If you still look pregnant months after giving birth, you may have a diastasis recti. That's what they call it when the rectus abdominis muscles in your abdomen separate during pregnancy, leaving a gap that allows your belly to pooch out. Here's how it happens.
What is a diastasis, does everyone get a diastasis, when do you need to take action, and can you control whether you get a diastasis? You can find the answers to these questions and a good exercise for after delivery in this article.
During pregnancy, the abdominal wall in the centre of the abdomen between the two halves of the midline abdominal muscle is weakened. The abdominal wall is made up of supporting and binding tissue, including collagen fibres. Due to the pregnancy hormones, the tension of the fibres decreases and they begin to stretch and your abdominal muscles give way to make space for your growing baby. The separation of the rectus abdominal muscles on the midline of the connective tissue connecting these (the linea alba) is called a diastasis. The linea alba runs from the bottom of the sternum to the top of the pubic bone and is usually about one cm in width. A diastasis can occur anywhere from the top to the bottom of the midline. After delivery, this process will redress itself and the collagen fibres will regain their normal tractive force. However, long term stretching or even tearing of the fibres can lead to the binding tissue not being able to recover fully. The two halves of the abdominal wall will thus remain separated, which, in medical terms, is referred to as diastasis recti. The chances of diastasis recti are increased by substantial weight gain during pregnancy or by a twin pregnancy. 3 out of 10 women will suffer from a mild form of diastasis following their first pregnancy. In addition, the likelihood of diastasis, as well as its severity, increase after multiple pregnancies.
The abdominal muscles are crucial to keep the pelvis stable and to allow the pelvic floor to function properly. And you’ll have to exercise them for strength and endurance. Even six weeks after delivery, with every activity exerting your abdominal muscles, you’ll notice that they’re not back to full strength yet. Leading an active lifestyle and exercising your muscles will ensure that your abdominal muscles recover as best they can.
The rectus abdominal muscles, together with the other abdominal muscles, make up a part of the core. The core is the centre of your body from which all movement is made possible. The core consists of:
These muscles make your body into a corset, as it was protecting the internal organs and the spine. Besides this, they stabilise the body. Because of this, you have more control over your body’s movements. A strong core allows you to be flexible and stable, reducing the chance of injuries. Your core muscles are active during most physical activities, both during daily activities and during a workout. These muscles are active as stabilisers during a lot of exercises, for instance when performing a plank. But you also use the core muscles when lifting your child or the shopping bag.
When you have just given birth, you will often still have a diastasis. There won't only be a separation between the rectus abdominal muscles, but you will also notice that the core muscles don't work together properly because of this separation. As a result, you could experience an overload of certain muscle groups, which could lead to e.g. lower back complaints, pelvic complaints or obstipation. It could take up to six months for your core to function optimally again. If the core doesn't heal by itself and the core muscles don't start to cooperate naturally, it would be wise to consult a specialised pelvic physiotherapist.
Having a diastasis is completely normal during the third trimester. There are however a number of factors that could increase the chance of a wide diastasis, which could decrease the speed of recovery after delivery:
It can be very troublesome to have a diastasis; you could have complaints like:
Things can also change cosmetically if there still is a diastasis after delivery. The stomach could not flatten, resembling a pregnant belly of a few months. We call this mommy-tummy. If this is the case for you, we advise going to a specialist to get personalised exercises to help with recovery.
Usually, a diastasis recovers naturally within the first six months after delivery. After pregnancy, you could do a monthly check of your diastasis to monitor the progress of recovery. If you are experiencing complaints or if progress stagnates, get in touch with a registered pelvic floor therapist.
The distance between the two rectus abdominal muscles is not the most important aspect. It is much more important that all abdominal muscles and the entire core can work together again for a good posture and movements. This test is just an indication. It could very well happen that the full function and collaboration of the core has returned, even though there is still a separation between the rectus abdominal muscles. As long as there are no complaints, this isn't a problem.
It is important to regain proper function of the core muscles after delivery. For this reason, it is helpful to be able to contract the deep transverse abdominal muscle, or the transversus abdominis, and to be able to integrate this into daily activities. Because the deep transverse abdominal muscle and the pelvic floor are part of the core and work together, contracting one of these will stimulate the contraction of the other. By training the deep transverse abdominal muscle, your entire core will become stronger.
Mom in Balance encourages you to start doing some mild exercises to strengthen your pelvis and abdominals in the first 6 weeks after childbirth. This exercise will, along with your abs, also strengthen your pelvis and pelvic floor muscles. Don't start immediately with a tough ab workout. There is a risk that you could put too much pressure on your straight abdominal muscles too soon, causing these muscles not to close at all. The exercise below can be started right after delivery.
Training the deep transverse abdominal muscle:
If the diastasis doesn't recover enough after delivery, complaints start to occur and the exercise above doesn't help enough, we advise getting in touch with a registered pelvic floor therapist. He/she can take measurements and give you personalised exercises which are aimed at proper cooperation of all the core muscles.
You can start 6 weeks after giving birth with the Mom in Balance Back in Shape workouts. You will work on an active recovery of your body and build up your physical fitness. The workouts are given by expert trainers and have been developed in cooperation with gynaecologists and pelvic floor specialists. This way you are sure you are working out in a responsible way. Moreover, challenging outdoor workouts will ensure that you will feel physically strong and energetic again!View our workouts