Ab separation in pregnancy: Diastasis what now?

By Megan Storey | October 8, 2019

Are you pregnant, or have recently been pregnant? Are you now internet trawling trying to find out what this abdominal separation thing is everyone keeps telling you about? You’re overwhelmed and busy enough either preparing for, or experiencing, newborn life to worry about ‘how many centimetres is yours?’ And rightly so. But it is important to look after yourself, so you can get your strength back, and avoid issues down the track like bulging belly and back pain. So, here’s a quick run down of what ab separation is and how you can treat it.

diastasis recti imageWhat is an abdominal separation?

An abdominal separation, or in medical terms, a ‘Diastasis Recti’ (yes, we prefer the non-medical term too), is a separation of the abdominal muscles. This regularly occurs in women during trimester three of pregnancy and can also affect them post-pregnancy.

Picture your ‘six-pack’ or ‘Rectus Abdominus’ muscles. There they are in all their glory (maybe just in your head, and that’s OK) – pairs of muscles nicely lined up, down the front of your belly region. These strips of muscles are separated by a piece of tough connective tissue called the ‘Linea Alba’. So your body can expand during pregnancy, the Linea Alba widens. This creates a gap between the two strips of rectus muscles. This gap can be felt by lying your own hand flat on the abdomen. If a person can fit two or more finger widths in this gap, that person is said to have an abdominal separation. Please note this is a very rough guide. We always advise to get an experienced health professional’s opinion when testing this.

It’s also not just pregnant women who get this problem… Post-menopausal women, newborn babies and men can also develop abdominal separation.

What causes it?

Contrary to popular views, being pregnant is not the cause of this issue (remember, men & babies can get it too), although it is a contributor. It is caused by excessive increases in intra-abdominal pressure. Yes, having a growing uterus inside you can lead to increases in abdominal pressure, but so can pushing during delivery, straining on the toilet, and obesity. A newborn may develop this issue due to under-developed abdominal muscles, but this will usually resolve itself with time.

What does it mean if I have ab separation?

There is debate over what the side effects of having an ab separation are. Most commonly you may notice a bulge appear in your belly when you try to sit forward, stand up or lie down. Often described as a ‘pouch’. After pregnancy, you may be left with a bulge in the belly region that may give the impression you are still pregnant. Evidence for anything else is limited, but you may experience abdominal pain, postural issues, bloating or constipation. Not so fun! Many people believe having an abdominal separation increases the risk of pelvic or low back pain, but while we see this in our clinic, there isn’t any hard evidence supporting this claim. Having a separation could also impact your core stability, which could lead to other problems like breathing issues or low back pain.

Can it be treated?

The short answer is yes, but it may not have to be. Some minor abdominal separations require very little intervention. A more severe separation may well require the help of a trained physio (ahem, why hello there!) and giving of rehab exercises. It’s not just a simple case of doing a load of sit-ups or crunches to get those abs back. Sorry! Did you know sit-ups and crunches will increase your intra-abdominal pressure? So, these exercises are not a good idea at this stage as they could make things worse… But that’s not to say you won’t get back to them!

Rehab requires working on your pelvic floor and deeper abdominal muscles. We will also address any breathing problems you may have with breathing exercises, as getting your diaphragm muscle and ribs to function correctly is also very important.

It is not always straight forward and not every exercise will be suitable for every person with an ab separation, so we recommend you book an appointment to see us first. We will be able to assess you accurately and get you on the ideal program for you, as well as advise you on all the do’s and do not’s about movement, lifting and general exercise.