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Diastasis Recti Abdominis - What the hell has happened to my stomach?!

One of the first things people ask me when they are starting to think about ‘getting back into shape’ postpartum is “how can I get rid of my belly?” My answer is always: embrace it for now, it carried your child into the world securely for 9 months, now give it the same time to settle back down.

With the abdomen is it really important to think about what went on during your pregnancy. Your stomach grew to several times its usual size, it carried around 10lbs of baby + placenta which undoubtedly put pressure on not only your abdominal musculature, but also the lower back and pelvic girdle. I am going to focus on Diastasis Recti Abdominis (DRA) which is “a separation of the two muscle bellies of rectus abdominis” (1) - the stomach muscles that run vertically either side of your belly button.

“Diastasis Recti is the result of excessive intra-abdominal pressure or loading” (3). Put plainly, as your baby grows your stomach expands to accommodate and at a certain point the stomach muscles will separate naturally. This happens in the majority of pregnancies (British Journal of Sports Medicine) and there is not too much you can do to stop it.

It is how we deal with it after birth that is important. The lengthening and separation of the Abdominis Rectus results in a weaker stomach which often has a knock on effect to the back muscles - causing weakness and pain. Furthermore, as a symptom of intra-abdominal weakness and pressure, the risk of hernia and prolapse is higher if left untreated. Although we are likely to focus our energy on the aesthetic of the stomach muscles closing, ultimately the correction of the muscles from the inside is more important.

Ideally we would like our stomach muscles to knot back together naturally, the NHS states this is common after around 8 weeks postpartum, especially if they are just slightly separated. My experience with my post-natal clients tells me that the vast majority of people have some sort of DRA several months after the birth of their baby - particularly after number 2. “For many women the gap remains widened at 8 weeks, and left untreated, this distance at 8 weeks remains unchanged at 1 year postpartum. (Coldron et al 2008, Liaw et al 2011).(3)

There are exercises that help to promote the knitting back together of this muscle group - and equally moves that are contra-advised. I would recommend a cautious approach, and not to rush the process.

How do you spot DRA?

You will definitely feel different after giving birth! The stomach will be softer, with less support from the interior muscles. After around 6 weeks, check if you have signs of DRA. Lie on your back with you knees bent and feet hip width apart. Take your head and shoulders off into a crunch position and allow your stomach to