Why do I still look pregnant months after giving birth?

Posted on 31 January 2018

Diastasis recti is a common post-baby condition that means your stomach muscles have separated. The correct exercises can help – as can surgery as a last resort.

During pregnancy, the linea alba (a fibrous structure that runs down the middle of your abdomen) thins out in order to accommodate your unborn baby, says Dr Josia Lebethe, an obstetrician/ gynaecologist at Mediclinic Medforum. ‘Once you’ve given birth, that elastic tissue settles back into shape,’ he adds. ‘But in many cases, this connective tissue loses the ability to retract into position’. This is when you’ll notice a gap between your right and left abdominal walls that can resemble what mother-of-three Judith Premin describes as a ‘tummy cone’.

‘I noticed I had diastasis recti after my third pregnancy,’ the Cape Town businesswoman explains. ‘My pilates teacher noticed it too. Whenever I was in a crunch position, I could literally feel the separation of my abdominal muscles.’

Interestingly, crunches are one of the worst exercises you can do if you have this condition. ‘Although it’s not noticeable when I stand, it’s easy to feel self-conscious about my flabby stomach when I sit,’ Judith continues. ‘And although there are certain exercises to do that can help, I’d definitely consider surgery in the future.’

‘If you’re petite, fall pregnant late in life, or have poor muscle tone, you may be more likely to develop diastasis recti,’ says Dr Lebethe. If you think you might have the condition, you can confirm your suspicions by lying on your back with your knees bent and your feet on the floor. Press the fingertips of one hand lightly on the middle of your belly and perform a little crunch, keeping your shoulders on the floor. You will be able to feel with your fingers whether your abdominal muscles have separated.

Exercise should be considered as a first approach to healing. ‘To begin with, focus on improving your posture,’ Dr Lebethe suggests. And if you are starting an exercise regime, ensure your coach is aware that you have diastasis recti as certain exercises – such as crunches, sit-ups, planking and the yoga pose downward dog can exacerbate the condition as they put too much stress on your abdominal muscles.

According to 2016 research published in The Journal of Orthopaedic and Sports Physical Therapy, strengthening your deep core muscles also helps. To do this, pre-activate your lower belly (transverse abdominals) before doing any squats or pelvic tilts.

‘For more severe cases – and if you are sure you are not planning to have any more children – ‘tummy tuck’ surgery, or combined mesh insertion and tummy tuck surgery can be considered in consultation with your healthcare practitioner,’ says Dr Lebethe.

Complications that can arise once your stomach muscles separate include lower back pain, constipation, and umbilical hernia. Some newborn babies also suffer from this ‘belly spread’, which usually heals on its own.

References

https://www.healthline.com/health/hyperemesis-gravidarum#diagnosis

https://www.webmd.com/baby/guide/abdominal-separation-diastasis-recti

https://www.livestrong.com/article/332482-exercises-to-correct-abdominal-separation-after-pregnancy/

Published in Pregnancy

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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