During pregnancy the uterus, abdominal muscles and skin in the abdominal area must expand to make room for the growing baby. All this leaves traces – because the connective tissue is heavily strained during pregnancy. It's therefore perfectly normal if the bulging belly doesn't disappear immediately after birth. Stretch marks, fewer muscles and a flabby belly are also part of the picture.
These are the factors that affect the appearance of the abdomen after pregnancy
How the belly looks after childbirth varies from woman to woman. However, the following factors have an influence:
- weight and muscle mass before pregnancy
- weight gain during pregnancy
- size of the baby
- previous pregnancies
- stability of the connective tissue
What is diastasis recti?
Diastasis recti is the condition in which the straight abdominal muscles separate at the seam of the connective tissue in the middle of the abdomen (linea alba). Diastasis recti restricts the muscles' ability to support and carry loads. During pregnancy this is normal, but afterwards the diastasis recti should disappear.
Abdominal muscles before, during & after pregnancy
How to recognise diastasis recti
These are the signs that indicate diastasis recti after childbirth:
- visible bump or gap along the midline of the abdomen – especially visible when leaning forward or when tightening the abdominal muscles
- back pain as the weakened abdominal muscles lead to overuse of the back muscles
- pain when exercising the abdominal muscles
- instability of the pelvis
- digestive problems such as bloating or constipation
- urinary incontinence when coughing, sneezing or laughing, as the diastasis recti increases pressure on the pelvic muscles.
The extent of the diastasis has an influence on how easy it is to recognise. It can be between 2-10 cm wide and 12-15 cm long. It’s easy to check if you have diastasis recti with a self-test:
- Lie on your back with legs hip-width apart, knees bent and feet flat on the floor.
- Place two fingers on the middle line of the abdomen (linea alba) between the breastbone and the belly button. The fingertips point toward the pubic bone.
- Exhale as you slowly lift your head and shoulders slightly off the floor.
- At the same time, gently press on the abdominal wall with your fingers. If you feel a clear gap or a vertical bump, this may indicate diastasis recti.
- Lower your head and shoulders again and repeat the test below the belly button.
- If you suspect you may have the condition, see a professional to have your straight abdominal muscles checked.
When is diastasis recti problematic?
We usually speak of diastasis recti when the gap between the abdominal muscle belly is wider than two fingers or 3.4 cm. How quickly diastasis recti recedes differs from woman to woman. It depends on factors like the severity of the diastasis, physical fitness and postpartum training.
Recovery takes time
No sooner is the child born than the body begins the process of recovery in which the woman's body develops back to its pre-pregnancy state. The recovery takes about 9 months on average. However, just as every pregnancy belly is different, so is the way in which each woman’s body recovers. It's important that each woman takes her time – recovery is a process.
Abdominal muscle training after childbirth
Mothers should first wait before practising sport after childbirth until the pelvic floor and abdominal muscles are back to their full resilience levels, especially if the abdominal muscles are affected by diastasis recti.
Living with diastasis recti
During the postpartum period, you should generally avoid training. After that, avoid exercises that involve rolling up from the supine position or overstretching the abdominal muscles, or any intense exercises at all. After all, the abdomen is still soft and unstable. Postnatal exercises help to re-stabilise the abdomen with specific practises that help build up the muscles.
- Avoid excess pressure on the abdomen at the start, both in daily life and when doing the exercises.
- Stand and sit with a pressure-relieving posture also after pregnancy.
- After childbirth, women should first strengthen their core before taking up more challenging training.
- When stabilising diastasis recti, pay attention to the whole body and how you move in your daily life.
- Increase training steadily and set new targets.
- A nutritious and balanced diet is essential for the connective tissue to heal.
When to see a doctor?
Always consult a doctor if you experience severe pain or discomfort during training or your everyday activities. It's possible that the abdominal muscles won’t close at all. However, if the abdomen is sufficiently stabilised, diastasis recti isn't necessarily problematic. But if regular therapy doesn’t bring any improvement, diastasis recti can also be corrected surgically.