What is Diastasis Recti?
If you are pregnant or postpartum and your stomach seems to be protruding more than normal, you may have diastasis recti. Diastasis Recti is a common condition in pregnancy, affecting approximately 30 percent of women, in which the abdominal muscles widen causing the stomach to stick out or create a bulge. Although in many cases the abdominal separation will resolve on its own, it is important to identify the condition so that you do not engage in any activities or exercises that may worsen the separation. Here’s everything you need to know about Diastasis Recti and pregnancy and what you can do to heal it.
What causes Diastasis Recti?
Diastasis Recti is the result of a combination of the uterus growing and putting pressure on the abdominal wall and pregnancy hormones that cause softening of the connective tissue. When the abdominal muscles are stretched, the uterus, bowels and other organs are left with only a thin layer of tissue to hold them in place. This results in the stomach bulging out. You are more likely to suffer from Diastasis Recti if you have had multiple children, have large babies or are having multiples. It is also more common over the age of 35.
How does Diastasis Recti affect pregnancy?
While you may not be bothered by a protruding stomach during pregnancy, the symptoms of Diastasis Recti can be uncomfortable and impact your daily life. This condition occurs when the abdominal muscles separate along the midline, weakening core support. Common symptoms include back pain from lack of stability, difficulty breathing due to reduced core function, pelvic floor problems such as pressure or discomfort, urine leakage when sneezing or exercising, and constipation from impaired abdominal strength. In addition to these issues, Diastasis Recti can make a vaginal delivery more challenging since the body doesn’t have the same muscular support to aid in pushing. Over time, if left unaddressed, this separation can also affect posture, cause a persistent "pooch," and even increase the risk of injury during physical activity. In rare cases, the condition may progress to a hernia, which requires medical intervention. Recognizing these symptoms early is key to seeking the right treatment, such as physical therapy, core-strengthening exercises, or medical evaluation if necessary.
How do I know if I have Diastasis Recti?
To determine if you have Diastasis Recti, you can conduct a self-abdominal separation test. To do this:
Lay on your back with your feet flat on the floor and knees bent.
Place one hand behind your head and the other on your abdomen. Your fingers should be parallel to your waistline at belly button level.
Gently press your fingers into your abdomen.
Roll your upper body off the floor into a crunch sit-up.
Feeling across your midline, find the right and left side of your abdominal muscles and test for separation at, above and below your belly button.
You may have Diastasis Recti if:
You detect a gap that is more than 2.5 inches when your abdominal muscles are contracted.
The gap does not shrink as you contract the abdominal muscles.
There is a protrusion along the length of the midline of your abdomen.
What should I do if I have Diastasis Recti?
You may not recognize the presence of Diastasis Recti until after you deliver when your stomach seems to still protrude several months postpartum. At this point, what you do NOT do is as important as what you do do in healing your abdominal separation.
Do NOT strain your stomach muscles by lifting heavy objects or when constipated.
Do NOT do exercises that utilize your stomach muscles such as sit-ups, crunches, push-ups or planks.
Do NOT engage in any exercises on your hands and knees.
Although it may seem like a good way to restore your stomach strength after pregnancy, all of the above exercises and movements can actually worsen the degree of separation between the abdominal muscles.
While minor Diastasis Recti will likely resolve on its own over time, if you are concerned or are considering becoming pregnant again, seek the help of a physical therapist. A physical therapist can guide you through exercises that are safe for the condition and will aim to strengthen your traverse stomach muscles without further separating the outer abdominal wall. Exercises may involve a belly splint or Pilates and can be effective at reducing the separation. If the separation is too great and rehabilitation is ineffective, you can undergo abdominoplasty surgery to correct the problem.
Although Diastasis Recti may be unavoidable for many women, the best way to reduce your chances of it happening is to strengthen your abdominal muscles before becoming pregnant. Strong core muscles going into pregnancy will be less likely to separate due to the pressure of the growing uterus. It should be noted though that ALL women will experience some degree of diastasis in their third trimester as the baby grows. For questions about Diastasis Recti, pregnancy or natural childbirth, contact Twin Cities Birth Center for an appointment through our website here.