The widely circulated idea that if you work out enough post-pregnancy your body will “bounce back” to its former shape is problematic for many reasons, particularly because this isn't always feasible or even accurate. The look of your stomach may change, for starters, because it just acted like a house for nine months, and also because your abs can separate during pregnancy, a condition known medically as “diastasis recti.”
Before you continue reading this from a permanent plank position, know that diastasis recti is common; a 2016 study published in the British Journal of Sports Medicine focusing on Scandinavian women found that at six weeks postpartum, 60 percent still showed signs of the ab separation.
So what is this painful-sounding condition, exactly? “The rectus abdominis muscle (i.e. six pack) is a pair of long, flat muscles that run down vertically on each side of the abdomen. In the middle is connective tissue,” Dr. Sean Clare, M.D., OB/GYN tells Romper. “With pregnancy hormones relaxing the connective tissue and the increased size of the uterus, this tissue is stretched and the rectus muscles separate.” This can look like a little bulge under the belly button which will be visible even after you're back in your pre-pregnancy weight range. Or in some cases, you'll see a physical separation, like a valley between the abdominal muscles.
When I heard the terrifying words “muscles separating” (especially pertaining to my own body), I imagined excruciating pain (I actually started to feel a little woozy, but this is coming from the person who needs to chug several juice boxes every time I have blood taken, so). Rest assured that it doesn’t typically hurt, and most people don’t even feel it happening. “Diastasis isn’t painful and is not typically obvious until the postpartum period,” according to Today’s Parent. If not corrected, it may, however, result in lower back pain, as the back has to overcompensate for the lack of core strength.
There’s also a way you can check for it yourself, according to Dr. Clare. To do so, lie on your back, place your feet flat on the floor, then, “place your fingers right above your belly button in the midline and do a crunch. If you have more than a two finger gap between the muscles, you have a diastasis,” he says.
You probably don’t want me to tell you having your abs separate is a small price to pay for creating a life, so I’ll refrain. Just know that diastasis rectus doesn’t discriminate: it may be more likely to happen if you’re petite, carrying multiples, “have had more than one pregnancy, carry... babies later in life, have poor muscle tone, or have a sway back posture,” per Parents. So, um, sorry but basically no one is immune, even celebrities like Kelly Rowland, who talked about this exact topic with Shape. But, if you’re interested, there may be ways to prevent it from happening in the first place, and ways to repair your abs if it does, though the research on both is inconclusive.
“Some say that core strengthening exercises prior to pregnancy may reduce the incidence,” Dr. Caitlin Szabo, M,D.,OB/GYN tells Romper. However, she adds that there isn’t a lot of data or research that says whether or not ab separation can be prevented. I (with zero medical training aside from a CPR class 12 years ago) am in the camp of why not give the exercises a shot, because strengthening your core before you're pregnant is always a good idea, and will also help to strengthen your pelvic floor.
“Prior to pregnancy, incorporate planks, mountain climbers, total body conditioning type routines into your workout regimen," Anita Mirchandani, RDN and pre and postnatal exercise specialist tells Romper.
However, I was surprised to learn that Mirchandani also says to avoid sit-ups and crunches from when you're 20 weeks pregnant all the way through the first few months postpartum. These exercises (and planks too, sorry yogis) can actually make the separation worse. Instead, Mirchandani says when you’re pregnant or newly postpartum you can “work on engaging your lower abdominals when rising up from a seated position.”
If you’re less into exercise and more into... breathing, than the soothing voices of NPR once again have you covered (as previously reported by Romper), with information about a daily 10 minute breathing “exercise” that’s designed to repair the abdominal muscles.
Sometimes you don’t have to do anything at all and “the tissue will heal and the muscles come back together,” Clare tells Romper. The not so good news? If it doesn’t close within three months, it gets more difficult to close the gap with measures like core strengthening or abdominal binders, he says. People who have diastasis at six months postpartum may “require surgical correction,” Clare says. “Unfortunately this is considered cosmetic surgery and not covered by most insurance plans.” I think I'll be sticking with the deep breaths.
Sperstad J, et al. (2016). Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. British Journal Of Sports Medicine. DOI: 10.1136/bjsports-2016-096065
Dr. Sean Clare, MD, OB-GYN, Doctors Medical Center
Anita Mirchandani, RDN and pre and postnatal exercise
Dr. Caitlin Szabo, OB-GYN, Atlanta Women's Healthcare