Oh motherhood… When we enter the amazing journey of carrying, birthing and raising a child, we learn many terms that we’d be previously unable to define… Like perineal tear, sitz bath, and for many of us, unfortunately, also diastasis recti or (DRA).
What the Heck is Diastasis Recti?
From a medical perspective, (according to the Mayo Clinic):
During pregnancy, the growing uterus stretches the muscles in the abdomen. This can cause the two large parallel bands of muscles that meet in the middle of the abdomen to separate — a condition called diastasis recti or diastasis recti abdominis. Diastasis recti might cause a bulge in the middle of the abdomen where the two muscles separate.(1)
In mom terms, it is that frustrating post-baby pooch that doesn’t go away when the baby weight does and often leads to the “when are you due” question while you are holding your two year old. (Not speaking from experience or anything *ahem*)
It is the thing that can keep jeans fitting incorrectly even when you are the same size/weight as pre-pregnancy, and at the extreme, diastasis can be connected to abdominal pain and even pelvic problems.
From my personal experience, I’m grateful to friends who first told me about the condition years ago and shared the resources that helped them fix it.
See, post baby pooch and the pee-when-you-sneeze syndrome that can accompany it, are not often topics of everyday conversation among moms. We share advice on potty training our children, but are more hesitant to open up about the abdominal, urinary, and pelvic problems that can come postpartum for many of us.
In fact, there is a good chance that many of us struggle with this condition in some way, since statistically 98+% of women have a diastasis after delivery (2). It seems that diastasis can be more common the more pregnancies a woman has (I can attest to this) or if she has had multiples or already has an underlying abdominal problem.
It is also important to note that while diastasis recti is more common in pregnant women, it is actually related to internal abdominal pressure, which pregnancy increases, but not specifically *caused* by pregnancy. For this reason, men and children can suffer from a separation as well, especially after a surgery or injury. (This video explains more)
Thankfully, diastasis recti has gotten some recognition lately, and there are now some great resources that can help remedy a slight diastasis.
Since I’m currently carrying my sixth baby, I’m going to be prepared postpartum this time and I’m passing on the wonderful advice I received that helped me discover my own diastasis…
How I Discovered My Diastasis…
During my pregnancy with my first child, I continued doing abdominal specific exercises like crunches because I thought it would actually help my body stay fit and recover more quickly after pregnancy.
Turns out, it did the opposite, and I noticed after that pregnancy that my stomach didn’t ever regain it’s previous “flatness” (again with the medical terms…). I also learned from my personal trainer brother-in-laws that exercises like crunches are not even that effective at increasing core strength. They recommend body weight exercises, kettlebells, and pull-ups, and their six-packs seem to speak to their effectiveness, but even these exercises can do more harm than good during pregnancy.
After I learned what diastasis was, I completed a self-check to see if I had it. According to Fit2b:
diastasis is a gap of more than 2.7 centimeters between the ab muscles
This is often documented by a gap of 2-3 fingers in an at-home check. As any pregnant woman who has been checked in labor can attest, “centimeter” measurements can vary greatly by finger size of the person checking, so this isn’t an exact science but a rough way to gauge a potential problem.
This article has excellent instructions and a video that explains how to self-check for a diastasis, and their graphic shows the potential types of abdominal separation that can occur:
Emily of Holistic Squid explains the basic steps of checking for a diastasis:
Lie on your back with your knees bent, feet flat on the floor
Place your fingers with the palm facing you on your belly button
Lift your head and neck just slightly off the floor while you press down with your fingers. If there is a gap, that is the diastasis
Conduct the same test just above your belly button and just below the belly button (as the gap can measure differently in these places) (3)
This video also gives a visual demonstration of the process:
What to Do About It?
Unfortunately, dealing with diastasis recti isn’t as simple and straightforward as many natural remedies are.
From what I’ve read and the programs I’ve used, many smaller separations can be helped at home with specialized exercises (these are what helped me) but severe cases can sometimes need a physical therapist or even surgery.
