Diastasis Recti- A Common Side Effect of Pregnancy

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Pregnancy – An important part of womanhood brings leaps and bounds of joy to the woman considered. But along with the happiness comes little inconvieniences in the body which usually back track as soon as the baby is delivered.

But sometimes certain things do not go back to pre-pregnancy days, and one of them is  protruding abdominal muscles otherwise called as Diastasis recti. These protruding ab-muscles are sometimes so prominent that you look pregnant even months after giving birth. In mommy terms it is called the stubborn baby pooch.

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What is Diastasis Recti ?

Your ‘Rectus Abdominus’ is a pair of flat, elongated muscles that run vertically on each side of the abdomen. They are also called ab-muscles or six pack muscles. These muscles give shape to your abdomen and hold the internal organs intact.

During pregnancy,the recti or the ab-muscles stretch out and relax to accommodate, the growing utres which in turn is carrying a growing baby. Pregnancy harmones play a great role in this process. Most of the time the muscles contract 3 to 6 months post partum once the pregnancy harmones decrease, but still there are prominent signs of once enlarged tummy.

It is a rare condition and we have fewer than 1 million cases per year in India.

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How to find if one has Diastasis Recti or not?

When there is a gap of roughly 2.7 cm or greater between the two abdominal muscles on either side of the abdomen, it is confirmed to be Diastasis Recti.

Diastasis recti , as it is thought is not exclusively caused by pregnancy, but it is due to the internal abdominal pressure that the ab muscles separate out. This clearly shows that other abdominal problems can also cause this, and not alone pregnant women but also men and children can be diagnosed with Diastasis Recti.

Diastasis Recti

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How common is Diastasis Recti ?

It is a rare condition and only 40% of the women are affected by this. In men and children the condition is still rarer. It is more common among premature and black babies,  and among men it is found only in those with severe abdominal problems.

Women are more suseptible to develop Diastasis recti when above the age of 35, carrying heavier babies during pregnancy, mutiple pregnancy or mutiple birth pregnancy.

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Is treatment required ?

This ab-seperation problem often ignored in the medical community. Most women don’t talk about it unless and until it is very prominent. But it is definitely a problem that screams out for attention.

When the ab-muscles move aside like this, there is only a thin connective tissue in front that is holding the other organs like utres and bowels together. The condition can cause lower back pain,  constipation, and urine leaking. In extreme cases the thin tissue that is holding other organs together may tear and the organs may poke out of the opening. This is called Hernia.Though it is said that after delivery the muscle shrinks back within 3-6 months,it is found in some women that the muscle was not back to normal.

Do’s and Don’ts

* Do not strain : Constipation, lifting weights(even your baby), sometimes even sitting down and standing up can put strain on the thin connective tissue that is holding other organs , as you are carrying around your own weight. So one has to be very careful , as even day to day activities become difficult.

* Be careful with exercises : Certain exercises like crunches, sit ups, push ups etc can make abdominal separation worse. Some trainers may suggest these to reduce the tummy without anticipating what could happen to women with Diastasis Recti.

* Let your belly heal : Give some time for the belly to heal, and then consult your gynaecologist before starting any exercise. Though there are not any standard guide lines regarding the exercises which might help ladies with Diastasis Recti,  but certain exercises done wearing a belly-splint might help. But then there is no fool proof to this also.

Best time to exercise is before pregnancy. Doing core strengthening exercises may help in the long run.

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Treatment

If ab-separation is not too big, one may ignore it and may decide to live with it. But before having another pregnancy you have to bring those muscles back together.

Many times under a doctor’s supervision, the women learn certain gentle movements which help them to bring the muscles close together. It is called Tupular technique, where the abs are supported by a belly belt or splint during the exercise.

If this doesn’t help then a cosmetic surgery might. The surgery is also called “Abdominoplasty” or tummy- tuck. The surgeon folds and sews together the weak central ridge. This surgery is done through Laproscopy where small cuts or incisions are made instead of a large cut ,which results in more scarring.

Any surgery has chances of scarring, infections etc, so one has to be careful and take good care of one’s body to lead a healthy and happy

Executive summary:

Diastasis recti abdominis or midline separation of the abdominal muscles is an acquired but rare condition, commonly found in pregnant women. The abdominal muscles found on either side of the belly are responsible for holding the internal organs of the stomach together. Pregnancy exerts pressure on these muscles leading to their separation. This ab-separation,primarily happens to accommodate the growing uterus,and once the baby is delivered, the muscles return back to normal within 3-6 months.

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But sometimes, the stretched muscles do not go back to their pre pregnancy state and the stomach continues to give an illusion of pregnancy long after the delivery. The frontal connective tissue which holds the internal organs becomes very thin. The abdominal pressure and straining cam lead to Hernia where the connective tissue tears away and organs poke out. It is a serious condition and should be addressed quickly.Men and children are rarely affected by diastasis recti.

Under medical supervision, gentle movements and exercises can be done wearing a belly splint. Surgery can be opted as a last solution. A simple laproscopic surgery called abdominoplasty can be done where the separated muscles are sewn together and excess skin and fat are removed. This gives a firm tummy.

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