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Abdominal Separation Affects 2 in 3 Women During Pregnancy. Here’s What You Need to Know.

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Sep 14, 2018

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When we think about pregnancy, the first image that jumps to mind is the most obvious physical change: a growing belly. But what goes on underneath the skin as the belly grows is less well-known. Many women assume their abdominal muscles are forever changed during pregnancy, and ‘mummy-tummy’ is inevitable. That’s simply not true. Strong abdominal muscles during pregnancy can help women avoid abdominal separation, a pregnancy complication that makes labor and delivery more difficult and leads to ‘mummy-tummy’ afterward.

The abdominal muscles that make the most difference in this regard are the rectus abdominal muscles. The rectus abdominal muscles are two muscular bands that run vertically up and down the stomach and meet in its center, where they are connected by soft tissue. During pregnancy, as the uterus grows and the belly increases, a forward and downward force puts pressure on the rectus abdominal muscles, which have to fight against gravity to keep the increasingly heavy uterus supported. So, having strong rectus abdominal muscles not only helps increase core strength (important for general good health), they also help protect the spine from becoming stressed during pregnancy.

When the rectus abdominal muscles are already weak, however, the strain of a growing belly can cause the soft tissue to tear vertically, opening like a zipper above and below the belly button. It’s a condition known as diastasis recti, or abdominal separation. (Diastasis means separation, while recti refers to the rectus abdominal muscles.)

Most pregnant women will never know they’ve developed this condition; it doesn’t cause any pain in the abdomen, as the soft connective tissue does not contain any nerves. Sometimes, abdominal separation during pregnancy may be evident by a bulge at the midline of the belly, which becomes more prominent while crunching.

About two-thirds of pregnant women’s rectus abdominal muscles separate. Women who have short time frames between multiple pregnancies, women who are carrying a heavy baby, twins, or triplets, women who in their final trimester of pregnancy or who are overweight are especially prone to this condition.

It may sound benign, but abdominal separation during pregnancy can make vaginal delivery difficult, as well as cause a host of other problems before delivery (and after); the split keeps abdominal muscles from providing a counterbalance to back muscles in supporting the weight of the belly, which can lead to lower-back pain. Abdominal separation during pregnancy can also contribute to constipation and urinary incontinence. In extreme cases, it can cause hernia, too. 

The good news is diastasis recti is often preventable. If you are not yet pregnant and looking to conceive, work on strengthening your abdominal and back muscles prior to conception.

For women who are already pregnant, there are many precautions you can take to keep your rectus abdominal muscles strong and prevent separation:

  • Avoid heavy- lifting, crunches, forceful abdominal exercises, sit-ups and planks after the first trimester until delivery.
  • Avoid straining and constipation as far as possible.
  • Engage your pelvic floor and abdominal muscles while moving.
  • Work on maintaining an optimum posture and use your corrected posture to support your belly and baby weight.
  • Stay active during pregnancy by taking up light exercises and following a regular walking regime.
  • Try and balance gain only the advised amount of weight during pregnancy.

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Written By Vanshika Gupta Adukia

Vanshika Gupta Adukia is a Mumbai-based physiotherapist who specializes in antenatal, postnatal and pelvic floor care, a childbirth educator, and the founder of Therhappy. She holds a Bachelor of Physical Therapy degree from DY Patil University, Mumbai. An avid reader, she is passionate about women’s health, little babies, all things colorful and happiness.

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