For me, exercises were enough in past pregnancies, though I had to rely on YouTube videos and exercises that friends had shared. Now, there are several specific programs created by DRA experts, and I’ll be using these after this little one arrives. In fact, many of you have recommended these programs in comments and in social media (if you’ve used either one, please let me know in the comments and share your experience!)
Fit2b: A family-friendly workout membership that has specific videos for diastasis. I’m planning to use this one postpartum, but there are also some great resources for children’s fitness and the whole family.
MuTu: A 12- week focused program that addresses Diastasis as well as other pelvic health issues.
The Tummy Team: A great resource for abdominal splints and programs designed to help even severe diastasis issues.
There are also some great YouTube videos that help with the basics of diastasis recti repair. According to Pre and Post Natal Corrective Exercise Specialist Lorraine (who runs the top pregnancy exercise website in New Zeland), breathing exercises and isolating the transverse abdominal muscles are the firs step in resolving the issue.
She explains the breathing and muscle isolation exercises in this video:
Diastasis: What to Avoid
As with many aspects of nutrition, sometimes what you avoid can be just as important as what you do…
Sources agree that many exercises specifically targeted at core strength should actually be avoided if a person has an abdominal separation. Movements like crunches, sit-ups and planks can actually make things worse instead of better:
Doing a standard crunch or sit-up is generally not recommended for postpartum women, especially when we know a diastasis recti or DRA is present. This is because the way a crunch is generally performed has the effect of severely increasing intra abdominal pressure, pushing your organs outwards against or through the gap, and downwards onto the pelvic floor – directions you really don’t want your organs forcefully heading.(4)
In fact, even if you don’t have diastasis recti, recent research suggests that isolation exercises like sit-ups and crunches are hard on the back and not effective anyway (Harvard Health agrees).
Diastasis Recti and Pregnancy
This is the question I’ve always had…
Since the large majority of women have a DRA after delivering a baby, and since pregnancy and pushing make the problem worse, is there anything that can be done to help stop the problem to begin with or avoid it during pregnancy?
I was unaware until this pregnancy that it is actually possible to check for and work on a separation during pregnancy and it may even be easier to detect at this time.
I found this Q&A about diastasis in pregnancy very helpful. In short, pregnancy doesn’t actually cause the separation, abdominal pressure does, but pregnancy of course often contributes to this pressure.
There have been cases of women who were able to reverse a separation during pregnancy, and there are steps that can help during pregnancy, including:
Avoiding any movement like a crunch or situp that isolates the abdominal muscles
Avoiding “rib thrusting” (here’s what it is and how to avoid it)
Laying down and getting up with correct posture to avoid strain on the core (this explains how)
Focusing on comprehensive movements like squats (with proper form!) to help strengthen the body correctly (this tutorial was very helpful to me)
Does a Splint or Binder help?
Sources seem to be divided on this subject. From my personal experience, a split helped a lot immediately post delivery and for a few weeks in conjunction with approved exercises once I was allowed to do them.
My midwife in past pregnancies and the Fit2b program recommend tummy splinting, especially in the short time after delivery. The Tummy Team website has some great articles and resources that address the potential benefits of splinting.
The MuTu system offers a different perspective, suggesting that splinting does not actually help the abdominal muscles reattach and that it may impede the body’s ability to resolve the issue correctly.
With research and sources divided, this is an issue that I personally spoke to my own midwife about before making a decision. Like I said, in the past, a splint greatly helped my postpartum pain and healing, but I used it in conjunction with exercises and had good results.
When to Seek Professional Help?
I have several friends who benefitted from seeing a physical therapist for a short time to address their specific diastasis recti problems. I haven’t done this personally, but absolutely would if I had a severe separation. To find a therapist who specializes in DRA problems, go to The American Physical Therapy Association’s website and choose “women’s health”.
Recommended Diastasis Resources
Is Diastasis To Blame for my Belly?
Befitmom Tutorial and Exercises for Diastasis
Do You Have a Diastasis?
Crunches, Curl-ups and Diastasis Recti
Good review of the Tupler Technique– another possible solution
Pregnancy Q&A about Diastasis
Under Pressure from Katy Says- Part 1 and Part 2
Fit2b System (paid subscription fitness program)
Mutu System (12-week paid course)