When I was pregnant with my first baby, I was sure I would revert to my pre-baby self postpartum. After all, I was a lifelong athlete and maintained a healthy and active pregnancy.
But there I was—months postpartum—when I never felt anything like my old self. Although the number on the scale matched what it was before I was pregnant, I couldn’t say the same about my physical appearance or abilities. I still have a small lump, but beyond that, my stomach muscles are so weak that I can barely get out of bed.
I never thought my body would look and feel like this in these months after giving birth, and I started to worry. Is this my new normal after baby? Can I do heavy lifting in CrossFit again? Or even find the core strength to do a push-up?
After doing some research, I discovered that what I was experiencing was not normal. My weak abs and protruding belly are symptoms of abdominal muscle separation known as diastasis recti.
What is Diastasis Recti?
Diastasis recti is a common condition that occurs when the connective tissue that holds your rectus abdominis muscles (aka your six-pack muscles) separates. This separation is not painful, but it can lead to many unpleasant side effects, including abdominal discomfort, abdominal bleeding, lower back pain, and urinary incontinence—symptoms that are acceptable of birth parents as postpartum body standards.
This condition affects 60% of birth parents and usually clears up within eight weeks after delivery. However, about 40% of those affected by diastasis recti continue to experience symptoms six months after giving birth—and possibly longer. These lingering symptoms are not only unpleasant, but they are also uncommon.
According to Becca Sanders Fung, DPT, a certified prenatal and postpartum physical therapist in San Fransisco, California, “Many birth parents are told it’s normal to have a dog around their midsection or even incontinence when you laugh or run after baby. Although these things are common, they are not normal and are signs of an underlying dysfunction.” Because diastasis recti itself is painless, many birth parents assume that the belly and weakness are a normal part of their new-parent physique.
Although often confused, Diastasis recti is different from a hernia, and both require unique treatments. While the separation of the abdominal muscles indicates diastasis recti, the wall fascia (the connective tissue under the skin) remains intact. In a hernia, an actual hole or defect is formed in the fascia and requires surgery for complete closure.
How to Tell if You Have Diastasis Recti
This quick trick can be done after both cesarean and vaginal deliveries to determine whether or not you are experiencing abdominal separation.
Lie on your back with your knees bent and your feet flat on the floor. Slowly lift your head into a crunch-like position (keeping shoulders on the floor) and use your fingers to check for separation. Depending on your finger widths (two, three, or more) will determine how wide the separation is within your abdomen.
How to Prevent Diastasis Recti
My new and unfamiliar shape left me confused and frozen, unsure of what would make my abs stronger and what would make the separation worse. But Fung assured me that all hope was not lost.
“Newborns will definitely get stronger abs and bodies post-baby. It will also help them feel more confident in their daily activities—whether it’s running or lifting their weights. son,” said Fung.
However, a lack of information can lead to new parents unknowingly making the separation worse instead of better. “Traditional core exercises, like crunches and sit-ups, generally won’t flatten your abs if you have diastasis recti,” he explains. “Without proper progression back to strength, many ab exercises can exacerbate abdominal separation by putting pressure on your abdominal connection.”
However, not all hope is lost. With proper strengthening exercises, good body mechanics, and avoiding activities and exercises that put pressure on the separation, expectant parents can heal their abs and get back to their favorite prebaby activities.
If you’re hoping to avoid diastasis recti during pregnancy, Fung shares some professional tips to help guide your muscle-strengthening routine to make sure it’s effective.
Tip: Avoid Crunches While Pregnant
Crunches are one of the most popular abdominal exercises, but it is best to avoid them during pregnancy. Crunching or piking puts pressure on the linea alba—the connective tissue that holds your abdominal muscles together. This tissue is already under stress from 40 weeks of growing a baby, and extra stress can increase the chance of tearing the tissue and developing diastasis recti.
Tip: Strengthen the Deep Core and Gluteal Muscles
Just because you should avoid crunches doesn’t mean you have to completely ignore your core. Instead, focus on deep core muscles, such as transverse stomach and pelvic floor muscles. The transverse abdominis acts as a corset by supporting the core and reducing stress on the abdominal connection. Strengthening the gluteal muscles also adds support to the outside of the pelvis. (Bonus: Working these muscle groups during pregnancy can help production and delivery.)
Tip: Roll Out of Bed
Instead of sitting up to get out of bed in the morning (or post-pregnancy nap), start rolling. To do this effectively, roll onto your side, then push up with your arms to get off the bed. Although it may seem like a small change, the change goes a long way toward reducing the stress on your abs.
Tip: Use Active Posture
We’ve all witnessed the “pregnant woman’s move,” with the hand behind the back and the navel protruding forward. This posture actually puts extra strain on your abs by pushing your stomach forward. A better way to stand is included active posturemake sure your shoulders are back and your head, spine, and pelvis are aligned (and, therefore, so is your midline).
Tip: Commit to a Rehab Program
Labor and delivery cause trauma to the body, and we need to recover in a focused and directed way—just as we do with other injuries under the care of a physical therapist. Finding a expert-guided ab-rehab program will be important in strengthening the postpartum ab muscles. Find something that specializes in postpartum recovery that you can trust and commit to.
What about C-section Delivery?
Regardless of how the baby was brought into the world, diastasis recti is a risk factor for all expectant parents. However, during a C-section, your muscles are stretched out more than usual because during surgery, doctors usually separate the muscles along the abdominal wall to access the baby as opposed to cutting into the muscle, thus creating more separation. There are different schools of thought on sewing the abdominal muscles back or allowing them to heal on their own (sometimes, it just depends on your individual autonomy).
Before jumping into a postpartum workout routine, it’s important to let your body heal for at least six weeks after surgery (some birth parents need more than 12 weeks) and discuss a safe and appropriate plan with recovery with your health care provider or OB-GYN.
While taking steps to prevent diastasis recti during pregnancy is ideal, it’s never too late to heal your body. Whether you are six months, six years, or even 16 years postpartum, there is a way to train your body and abdominal muscles to be strong again. If a professional athlete sprains their ankle, we don’t expect them to limp forever. Similarly, when a birth parent has a baby, they shouldn’t expect to have a weak core and abdominal separation forever. Both just need proper therapy, guidance, and exercise—and both can be cured.
