Family health

Fixing my "mommy tummy" without surgery

Sixty-six percent of pregnant women have Diastasis recti in their third trimester. It doesn't go away on its own and can cause a host of medical problems. So why do so few women know about it?

By Kristin Auger
Fixing my "mommy tummy" without surgery

Photo courtesy of Kristin Auger.

The emails start flowing into my inbox, hours after I publish my last post.

The first is from a mom of three, an astonishingly fit woman approaching her 50s. She has been unable to get rid of her "baby belly", although the rest of her is hard and muscled.

"I think," she says, "that C-sections were rough when I had my babies. Maybe that's it. Maybe they pulled me apart and it never went back together." 

Another message comes from a mom of two.

"My baby is six," she says, "and just today I found I can stick my entire hand between my abs. My entire hand! How did I not know about this giant gap?" She went on to explain that she always wondered about the persistent back pain and weakness in her core, but never really knew why it was there.

Other moms at my son's school, strangers who have read my stuff for years, friends of friends and fellow moms at my gym have approached me after reading my post, wondering whether they have Diastasis recti. And if they do, why didn't their doctor ever tell them about it? 

New moms are often told to do kegels and are provided with treatment advice for C-section scars. We're given explicit instructions on postpartum care for our babies. Why has no one been telling postpartum women how to take care of themselves?

I understand that Diastasis recti is not a life-threatening illness. But, as my physiotherapist notes, the rectus abdomens is part of the system that supports the back, pelvis and the internal organs. If it's weak it can cause a lot of problems in future (back pain, incontinence, etc.) Many women have problems stemming from this and don't seek help until they have major problems simply because they didn't even know they had it. Also, Diastasis recti is a condition that's worsened by exercises like crunches and sit-ups — movements that postpartum women often do, ad nauseum, in an effort to improve their often ravaged bellies. I think those things alone make it something that doctors should acknowledge and address with women at their six-month postpartum appointment.  

But it's the emotional impact that worries me the most. So many women I've spoken with have been punishing themselves for years, berating themselves for still having a "pot belly" two years after their babies. They assumed their diet must be too sugary, their sit-ups too infrequent, their willpower too weak. They had no idea that their belly protrusions and back pain are directly related to the birth of their babies and that, with proper exercises, they can be improved and, in many cases, fixed.

Information on the Internet is vague and conflicted. Surgeons insist Diastasis recti can only be fixed via tummy tuck. Julie Tupler advises that her kit — including DVDs, books and a binding wrap — will teach us how to close a Diastasis recti. Other sites, like MuTu, are seemingly super-helpful, but ultimately want money. Some videos advise that planks will help a Diastasis, while other videos advise to run far away from anything plank related. It's overwhelming, frustrating and it makes me want to fix it.

I was fortunate enough to find an amazingly knowledgeable physiotherapist who specializes in women's health. Anniken sent me some information on Diastasis recti and it's the best I've read to date. 

Through her I've learned that:

1) 66 percent of women have Diastasis recti in their third trimester
2) 53 percent have it immediately postpartum
3) 36 percent (I'm included in there) remain so at seven weeks postpartum

If you have Diastasis recti at seven weeks postpartum, you will still have it at a year postpartum if it's left untreated. You should absolutely see a physiotherapist even if you are 10 years postpartum, or even if you have a very deep gap in your stomach that you just realized is there. Physiotherapy can help you even if your child is now 12 years old.

"Women with DRA are highly variable; some have a gap, but their muscles still function well enough to stabilize their spine," Anniken says. "Others are unable to stabilize." Of these latter women Anniken thinks most can be taught by a physiotherapist to stabilize through treatment, exercise and education — largely through core stability, recruiting the proper muscles and not cheating with the wrong muscles. Those that can't be retrained (where physic fails and the muscles just can't work with the separation there) need surgery.

I don't want surgery. I need to keep exercising because it brings me joy and a sense of community. I've been diligently performing the core exercises Anniken has prescribed for me. Though it feels like I am doing nothing and looks like I'm doing nothing — Corey has caught me "exercising" on the floor in the baby's room a few times and I suspect he thinks I'm napping with my knees up — after less than two weeks of core exercises, my Diastasis has improved and is visibly more shallow than it was just two weeks ago.

I can now feel firm tissue when I press on my mid-line, though I still have a lot of work to do. I've never been scared of hard work and I'm determined to reclaim my strength and to share with other women that they can too. In so many cases, there is an additional option to either live with a flabby belly and weak core or go under the knife for an expensive (and emotionally draining) tummy tuck. 

I'm going to give it a go and I'll report back to you, as always.

This article was originally published on May 03, 2012

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