If you’re like most women, along with all the other concerns about having a new baby to take care of, lurks worry about the long-term impact that pregnancy may have on your figure—especially your waistline. But nothing quells worry better than learning valuable and accurate information and putting it into positive action. Following through on the postpartum exercise advice in this web site will ease your anxiety and help you regain or even surpass you former fitness level.


Yes, You Can Recover from Abdominal Separation/Diastasis Recti

Unfortunately, flurries of misconception swirl around the issue of abdominal reconditioning—and particularly abdominal separation/diastasis recti—after pregnancy. You’re likely to encounter a broad range of contradictory opinions and advice about how to recondition your abdominal wall and how to restore the midline after childbirth. Some of these assertions can cause unnecessary alarm, while another common piece of advice—do a lot of “crunches”—can actually worsen abdominal separation/diastasis recti.

COMMON MYTHS about
Postpartum Abdominal Conditioning and Abdominal Separation/Diastasis Recti:

•	Abdominal separation/diastasis recti causes permanent damage to your midline.
•	Abdominal muscles will never flatten after separation/diastasis.
•	Abdominal separation/diastasis recti requires surgical repair.
•	The abdominal muscles will always be weaker after childbirth.
•	Everyone should wait for at least six weeks after delivery before beginning a postnatal reconditioning program.

None of these statements are true!

Keep in mind that women who hold themselves up as living examples of the
inevitable and lasting damage pregnancy has done to their bodies may not have had the benefits of a systematic postpartum exercise program designed by an expert in reconditioning after pregnancy.


Abdominal Separation/Diastasis Recti: What it is, and what to do about it

For some women, pregnancy can cause abdominal separation (also called diastasis recti), a condition where the two right and left sides of the Rectus Abdominis—the “six-pack” muscle—spreads apart at the body’s midline, the linea alba. Separation occurs in response the force of the uterus pushing against the abdominal wall, and pregnancy hormones that soften connective tissue. Separation can occur anytime in the last half of pregnancy but is most problematic after pregnancy when the abdominal wall is weak. Abdominal separation reduces the integrity and functional strength of the abdominal wall and can aggravate lower back pain and pelvic instability. Separation in a previous pregnancy significantly increases the probability, and severity, of the condition in subsequent pregnancies. Women expecting more than one baby, very petite women, those with a pronounced sway back, or with poor abdominal muscle tone are at increased risk. Genetics also plays a big role. For some women, it simply how their bodies respond to pregnancy.

Abdominal Separation/Diastasis Recti Test

This simple self-test will help you determine if you have abdominal separation and how severe it is.

1.	Lie on your back with your knees bent, and the soles of your feet on the floor.
2.	Place one hand behind your head, and the other hand on your abdomen, with your fingertips across your midline—parallel with your waistline— at the level of your belly button.
3.	With your abdominal wall relaxed, gently press your fingertips into your abdomen.
4.	Roll your upper body off the floor into a “crunch,” making sure that your ribcage moves closer to your pelvis.
5.	Move your fingertips back and forth across your midline, feeling for the right and left sides of your Rectus Abdominis muscle.

Use Correct Form for an Accurate Assessment

Make sure that you don’t simply pull your head off the mat—a common mistake. To effectively contract your abs, you need to move your ribcage closer to you pelvis. If you don’t adequately activate your abdominal wall, you might assume that you have abdominal separation. But for most, as the rib cage moves closer to the pelvis and the contraction deepens, the width of the gap at your midline will decrease.

Don’t panic if you feel a “hole” in your belly in the first few postpartum weeks. Everyone’s connective tissue at the midline is lax after childbirth. As you recover, your midline will slowly regain its former density and elasticity, and the “hole” will become shallower, and if you do the right exercises, more narrow too.


Signs of Abdominal Separation/Diastasis Recti

A small amount of separation of midline—one to two fingers’ width—is common after most pregnancies, and is not a problem. But if the gap at your midline is:

•	more than 2 1/2 finger widths
•	does not shrink as you deepen the work of your abdominals or
•	you can see a small mound protruding at your midline

then you probably have abdominal separation and need to take a few special precautions during exercise and other activities.


