Diastasis Recti is a common condition that can be easily rectified in the postpartum period with patience, care and the help of a good Women’s Physiotherapist. But is there anything we can do during pregnancy to lessen the chances of issues later on? Whilst it may not be possible to prevent it altogether, the following tips on ‘how to prevent Diastasis Recti during pregnancy’, may help to avoid more severe cases.
Here in the UK, July marks Diastasis Recti awareness month. The term sounds pretty technical (an exotic plant? insect maybe?) and unless you are a mum or a women’s health professional it is possible you have never heard of it. That is because Diastasis Rectus Abdominis mainly affects women during or after pregnancy.
What is Diastasis Recti?
Pregnancy related Diastasis Recti is a medical condition whereby the two sides of the rectus abdominus (aka six-pack muscles) separate to make room for a growing baby. It is the widening of the linea alba which is the connective band of tissue that runs vertically down the centre of the stomach and connects the rectus abdominis muscles. Up to 60% of pregnant women experience Diastasis Recti to some degree. By 12 weeks postpartum this drops to 33%.
Although this problem is not serious, many women dislike the look of their compromised abdominal area and the decreased functionality of their core muscles.
Who is more at risk of experiencing Diastasis Recti?
Helen Crossdale Smith the Physiotherapist behind Maternally Fit tells me :
‘Bearing in mind that all pregnant ladies will experience it in their third trimester it should be thought of as a normal pregnancy adaptation that allows our body to adapt to carrying a baby, but the degree of diastasis can however vary.
There are certain risk factors for developing diastasis recti including; having a big baby, carrying more than one baby, having had lots of babies, age, having developed it in a previous pregnancy, pelvic floor dysfunction and overactive abdominal muscles during pregnancy.’
How to prevent Diastasis Recti during Pregnancy
​1. Ditch the crunches for pregnancy safe core exercises
We’ve just heared that overactive abdominal muscles during pregnancy can exacerbate DR but that doesn’t that mean all abdominal exercises are off the menu. With the help of a Women’s Physio or trained prenatal fitness professional, modifications can be made to maintain core strength.
Working for a strong core and pelvic floor pre conception is going to pay off once you actually launch into pregnancy. But if pregnancy is unplanned there is still the first trimester to gently strengthen the abs with pregnancy specific exercises. Diastasis Recti tends to occur from 14 weeks of Pregnancy.
Whilst this is a significant difference, there is no conclusive evidence that maintaining strong abs will prevent the severity of DR. However we do know that there are benefits to be had by doing appropriate prenatal exercise. Going in to the second trimester with a strong functional body will help combat lower back pain, pelvic pain and pelvic floor problems. This will in turn set you up for an easier delivery and postpartum recovery. It will also enable you to perform the daily activities of caring for a small baby with ease and comfort.
Find an exercise program that is specific to your pregnancy. Maternally Fit offer tailor made classes to pregnancy.
2. Learn to Belly Breathe
According to Wendy Powell of the MUTU system: ‘Taking deep, full breaths (diaphragmatic breathing) where the air in your lungs expands your lungs and not just moves your belly in and out can help lessen your chances of having Diastasis Recti. It can also help you bring an abdominal separation closer together again’
The MUTU Website is an excellent resource for mothers at all stages of motherhood. Wendy points out that the core muscles also comprise the diaphragm under the rib cage. By breathing in deeply and filling up the lungs and then relaxing the muscle to fully breathe out we are in fact exercising our core in the safest way possible. This natural movement will encourage the abdominal muscles back to the midline whilst simultaneously replenishing the muscles with fully oxygenated breaths to encourage strength and healing.
This breathing is also known to relax us and relieve stress and is a fundamental strategy for coping with the demands of Childbirth.
3. A collagen rich diet
In an ideal world you would have overhauled your diet even before conception. But for many it may take the appearance of two blue lines to get you scrambling for a prenatal supplement. Generally speaking most prenatal vitamins are loaded with all the necessary nutrients. Folic Acid, Calcium, Vitamin D and less widely known Choline are now all considered Pregnancy Musts.
However collagen might one to add to the list in the pursuit of a quick recovery and improved Diaststis Recti.
In her brilliant book ‘Real food for Pregnancy’ Liliy Nicholls writes:
‘The Role of Gelatin and collagen in healing connective tissue and skin explains why foods such as ‘Pig Trotters Soup are encouraged for women healing from Childbirth from China’.
Collagen plays a big part in optimising connective tissue and muscle repair. Eating collagen rich food or foods that promote collagen production are key. Although bone broth has seen a recent surge in popularity, it is not just animal products that contain collagen. Dark leafy vegetables and fruits high in bioflavonoids and Vitamins C,E and A play a role in collagen production.
Failing this Purermama make an excellent collagen supplement designed for pregnancy and postpartum.
4. Avoid Constipation
Constipation is synonymous with pregnancy, especially if you are taking an iron supplement. But constipation also goes hand in hand with Diastasis Recti. Straining can put pressure on your already over stretched abdominals, forcing them further apart. The pelvic floor muscles also take a hit when your bowels aren’t easily emptied.
A fibre rich diet and plenty of water should help. Consider switching out your iron supplement for a water soluble or gentler variation (I can recommend both Spatone and Active Iron))
Also try leaning forward with your feet on a stool whilst on the toilet. Of course be guided by your pregnant belly and what feels comfortable.
5. Keep your weight in mind
You don’t need me to tell you about ‘eating for two’. But it is believed that gaining too much weight can contribute to Diastasis Recti as the excess fat deposits increase the pressure driving the abdominal muscles apart. In fact outside of pregnancy, Diastasis Recti is a common result of obesity.
Again the evidence on this is not conclusive. However avoiding weight gain has many additional benefits. These include keeping gestational diabetes at bay and other complications. We do know that gestational diabetes can lead to having a larger baby which puts you at greater risk of increased DR.
Something to keep in mind.
6. Posture
Being mindful about your posture is key to your postpartum recovery and poor posture can make Diastasis Recti worse. The heaviness of your growing bump may cause you to shorten and curve at the lower back and let your your abdominals loosen in the front. Instead aim to draw in the belly button for a more neutral spine.Standing straight by engaging and holding in the abdominal muscles will make them stronger and improve your chances of averting or quickly rectifying DR.
Should I use a belly band?
Your physiotherapist may recommend a support to encourage good posture and awareness. However beware of belly binding techniques that claim to bind your abdominals back together. Read my interview with Women’s Physio Camilla Lawrence on the pitfalls of Belly Binding.
Disclaimer – Always consult a medical professional before making any changes to your lifestyle whilst pregnant.
