During pregnancy, your body has many ways of surprising you – strange food cravings, back pain, and skin colour changes are all part of the pregnancy parcel. One of the more surprising changes is how your body adjusts to accommodate your baby. Most pregnant women look forward to seeing their belly grow, but are not as excited to find out their abdominal muscles might separate as a result. Abdominal separation during pregnancy (diastasis recti) affects about 1 in 3 mothers, and most aren’t aware they have it, or how to treat it.
Abdominal Separation During Pregnancy
Here's everything you need to know about abdominal separation during pregnancy.
What Is Diastasis Recti?
Abdominal muscle separation is technically called diastasis recti, and is caused by internal abdominal pressure. While it’s common during pregnancy, it can also be found in children and other adults.
During pregnancy, as your baby grows, the uterus pushes against the abdominal wall. Pregnancy hormones allow the connective tissue to relax and soften.
As this pressure increases, the right and left sides of the rectus abdominis (the ‘six pack’ muscles) begin to widen at the linea alba, which is the connective tissue where your abdominal muscles meet. The muscles don’t tear or rupture, but a gap occurs between them.
Usually the separation occurs in the third trimester but can also happen after pregnancy, when the abdominal wall is weakened and there isn’t a baby inside to support the muscles.
During pregnancy, there are a few symptoms of diastasis recti – mainly feeling a gap, or even a bulge, on either side of the midline of your belly.
After pregnancy, symptoms can include:
- Lower back pain
- Pelvic pain
- Leakage of urine when coughing or sneezing
Abdominal separation during pregnancy can lead to further issues, such as hernias, and a protruding pregnant-looking belly. Many women don’t have any symptoms but find no amount of exercise and dieting can improve their belly. Exercising with diastasis recti means you could be relying on other muscles to do the work your core should be doing. Over time, this instability could lead to injury.
Who Is At Risk?
Diastasis recti is very common in pregnancy. It’s believed around 70% of women will experience it to some degree. Women who have a direct relative who experienced diastasis recti are more likely to have it themselves.
Risk factors before pregnancy can include:
- Previous pregnancy causing muscle separation
- Multiple pregnancy
- Being overweight or obese
- Petite frame
- Pronounced swayback
- Poor abdominal muscle tone
Factors during pregnancy which can cause separation:
- Poor posture
- Incorrect exercise, particularly heavy core exercises such as planks, crunches, burpees and push-ups
- Being pregnant with multiples
- Daily activities
- Becoming pregnant again soon after a previous pregnancy
How Do I Know I Have It?
You can check, at home, whether you have a diastasis recti separation, or you can ask your GP, midwife or women’s health physiotherapist.
To check at home:
- Lie on your back with your knees bent at a 45-degree angle. Make sure your pelvis is not tucked, and your spine is relaxed. Practise taking some deep breaths from your diaphragm
- Contract your pelvic floor muscles (as though stopping the flow of urine) and exhale, then lift your head, tucking your chin towards your chest
- Starting just below your rib cage, walk your fingers down towards your belly button. If there is a gap in the abdominal muscles you should be able to feel the area where they separate (if you get fatigued, stop and rest, and start again from step 2)
- Push the space where you can feel a gap. Diastasis recti will feel soft and spongy, not strong and tight.
Separation of the muscles is measured by the number of finger spaces that fit between each side of the rectus abdominis muscle. Two or more finger spaces is considered diastasis recti.
Can Diastastis Recti Be Prevented?
Separation of the abdominal muscles during pregnancy can be minimal, and return to normal after the birth of your baby. If you want to reduce the chances of a diastasis recti occurring, there is a number of things you can address.
If you have a diastasis recti from a previous pregnancy, seek help with closing the separation as soon as possible. You can reduce your chance of another separation, or increased diastasis recti, in subsequent pregnancies
Before pregnancy, ensure your posture is correct. Poor posture becomes a habit and leads to instability of the core muscles. Any exercise training you do should be done correctly, and involve correct core training. Be aware of the effect your weight has on an increased risk of a muscle separation.
During pregnancy, correct poor posture; over time it can lead to weakened abdominal muscles and back pain. Pregnancy-specific strength and postural correction exercises can help.
Be aware of your posture during daily activities, such as pushing a shopping trolley or a pram. Rather than pushing through your arms and shoulders, you should be letting your legs and glutes do the work.
Avoid exercise training activities that place more internal pressure on the abdominal walls, such as planks, crunches and push-ups. Seek out a trainer or an exercise program that is specific for pregnancy, and ensure these exercises are not part of the routine.
How To Treat Diastasis Recti
If you are dealing with Abdominal separation during pregnancy, it can be hard to know which are the right exercises to do. There is so much information on the Internet that it’s a good idea to seek the advice of your care provider, or someone who specialises in women’s health physiotherapy.
Smaller separations tend to decrease easily with exercises you can do at home, but it’s important you choose a program that is reputable and has been designed by someone who is experienced in corrective exercise.
Abdominal muscle separation is a common occurrence during pregnancy, as your uterus and abdominal wall expand to accommodate your growing baby. With mindful attention to your body posture, and correct exercise, you can limit the extent of separation. If you do have any muscle separation, recovery after your baby is born is important. Speak to your care provider about being referred to the support services which can best help you.
Recommended Reading: 7 Great Times To Do Your Pelvic Floor Exercises.