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The postpartum body problem no one talks about

The baby bump is the visible proof that you are having a baby! As baby grows, so does the bump; then, after baby is born, the bump goes away. But what about bumps that stick around after pregnancy?

After delivery, some women notice an abdominal protrusion that seems to be more prominent when going from a lying to sitting position, or when using their abdominal muscles. This protrusion is often the result of something called diastasis recti or abdominal muscle separation.

What is diastasis recti
Your abdominal muscles are naturally pushed to the side during pregnancy because of your growing baby. For most women, the abdominal wall will resume its normal position; however, in a small percentage of women, the connective tissue does not pull the muscles back together. This leaves an abnormally-wide distance between the two longitudinal abdominal muscles, which are the same muscles that visibly protrude when someone has a "six-pack." Your abdominal organs (such as your intestines) can protrude outward, forming a bump when force is exerted in this area.  

Diastasis recti is different from a hernia, which is a when an organ (such as your intestines) protrude through an opening in the muscle and becomes trapped.  

What causes diastasis recti
In addition to your uterus pushing against your abdominal wall, pregnancy hormones can soften connective tissues between the abdominal muscles. Women who are most at risk are those: 

  • with multiple pregnancies
  • carrying multiple babies
  • with weak connective tissue that can be caused by certain medical disorders

What can be done about diastasis recti
Fortunately, it is only a cosmetic inconvenience and typically does not cause pain.  Before pregnancy, begin strengthening your core to prevent abdominal separation during pregnancy.

During pregnancy, no treatment is needed for women with this condition. There may be certain strengthening exercises you can do while pregnant to help prevent abdominal separation, but talk with your doctor or an exercise physiologist to create a plan for you.

Certain exercises after birth can be done to strengthen and reduce abdominal muscle separation. Occasionally, the area can improve spontaneously. Weight loss may also help. In severe cases, or when it is extremely bothersome or unseemly, surgery can be done to correct the connective tissue. You'll want to delay any surgical repair until you are done planning future pregnancies because there may be recurrence of the weakened muscles even after a surgery.

Undoubtedly, having a baby changes your body in many ways. Bumps can come and go. Diastasis recti may be one of those "bumps," but it is reassuring to know that it is common, most often not medically concerning and can be remedied.

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