy after giving birth, sometimes, it can lead to what is called Diastasis Recti. This is an extended flab that is formed between the extra space where your left and right belly muscles are. While this may essentially be harmless, it is definitely an unflattering sight that continues to make you look pregnant.
So, what is Diastasis Recti and how does it happen?
During pregnancy, it is common for the abdominal wall in the centre of the abdomen between two halves of the midline abdominal muscle to weaken. Now, the abdominal wall is made up of supporting and binding tissue which includes collagen fibres. Because of the pregnancy hormones, the tension of the collagen fibres decreases and thus begins to stretch. Normally, after delivery, the collagen fibres will regain their normalcy but if there are long term stretching or even tearing of the fibres, it can lead the binding tissue to not recover fully. This is when Diastasis Recti occurs as the two halves of the abdominal wall is continually separated. In a scenario like this, you end up with a ‘pouch’ that resembles a pregnant belly.
Who does Diastasis Recti affect?
While it is a common condition, the chances of Diastasis Recti are increased for women who:
• Are petite
• Had a substantial weight gain during pregnancy
• Are carrying multiple babies at a time
• Have had more than one pregnancy
• Are carrying their babies at a slightly older age
• Have poor muscle tone
• Have a sway back posture
• Who had developed diastasis recti from a previous pregnancy
• With a medical history of umbilical or ventral hernia and pelvic instability
Three out of ten women are also predicted to suffer from a mild form of diastasis following their first pregnancy.
How can I tell if I have Diastasis Recti?
It can be done through a simple home test where you can check if the flab you have is Diastasis Recti or just belly fat.
1. Lie on your back with your knees bend and your feet on the floor. Then, place your hand palm down over your belly, with your fingers pointing towards your toes.
2. Press your fingers gently into your navel area then slowly lift your head, drawing your chin to your chest. This would cause your abdominal muscles to contract.
3. 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 squeeze the sides of your fingers as the muscles contract.
4. Use one, two and three fingers to see how wide the gap is. The more fingers you can fit in the gap, the more severe the condition.
After which, this is how you gauge your Diastasis Recti’s degree of severity:
• Minor Diastasis Recti – It will generally correct itself naturally once you slowly start stimulating your abdominal muscles. (The gap is about 5cm in length, 1cm in width or less then 1 and a half fingers)
• Mild Diastasis Recti – It will not be able to fully correct itself but abdominal exercises may help prevent any health issues from arising. (The gap is up to 10cm in length, 2cm in width or 2 to 2 and a half fingers)
• Severe Diastasis Recti – It will not correct itself and it must be corrected surgically as it is comparable to an umbilical hernia. Even if you were to undergo high training, elevated pressure and tension in the abdomen can no longer be absorbed by the abdominal muscles. (The gap is longer than 10cm, wider than 2cm or 3 to 5 fingers)
Can Diastasis Recti lead to other health complications?
While it is harmless and mainly affects the abdomen, Diastasis Recti can sometimes lead to implications on functioning of other organs and body parts like:
• Chronic backache
• Urinary incontinence
• Postpartum constipation
• Pain during sex
What can I do about Diastasis Recti if I have it?
The bad news is that once the connective tissues of your abdominal muscles have stretched out, it is difficult to put them back together. Even traditional crunches may be rendered useless as they might strengthen the stretched tissues that are in the same position, leaving the gap where it is.
However, there’s still hope with abdominal rehabilitation; which is a way to help you get rid of Diastasis Recti. In abdominal rehabilitation, you will need to work with a physical therapist who can suggest the specific type of exercise to strengthen as well as tone your weak abdominal muscles.
Here’s a breakdown of what to expect during abdominal rehabilitation:
1. Strengthening the abdominal muscles: You might have to perform mini crunches while wearing a belt that is tightly wrapped around your waist. This helps to strengthen your abdominal connective tissues and prevent them from stretching further.
2. Strengthening the transverse abdominal muscles: This is a part of the abdomen that acts as a corset which protects and provides strength to the core.
3. Daily exercises: These are abdominal exercises which your therapist may show you for incorporation in to your daily activities such as getting up from bed, sitting on a chair, picking up light objects from the floor.
It is recommended to start abdominal rehabilitation a minimum of six weeks after normal delivery or, eight weeks after a caesarean section. Physical therapy when done consistently and over time is usually enough to correct cases of Diastasis Recti. Surgical options do exist and might help in very severe cases but it is often unnecessary.
Are there natural ways to prevent Diastasis Recti from developing?
Yes, there are but there is no guarantee that it will help prevent Diastasis Recti from developing. Even women who actively try to prevent the condition from occurring still get it after pregnancy. All you need to remember is that some things are beyond our control so even if it does happen, it is not your fault.
With that said, it still doesn’t hurt to give these few tips a try to help prevent or make the symptoms less severe.
• Maintaining a healthy lifestyle and getting to a healthy weight
• Start or continue to exercise safely
• Practice safe abdominal and pelvic floor strengthening
• Practice good posture
• If this will be your second pregnancy, look to reduce your Diastasis Recti gap (if you have one) and strengthen your deep core muscles
• Avoid heavy weight training, holding your breath, and any kind of abdominal exercise that work your abdominal muscles like crunches, sit-ups, head curl-ups
• Practice pregnancy-safe core and pelvic floor exercises like simple walking, proper sitting
• Stop anything that causes doming – it is important to roll to your side to sit-up or lay down
• Practice and maintain a good posture; try not to walk or stand with your belly pushed out
• Try not to life heavy objects unless absolutely necessary; bend at your knees rather than at your back and exhale as you pick up the object – do not strain or hold your breath
• Wear a belly band if needed, for extra support
• Eat plenty of protein and healthy fat to support muscle development and skin elasticity
• Start or continue with deep core engagement exercises for your transverse abdominal muscle
• Get adequate rest immediately after childbirth
• Avoid heavy lifting at all costs
• Refrain engaging in any exercise that builds abdominal pressure like heavy lifting, crunches, planks
• If you’ve had a caesarean section, make sure your incision has healed fully before resuming your regular activities
• Practice good posture
While it can be incredibly stressful to develop Diastasis Recti, it is not something that you should be stressing out about. All you need to do is remember good body mechanics and take strides in fixing any separation earlier rather than later.