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The postpartum body problem no one talks about

A 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 childbirth, 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  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 (including 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 intestine) protrudes 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: 
  • who have had multiple pregnancies
  • are carry more than one child  
  • have a medical disorder that causes weak connective tissue.

What can be done about diastasis recti?

Fortunately, this condition usually is only a cosmetic inconvenience and typically does not cause pain. Before pregnancy, you can begin strengthening your core to prevent abdominal separation during pregnancy.

During pregnancy, no treatment is needed. You may be able to do some strengthening exercises while pregnant, 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 and sometimes the area will improve on its own. Weight loss also may 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 a recurrence of the weakened muscles after surgery.

Undoubtedly, having a baby changes your body in many ways, but it is reassuring to know that diastasis recti is common, usually not a big problem and one that can be remedied.


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