Special Precautions for Women with Abdominal Separation

Avoid all activities that place stress on the midline, that stretch or overly expand the abdominal wall through everyday activities, exercise or inhalation techniques.


Some Types of Movement to Avoid

•	Movements where the upper body twists and the arm on that side reaches backward, such as during a tennis serve.
•	Exercises that require lying backward over a large exercise ball.
•	Yoga postures that stretch the abs, such as “cow pose,” “up-dog,” all backbends, and “belly breathing.”
•	Most traditional abdominal exercises that work the exterior abdominal muscles, such as crunches and oblique curls.
•	All exercises that cause your abdominal wall to bulge out upon exertion.
•	Rising from a supine position by rolling up and twisting at the same time. Instead, roll first onto your side, and then use your arms to help push yourself up to a sitting position.
•	Lifting and carrying very heavy objects.
•	Intense coughing while your muscles are unsupported.

After childbirth, if you develop a cough from allergies or a respiratory illness, such as a cold or flu, place your hands across your belly and manually splint your abdomen together during coughing episodes. This will provide needed additional support, and prevent further separation of your midline.


Manual Splinting of the Abdomen May Perpetuate Muscle Weakness

Most postnatal fitness programs advise women to manually splint their midlines together while performing exercises like head lifts, crunches and curls. However, reliance on external forces only will not adequately close the gap in your midline. In fact, manual splinting of the midline without first having established adequate strength in your “internal girdle”, the Transverse Abdominis, is not effective. Because external splinting performs the function that your deep abdominals should do, they don’t have to work, and so stay weak. If the Transverse Abdominis does not have enough strength, then the abdominal wall will bulge out upon exertion, which stretches the midline and can make abdominal separation worse. (Please see the Abdominal Reconditioning after Pregnancy page of this web site for more information.)

Abdominal splinting with the hands or other devices is an acceptable technique only after the Transverse Abdominis has been thoroughly reconditioned.


Another Common but Ineffective Idea: “Mini-crunches”

Other postpartum exercise programs suggest that women with abdominal separation start abdominal reconditioning with “mini-crunches,” or lifting only the head, while applying manual compression with the hands across the abdomen. Isolation of the head exerts a small amount of work on the external abdominal muscles, but only in some individuals. Women with good neuromuscular coordination will, for the most part, engage the muscles that flex the neck, not their abs.

In addition, lifting the head off the floor as a preamble to exercises like crunches teaches poor technique. Ideally, in all abdominal exercises that flex the upper spine, movement should be initiated in the thorax, which will pull the rib cage closer to the pelvis. The head and shoulders should stay fairly relaxed, and basically “go along for the ride.” In Pilate’s exercises, this is aptly called the “head-float position.” (For more information see the Abdominal Reconditioning After Pregnancy page of this web site.)



Signs of Midline Recovery

Abdominal separation resolves when either your muscles have pulled back together to less than two finger widths, or when you can feel that your midline has become strong and elastic, at about six months postpartum. At this point, you will no longer feel a hole in your abdomen. Once your connective tissue has regained its former density and elasticity, you are no longer at risk for hernia or other associated problems.


For Best Results, Start Reconditioning Soon after Childbirth

Starting your abdominal reconditioning soon after pregnancy will yield the best results. If you begin abdominal reconditioning at more than six months postpartum it is unlikely that you will be able to decrease the width of the gap at your midline. So if at all possible, start exercises that restore the abdominal wall in the initial months after childbirth.

A Program Designed for Postpartum Abdominal Separation Is Crucial

Reconditioning after pregnancy with abdominal separation can be more challenging. To safely and effectively restore your abdominal wall you need a postnatal exercise program that is specifically designed for women with abdominal separation.

If you have abdominal separation and would like to get started on reconditioning, see my DVD, “Bounce Back Fast! Post Natal Core Conditioning.” This DVD contains three easy-to-follow progressive postpartum workouts:

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