Pregnancy

What is diastasis rectus abdominis and will it get better?

Diastasis rectus abdominis (also sometimes known as recti divarication) is when the 2 sides of the rectus abdominis muscle separate during pregnancy (this is the muscle at the front of your tummy, the so-called six-pack for the lucky few!)

It is generally considered a normal process of pregnancy as the hormones your body produces during this time cause softening of the connective tissues. This allows your abdominal muscles to stretch and provide the room needed for the developing baby.

It is believed to occur in at least 2/3 of women by the end of the third trimester. After delivery of the baby there is often a rapid recovery of these tissues, usually within the first 8 weeks. However, unfortunately about 1/3 of women affected are left with a persistent gap in the muscle wall.

There is very limited available evidence on the best course of action in these cases. The main thing to consider is how the defect is affecting your abdominal wall function – this may present with symptoms of back pain, pelvic pain and urinary or bowel control symptoms. Interestingly this doesn’t always correlate with the size of the gap and there is no recommended size of defect that requires treating.

Current advice recommends referral to see a physiotherapist. They will then teach you exercises to help strengthen the deeper muscles of your abdomen to regain general abdominal strength. This is particularly important if you are considering further pregnancies. They may recommend abdominal support during treatment, but I wouldn’t recommend doing this without advice from a physiotherapist.

Of note, this treatment won’t necessarily reduce the size of the gap you are left with, but will resolve the underlying problem. Unfortunately, the media generates the expectation that we all need to regain our pre-pregnancy bodies and this can have negative psychological consequences for some women. In these cases surgery may also be considered, but this does not usually help improve function and, as with any operation, is not without risk.

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