#301: "Abs" After Pregnancy


We all know how your body can surprise you with a change by adding a new habit in your life style or getting rid of one, and pregnancy has definitely give me the most surprises of all!! Weight gain, a sore lower back, breasts pain, migraines, skin changes etc… are all part for the nine-month course. So is a fairly harmless but undesired condition called diastasis recti.


Diastasis recti is a separation of the rectus abdominal muscles in the midline, more commonly known as your “abs.” Your abs are made up of two parallel bands of muscles on the left and right sides of your torso. They run in the center of your abdomen from the bottom of your ribcage down to your pubic bone. These muscles are joined to each other by a strip of tissue called the linea alba.

What causes it?

The pressure of a growing baby, helped along by the pregnancy hormone relaxin, which softens body tissue, can make your abs separate along the linea alba. This causes a bulge to appear at the center of your tummy. Some diastasis recti look like a ridge, but most cases are a classic pregnancy “pooch.”

I had this “pooch” for about 3 and half months. I have to say it was not fun when someone came to me and say “you still look a little pregnant”, “why do you still have a belly?” “Is that normal?” I would literally look at them straight to their eyes and tell them “I’m okay with how my body looks right now, I have a healthy baby and that’s all I care about.” But inside of me all this comments really got into my head and started making me uncomfortable with the way I looked, most likely my “abs”.

After breastfeeding for close to 7 months, eating healthy, staying hydrated that “pooch” wasn’t noticeable anymore. I was a little scare about starting my workout routines because I had a c-section and for some reason my head wouldn’t let me do certain movements because I thought it will hurt or do some damage after the c-section. Don’t judge me, all this was extremely new for me and it is for sure to every new mom. I’ve always been an active person since I was a teenager so this phase of my life affected me. I started doing some research, talked to my doctor and found out it was okay to exercise.

Starting to exercise again after my pregnancy absolutely changed everything. My mood changed instantly, there were not more headaches, and back pain was definitely a huge change in my life.

So coming back to diastasis recti. There’s good news! is that you can heal diastasis recti with some gentle but effective exercises. Getting your abs back into pre-baby shape might take a little more work, however learning proper breathing techniques is the first thing you’ll need to do. Meaning learning to guide the breath into the full 360-degree circumference of the diaphragm.

Exercise 1: Diaphragmatic breathing


The diaphragm is a wide, domed muscle that crests at the bottom of the rib cage. It separates your thorax, or the lungs and heart, from your abdominal space. Optimally, it and its neighbor — the traverse abdominis muscle — keep your core stable. A stable core protects your back and allows for a full range of movement of the limbs and torso.

Once you’re confident that you’re breathing into your diaphragm, go on to the next two exercises.

Exercise 2: Standing pushups


Stand facing a wall at arms’ length with your feet hip-width apart. Placing your palms flat against the wall, inhale. “Encourage the breath to flow deeply into lungs,” says Chazan. “Allow the ribs to expand circumferentially rather than letting air create a puffed belly.”

On the exhale, draw your belly tightly in toward your spine. Allowing your arms to bend, lean into the wall on your next inhalation. Push away from the wall on the exhale and resume your straight-up position.

Exercise 3: Bridge pose


To start the Bridge pose, lie on your back with your spine gently pressed into the floor. Your feet should be flat and your knees bent. Lay your arms at your sides with your palms facing down. Inhale slowly, using your diaphragmatic breathing.

On the exhale, tilt your pelvic area toward the ceiling until your body forms a straight incline with your knees as the highest point and your shoulders as the lowest. Inhale gently as you hold the pose, and on the exhale, slowly roll your spine back onto the floor.

This sequence helps you transition into your daily functions as you heal. Awareness of your breathing and how you’re using your deep abs throughout the day as you pick up your baby, or bend over to change them is as important to healing diastasis recti as the more physical exercises.

Your chance of developing diastasis recti increases if you have twins (or more) on the way, or if you have had many pregnancies. If you’re over 35 years old and deliver a baby with a high birth weight, you may also have a higher likelihood of developing diastasis recti.

The likelihood of diastasis recti goes up when you strain by bending or twisting your torso. Be sure to lift with your legs, not your back, and to turn on your side and push up with your arms when you want to get out of bed.

A little light activity a few days a week can go a long way toward healing your diastasis recti, then I started adding more exercises in my routine. However, remember to check in with your doctor before trying more strenuous exercises.

How often should I perform these exercises? How soon will I see results?

Assuming you have had a vaginal delivery, you can begin these gentle exercises soon after birth, and perform them daily. A cesarean delivery will likely prevent you from doing any core/abdominal muscle exercises for at least two or three months after your delivery. As every patient is different, you should check with your doctor as to when you are cleared for abdominal exercise.

While diastasis recti often resolve on their own as patients lose pregnancy weight postpartum, these exercises may help the muscles reposition themselves more quickly. If after 3-6 months of regularly performing these exercises you fail to see improvement, check with your physician to rule out a hernia.

Lastly, wearing an abdominal binder or corset in the postpartum period may assist your rectus muscles in returning to their midline position. — Catherine Hannan, MD

Answers represent the opinions of medical experts. All content is strictly informational and should not be considered medical advice.

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