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Still Look Pregnant Months After Giving Birth? You Might Have This Condition

December 14, 2021

If you still look pregnant or experience abdominal pain weeks or months after giving birth, you might be suffering from a condition called diastasis recti, or abdominal muscle separation. 

What Is Diastasis Recti?

The abdominal muscles are like an internal corset tied together by connective tissue. As the uterus expands during pregnancy, the corset loosens to allow room for your baby to grow. Weight gain and hormonal changes cause the connective tissue to relax and the muscles surrounding the abdomen to separate, also known as diastasis. 

Nearly all women experience diastasis during pregnancy, and as many as 50 percent of them will still have some degree of separation weeks to months after giving birth, research shows. If that separation is greater than 2 centimeters, you may be experiencing diastasis rectus abdominis. 

Diastasis recti can come with visible bulging or doming at the center of the abdomen that appears with certain movements, with some women saying they still look pregnant long after giving birth. 

Think you might be experiencing diastasis recti? Try this:

  1. Lie on your back.

  2. Place two fingers parallel to the belly button with your fingers pointing toward your pelvis.

  3. Curl up as if doing a crunch.

  4. Feel for a separation in the abdominal muscles near the center of your abdomen.

  5. You can repeat these steps along the center line of your abdominal muscles both above and below your belly button. 

Physical Effects of Diastasis Recti

Your core is made up of the abdominals, back, hips, pelvic floor and respiratory diaphragm. When one of those core elements is compromised, there is more strain on the other areas. 

While some women experience strictly cosmetic side effects, if left unaddressed the lack of abdominal support and decreased trunk muscle strength can result in:

  • Back or pelvic pain

  • Incontinence

  • Prolapse

  • Difficulty performing everyday movements

  • Decreased stamina and stability when returning to regular exercise 

Physical Therapy Treats Diastasis Recti

In the early weeks postpartum, exercises as simple as sit-ups, curls and planks can make diastasis recti worse, so performing the right movements is crucial to recovery. Your doctor may recommend physical therapy to help close the gap between your abdominal muscles. 

The primary goal of physical therapy is to teach patients how to properly and safely use their core, hips and pelvic floor to avoid injury. The abdominal muscles are comprised of multiple layers, and most people are only taught how to engage the most superficial of those muscles, the rectus abdominus. 

A physical therapist specializing in pelvic floor therapy can aid in carefully retraining the abdominal muscles beginning with the deepest layer — the transverse abdominis — and progressing to other muscle groups such as the internal and external obliques until you can more easily perform functional activities. 

These deeper muscles are essential to reducing pain, narrowing the waistline and stabilizing the spine, ultimately allowing you to safely return to your desired level of activity. Your therapist will also focus on teaching you to breathe through movement, as holding your breath increases intra-abdominal pressures. 

Many women may also benefit from physical therapy during pregnancy if they are experiencing back pain or pelvic girdle pain. A physical therapist can offer strategies for pain management, limiting or reducing the progression of the diastasis recti and information on support garments. 

Is Diastasis Recti Preventable?

While there is no way to prevent diastasis recti, deep core support is essential to recovery. Experts have found that this condition is made worse by factors like carrying multiple babies or excessive weight gain, and women who lack good baseline core strength may be more likely to develop diastasis recti. 

Regular exercise and maintaining good pelvic floor and hip strength throughout pregnancy can help you rebound more quickly. Working under the guidance of a pelvic floor physical therapist has also been shown to reduce the risk and size of the diastasis. 

If you’re feeling the separation or struggling to lose your postpartum belly, considering talking to your physician about a referral.

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