Many women complain that it’s difficult to get their pre-baby bodies back after pregnancy, especially around the midsection. If you can relate, you’re not alone. The cause of that nuisance belly pooch could be diastastis recti abdominus (or just diastasis recti), which is not an uncommon postpartum condition.
What is it?
During pregnancy, the muscles of the abdomen tend to stretch apart and away from the middle. This muscle group is called the rectus abdominus, also known as the “six-pack” abs. The tissue that holds the muscles together in the midline (called linea alba) weakens during pregnancy, and with increased pressure within the belly, the muscles tend to weaken and separate. They usually come back together in the midline after pregnancy, but when they do not, it’s called diastasis recti abdominus.
It is usually diagnosed by a clinician who palpates, or feels with his or her hands, how much separation there is between the muscles at the midline of the belly above the belly button. This should be measured while lying down so the muscles are relaxed.1
What causes it?
Well, the cause is pretty obvious, but no one knows for sure why it persists in only some women after giving birth. Risk factors (things that may make it more likely) such as number of children, increased maternal age, and weight gain have been discussed, but again, there is not much data to support these.2
In a recent study, 60% of women who had given birth to their first child had diastasis recti at 6 weeks postpartum. Even still, 33% of those women had it one year after giving birth. Other studies support a lower prevalence at 6 months, but because diastasis recti is not always measured the same way, it’s hard to tell which numbers are more accurate.2
Does it put me at risk for anything else?
Diastasis recti is not a hernia, so there is usually no risk of injury to the internal organs. (The linea alba, that tissue that weakens and allows the muscles to separate slightly, stays intact. If the linea alba tears, there is more risk.)1 You can learn more about hernias in pregnancy here.
However, women with diastasis recti tend to have other aches and pains, such as pelvic pain or low back pain. It’s possible they may all be related, since a weak core (which includes the abdominal muscles) may contribute to back problems.
What can I do about it?
According to the experts, prevention is key. Exercise that engages the core before and during pregnancy can help strengthen the rectus muscles and make them less susceptible to diastasis recti. However, there is no standardized protocol for such exercise – another area where we need more research. If you’re pregnant or thinking about becoming pregnant, ask a professional about core exercises that are safe. It should be noted that although you can find plenty of suggestions online, it’s always wise to consult with a doctor and/or physical therapist to help you sort through all of them.
If prevention (exercise) before or pregnancy didn’t work for you, don’t despair. Recent studies suggest that very specific, targeted exercises with the core muscles can help bring the rectus muscles back together and repair diastasis recti.3 See the previous note about asking an expert for help before beginning. The last thing you want to do is make it worse!
If all else fails, surgery may be an option for those with severe diastasis recti that gets in the way of day-to-day living. Surgical repair is usually similar to the type of surgery for hernias, but it’s not clear which type of surgery is best.1
In summary, diastasis recti is a common problem and may be contributing to lots of stubborn mommy pooches out there. If you have questions about the condition of your own abdominal muscles, the best place to start is a visit with your own doctor.
- Mommers EHH et al. The general surgeon’s perspective of diastasis rectus.
- Sperstad SE et al. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain.
- Geeta S, Lobo T, Keller L. Postnatal Exercise Can Reverse Diastasis Recti.