During pregnancy and postpartum, the human body undergoes a wide range of changes. The abdomen rearranges organs, shifts ribs, creates a new ligament to support the growing belly and uterus, and in some cases, the abdominals separate to accommodate the changes. This abdominal separation is called “diastasis recti”. Diastasis recti can occur in both men and women and is not pregnancy-specific, although pregnancy is a time when it is most evident.
So what is diastasis recti?
- Diastasis recti is the partial or complete separation of the rectus abdominis, or “six-pack” muscles, which meet at the midline of your stomach.
- A diastasis can occur anywhere along the midline, around, above, or below the belly button. It can appear as a gap, protrusion, or dome on the belly.
- It can be difficult to know if you have a diastasis recti at a glance, as skin and fat can obscure it visually. The most telltale signs are doming or coning along the front of the abdomen, a visible gap or space around the belly button, or a bulging belly lasting long after pregnancy.
How common is it?
- Some studies suggest that up to 60% of pregnant people experience some degree of abdominal separation.
- While abdominal separation is common, it can be minimized with proper care and trained support people.
- It may be minimized or prevented during pregnancy with deep belly breathing and pelvic floor engagement techniques used during exercise, daily movements, and labor.
- Diastasis recti is widely underdiagnosed as many providers never check or provide adequate resources, but it can be treated years after occurrence.
What’s the big deal?
- Diastasis recti can contribute to back pain, bloating, distended belly, organ prolapse, constipation, and incontinence due to a lack of support of your internal organs and pelvic floor.
- The linea alba, the connective tissue at the midline of the six-pack muscles, contributes to optimal function and protection of the internal organs, along with the diaphragm and pelvic floor. When this tissue is separated, the internal organs can push forward and cause dysfunction.
How to self-check?
STEP 1. Lay flat on your back, knees bent with feet on the floor. Bring your hands behind your head for support. Take a big inhale and allow your belly to relax.
STEP 2. On the exhale lift, your head and shoulders off the floor slightly, while engaging your abdominal muscles as if you were doing a crunch.
STEP 3. Take a look at your belly. Leave one hand to support your head as you take the other hand to the belly and feel around the belly button and up and down the midline.
STEP 4. Use your fingertips to feel for separation. You may feel softness or tension along the area around your belly button or midline. Use your fingertips to feel for space between the centerline of the six-pack muscles. If there’s separation beyond 1 or 2 fingers width, it is likely that you have a diastasis recti.
Your OB/GYN or Midwife can check you for a diastasis at your six-week postpartum visit. Not all will offer it as part of the check up but you can request it. If you or your care provider feel that you have a deeper degree of separation, you may wish to seek out a trained pelvic floor occupational therapist (OT) or physical therapist (PT) to assess further. There are trained pre/postnatal fitness instructors who can support your recovery as well. If you do seek out a fitness trainer, verify that they have the proper education to support your postpartum and diastasis recti recovery. Fit For Birth is a highly knowledgeable organization to search for a trainer. In extreme cases, a surgeon may be necessary to repair the muscles if physical therapy and/or fitness are not enough.
If left untreated?
- If left untreated, a mild diastasis may resolve on its own with proper precautions taken such as engaged belly breathing with pelvic floor engagement or gentle exercise.
- A severe diastasis recti left untreated can cause serious physical discomfort such as urinary or rectal incontinence, pelvic organ prolapse, severe back pain, and physical discomfort as well as the emotional toll of these conditions.
A diastasis recti diagnosis may feel daunting at first. But remember, your body is amazing and was able to create this needed space to grow a human being. It may take time and commitment to heal, but you have the tools and support at your fingertips - literally! Even if you are years postpartum, it is not too late to diagnose and heal a diastasis recti.