What is Diastasis Recti?
Diastasis recti, also known as diastasis rectus abdominis or simply diastasis, is a condition where the rectus abdominis muscles, often referred to as "six-pack abs," separate during and after pregnancy. These muscles run vertically along the front of the abdomen and are divided by the linea alba, a band of connective tissue. As the uterus expands during pregnancy, it stretches the abdominal muscles and thins the linea alba, causing it to spread apart. This process accommodates the growing baby but can lead to a widening of the gap between the abdominal muscles.
After childbirth, the linea alba is capable of “snapping back” much like a rubber band. This process is typically complete by 8 weeks postpartum. However, if the tissue has lost elasticity due to overstretching, the gap may not close fully, resulting in diastasis recti. This condition can cause a noticeable bulge above or below the belly button, making some women appear pregnant even months or years after giving birth - what some women refer to as a “pooch” or “mommy tummy”.
According to the Cleveland Clinic, other symptoms of diastasis recti may include:
A visible bulge or "pooch" that protrudes just above or below the belly button.
Softness or jelly-like feeling around your belly button.
Coning or doming when you contract your ab muscles (such as when you’re leaning back in a chair or getting up out of bed).
Difficulty lifting objects, walking or performing everyday tasks.
Pain during sex.
Pelvic or hip pain.
Low back pain.
Poor posture.
Urine leaking when you sneeze or cough.
Constipation.
Feeling weak in your abdominals.
Caring for DR weeks 0-8:
Anywhere from 60-99% of women will have some degree of DR during this period.
The goal in the early period is simply to rest your abdominals and give them a chance to heal on their own.
Avoid lifting anything heavier than your baby.
Log roll when getting out of bed - roll onto your side and use your arms to push yourself up.
Skip activities and movements that engage your abs - including crunches, sit-ups, planks or push-ups, downward dog, boat pose, double leg lifts, scissors, to name a few.
Do not suck your belly in - this puts pressure on your pelvic floor and can make symptoms worse.
Hydrate! It is so important for all aspects of healing and recovery.
Drink 1/2 your body weight (lbs) in ounces/day.
Caring for DR weeks 8 and onward:
Continue to follow the recommendations outlined above.
Know that DR is very common, about 40% of those who have diastasis recti will still have it by six months postpartum. Be compassionate with yourself and know that having DR doesn’t mean you did anything wrong. It is very difficult to predict who will get it and who will not. Luckily, it is very treatable. Often all it takes is a personalized regimen of home exercises to close the gap. A pelvic floor therapist can evaluate you and come up with a plan that takes into account your unique needs.
See blog, ‘Why every birthing person should see a pelvic floor therapist’ to learn about this valuable service and access directories to help you find a provider near you.
Self check for DR:
Wait 8 weeks postpartum.
Lie on your back with your knees bent and feet flat on the floor
Lift your head slightly, trying not to engage abs, just enough to look down at your belly, you can use your hand for support
Move your other hand above your belly button area, palms down and fingers towards your toes
Use your fingers to feel for a gap between the abs
See how many fingers can fit in the gap horizontally (left to right) between your right and left abdominals at your belly button, 3 inches above belly button, and 3 inches below. A gap width of 2 fingers or more = possible DR. You may have a gap in one location but not in the others, a gap greater than 2 fingers at any point is considered DR.
If you have a larger belly and overlying soft tissue makes it difficult to feel, your provider can use ultrasound to assess the separation.
Note: even if you are many years past your last pregnancy, you still have options for treating your DR, it is not too late.
