Abdominal Separation [and what to if you have it or suspect you have it]

Hey there,

There are SO MANY things I wish women knew about pregnancy that simply aren’t talked about nearly enough. Pelvic floor health, the postpartum period, perinatal anxiety, your choices during birth, and perhaps really important [to me as a yoga teacher] is sharing the RIGHT movement for your body.

There’s something called diastasis recti (DR) that occurs for many women [and I might argue all] during pregnancy, especially towards the end of the third trimester. Diastasis recti means “abdominal separation.” It occurs when the connective tissue, known as the linea alba, between the two sides of the rectus abdominis (the “six pack” muscles) is stretched. During pregnancy, our bellies and the linea alba naturally stretches to accommodate a growing baby. See figure below:

diastasis during pregnancy.jpeg

After giving birth, we want to encourage the rectus abdominus to start to knit back towards one another, decreasing the stretch of that linea alba. Some women experience greater degrees of separation during pregnancy and postpartum. While this is a common experience, living with DR is NOT normal and also not healthy. Why? Because you may experience:

  • Chronic low back pain'

  • Incontinence

  • Lack of core strength

  • Lack of stability in your pelvis and pelvic floor

And, because the linea alba is so stretched, there is only stretched connective tissue/skin to protect your internal organs, rather than your core muscles.

While I do believe that most (if not all) women experience some degree of abdominal separation during pregnancy and initially postpartum, there are postures in yoga and physical fitness that can exacerbate it, and ones that can minimize it, too.

During Pregnancy:

  • When your belly starts to become noticeable, STOP the planks, crunches, bicycles, anything that puts pressure on the abdominal wall. You’ll know you’re contributing to DR when your belly “cones” or “shark fins” in the center. That’s skin pushing through the abdominals. Core work is important during pregnancy, so try deep breathing and modified side planks to engage the obliques - not the rectus abdominis muscles.

  • Let go of deep backbends in pregnancy. Heart opening is lovely and stretches the chest and the shoulders, and is especially helpful as the breasts become heavier. However, postures like wheel, full camel, even too much of cat posture (from cat/cow) stretch the belly and linea alba way too much. Protect this area with light heart opening postures - if you can feel a stretch across the top of your belly (and definitely the bottom), you’ve likely gone too far.

During the Postpartum Period:

  • See above! Refrain from “core work” like planks, crunches, etc. and refrain from deep backbends, even if your care provider has confirmed you are ready for “exercise.” Rebuilding core strength slowly and taking into account the massive changes your body has experienced will encourage stable and long lasting healing/strength.

  • A few days postpartum, start practicing belly breathing. While seated on a chair or cushion, or even lying on your back, sit up tall, close your eyes, and place your hands on either side of your abdomen. Inhale to feel the belly expand a bit, and as you exhale gently encourage the rectus abdominis towards one another with your hands. Emphasis on gently. As the weeks go on, start to deepen your breath, taking longer inhales and slower exhales. You’ll start to “turn on” your core muscles slowly. Try for three minutes, five minutes, maybe even 10 if you have it.

  • Six - eight weeks postpartum, try pelvic tilts. While lying on the floor, bend your knees so the soles of the feet are in contact with the floor. Relax. Notice the space in between the low back and the floor. Place your hands at your hip points. Take an inhale, and as you exhale, gently scoop the pelvis up so your low back presses into the floor (do not lift the hips to do so). Inhale to release. Try five times, then 10. Taking breaks and repeating. This should feel subtle, but enough that you start to feel muscles working that had been dormant for awhile!

I cannot emphasize enough how important it is to take it slow postpartum. Prioritizing your healing and a rehabilitation of the core, rather than how quickly to strengthen and tone it, will be much more beneficial for your body. Re-entering into exercise, especially high impact, too quickly can worsen diastasis recti and cause issues like incontinence and prolapse. Think tortoise, rather than the hare, during the postpartum period.

As always, I do love reading your stories. Have you experienced DR? What did you do to heal your abdominal separation? I learn a great deal from you and the students I work with in class. If you’re still seeking support, please find a Pelvic Floor PT to assess your DR, or contact me to create a therapeutic postnatal yoga program. Yes, I am in Rhode Island, but we can also work together via Zoom/Skype! I hope this is helpful to you, dear mama.

With love,