While pregnant there is the misconception that the abdominals can tear, pull apart and only surgery will be able to rectify this.
Not the case!
As you grow a little human space must be made for them to live until they are evicted, it is actually necessary so that the organs in your body can continue doing their jobs.
The rectus abdominis (the six pack abs) are connected by connective tissue called the linea alba. The linea alba is what is stretches to accomodate the growing baby. It is thought that all women will have a degree of abdominal separation (or rectus diastisis but will be calling it separation in this blog as that is what people normally call it) during pregnancy, in fact at 35 weeks 100%. In my experience with all the women I have trained they have all had a separation by the end of their pregnancy and into their post natal months.
What we must be wary of during pregnancy is doing all we can to set ourselves up for optimal recovery and healing post birth, minimising the amount of abdominal separation as we go into labour (with the pressure of pushing an abdominal separation can be worsened) and the post natal period.
How can we minimise the risk of worsening the separation during pregnancy and help the healing process post birth? Here are a few tips I can share with you that you can apply everyday.
Breathing Strategies and Integrate into Everyday Movements and Exercise.
During pregnancy and then into those early post natal months (and beyond) we HAVE to look at how we breathe. Read this blog to explain further how to breathe properly to protect, and encourage healing of the abdominals. In my experience it is the every day tasks where we as mums are most at risk, we need to do mindful movements. When picking up other children, washing baskets, shopping, prams ect.
Safe Ground to Stand or Getting Out of a Lying Position
Learning how to get out of a lying position to a standing position, to minimise the intra abdominal pressure and reduce separation and to help protect the soft tissue post birth.
Getting out of a lying position by crunching up and holding the breath is not an ideal strategy and will cause the pressure to try and escape out of the stretchy connective tissue a the midline. Ever seen a doming at the midline? Yeah not such a great party trick a definite sign that there is a separation there!
Avoid Inappropriate Exercises and Movements for Pregnancy and Post Natal.
Avoid front planks, crunches, bridges, full pushups as this is a lot of pressure on an already very stretchy midline.
If you want to continue heavy lifting, running and jumping (not something I personally recommend to clients) to make sure you do so under the guidance of a women's health physiotherapist.
Post birth ENSURE you see a women's health physiotherapist for an assessment before returning to exercise, and find a fitness professional who can guide you to build the foundations and get you back to the exercise, sports and movements you want to be doing.
Don't just jump back into exercise without doing the work to build the foundations. You get one body, respect it.
Focus on Nutrition.
Setting yourself up for healing post birth starts in pregnancy ensuring you are getting enough nutrient dense foods to support your body, to help regulate hormones, support gut health, and support tissue healing.
Learn How to Properly Activate the Pelvic Floor and Deep Abdominal Muscles.
No I am not talking about doing a shit load of kegels.
A lot of women do not activate their pelvic floors correctly, it is a part of a integrative system that is the central stabilising system for the whole body!
Again if you feel you are unable to correctly perform pelvic floor activations and engage the deep abdominal muscles then I suggest seeing your local Women's Health Physiotherapist!
Not every pelvic floor is weak, but it may need help to be functional!
Do Safe Healing Promoting Core Exercises.
Protect the midline during pregnancy and then work to heal it post birth.
As soon as you have your baby, women are focused on STRENGTHENING the midline as it feels weak. WE need to focus on FUNCTION.
Download my Safe Core Exercises for Mums here.
Focus on Your Posture.
Something to be aware of during pregnancy, and will need some help reorganising post birth.
Ensure that the sternum is stacked over the top of the pubic bone and that your pelvis is in a neutral state. So we do not want the bum tucked under (will look like a flat bum) or the bum in an anterior tilt (looks like a duck bum ;) ).
Things to also note;
It is NOT about how far apart your abdominals are but how functional the tissue is and how well it can distribute force throughout the system. They may not ever come 'back' together. SO you can have a separation going forward into life that is functional and safe. In fact at my belly button I still have a 2cm gap BUT the tissue underneath has good tension (feels like the tip of your nose not the softness of the cheek. Softness at the midline like your cheek is typically not functional and you will need to get some guidance).
Women with a separation have been found to also suffer from some other kind of pelvic floor dysfunction like prolapse, back or pelvic pain or continence (urinary or rectal).
Some women will require surgery to restore the separation, but in most cases if aware during pregnancy and have a focus on healing post natal a non surgical conservative approach is all that is needed.
Surgery is not a quick fix option, like everything work will need to be done in order to minimise the separation and to heal it post birth.
Hopefully this has helped clear up some questions and given you some strategies to use, reach out with any questions as this can be a very confusing topic and very different for each mumma.