What to do about a diastasis recti

Upwards of 90 percent of women develop a diastasis during pregnancy, often unknowingly. And while it won't cause any damage to your baby, it can lead to back pain and stall your post-baby slimdown. The good news is that the separation may close on its own some time after child birth. But, in some cases, diastasis may cause changes that can stick around long after the newborn phase.

Do you have a diastasis?

Any kind of forward motion, from sit ups to getting straight up from a sitting position, coupled with the flip-flopping of your muscles and organs during pregnancy can cause a diastasis recti. You'll know if you have one during pregnancy if your baby bump turns into a cone-shaped bulge anytime you sit up from a lying position. That football-like shape is actually your organs pushing through the gap, which may widen as your baby grows, and, sometimes, when you push during labor.

After pregnancy, your OB/GYN or midwife may check for a diastasis, or, you can do this self-diagnosis, as suggested by Kristen Horler, CEO and founder of BabyBootCamp.com and author of Baby Boot Camp: Lie face-up with you're your legs bent, feet flat on the floor, and do an abdominal crunch, bringing your head and shoulders off the floor. Place one hand above your belly button and one below. If you have a diastasis, you'll feel a two- to three-inch ridge, bulge, or separation about one to two inches above or below your belly button.

Downsides of a diastasis

If you do develop a diastasis during pregnancy, don't fret. It will not cause any birthing complications, and your baby, safely tucked away in its cocoon, will experience no ill effects from the separation. Plus, if your diastatis is minimal, there's a good chance it'll knit itself back together soon after you have your baby.

There are, however, some adverse effects of a diastasis, especially if it's large. For starters, because of the way your organs and abs have shifted around, you may still have a baby bump, no matter how much pregnancy weight you lose.

"I call this the 'Mummy Tummy,'" says Julie Tupler, a registered nurse and childbirth, educator and fitness instructor who has done extensive research on diastasis recti through the Columbia University Deptartment of Physical Therapy. "It's that bulge that makes you look pregnant long after you've given birth."

Even worse? The separated abs mean less support for your back, meaning you're at greater risk for lower back pain and even a hernia if there's any trauma to that area (say, a boisterous baby kicking you in the stomach during a diaper change).

Diastasis damage control

Despite the potential damage a diastasis may cause, Tupler – and many other experts who specialize in postpartum health and fitness – are extremely optimistic about the ability to correct a diastasis, no matter when you gave birth.

"Your mother may still have one decades after having you, and she can still close hers with the right techniques," says Tupler.

And just what are these techniques? Horler says it's key to build a strong foundation of strength and stability in your deeper ab muscles so your outer abdominal muscles can properly recover. Pilates, yoga and abs work all help, but crunches and the Pilates "100" should be avoided at all cost as it can make the gap bigger. Instead, Horler recommends doing a "Tummy Tuck" exercise.

Tummy Tuck: Stand, lie faceup, or sit in a chair or on the floor. Place your palms on your lower abdominal muscles with your thumbs touching and your index (pointer) fingers touching to form a triangle shape. Take a deep breath in and relax your abs. As you breathe out, tighten and flatten your abs, as if drawing your belly button toward your spine. You should feel your lower abs gently pull away from your hands. Repeat this sequence nine times.

Tupler, meanwhile, has a more concrete approach with her four-step "Tupler Technique" program that focuses on stretching and strengthening the transverse muscle, the deepest abdominal muscle that's especially engaged during labor. The Tupler Technique includes splinting and exercises to close the gap, as well as ways to breathe, sit up and even sneeze in a way that will minimize any further separation. The program can be done at any time during and after your pregnancy, and, according to Tupler, can show results in as few as six weeks.

You can find more information on the Tupler Technique at DiastasisRehab.com.

Does your diastasis need surgery?

Some diastasis' seems so severe that doctors may recommend a more invasive approach, including surgery to bind together the abdominal muscles or to insert a mesh band to serve as a bridge between the two halves. But experts like Tupler and Horler insist this is not only unnecessary, but may be futile as well.

"The problem with a surgery is that the work can still come undone with any forceful forward motion. Stitching is easily undone," she says. "Besides, even if you do have surgery, you still need to do exercises to keep the gap closed."

Not to mention you'll have to deal with post-surgery pain and recovery – not quite an ideal situation for a new and busy mom. An easier option? Working with a trainer or a program like the Tupler Technique for at least one year after giving birth to see if you can close the gap yourself. And, as with any medical issue, prevention is the best medicine.

"You can start working on preventing a diastasis the moment you get pregnant," says Tupler. "It's never too early -- or too late -- to fix it."

More postpartum tummy toning tips

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• 15 minutes to fab abs
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