Should You Check For Diastasis During Pregnancy?
Like with many things in the pregnancy world, you are going to have some contradictory opinions. I bet you have gotten a myriad of other people's opinions during your pregnancy already. One myth I have been hearing a lot of lately is to NOT check for diastasis recti during pregnancy. I would like to provide you with my educational conclusions on why I believe you definitely should check for diastasis during pregnancy. And it is way easier than you think!
Simply put, diastasis recti is an abnormal separation of the rectus abdominis into left and right halves. While pregnant, women have an increase in the hormone relaxin which is stated to relax and soften fascia all over the body. The linea alba is the fascia and connective tissue that connects the muscles of the inner core, obliques, and rectus abdominis. The softening of the linea alba fascia coupled with the outward pressure from a growing uterus and often times already weak core, makes up the recipe for potential diastasis. This separation does not only occur during pregnancy and can also occur in infants and men!
We all have a natural separation, think of a body builder with 6-pack abs, you can see there is a split down the center of his/her abdomen. When women become pregnant, and their bellies grow, sometimes that natural one and two finger split can separate further. Separation can occur evenly, down the entire abdomen wall, or it can split below, around, or above the navel. When diastasis occurs and is not properly healed, core functioning is reduced, which can cause a myriad of musculoskeletal imbalances and increase risk of injury down the road. Some issues you may experience due to diastasis include back pain, pelvic floor dysfunctions such as urinary and fecal incontinence and pelvic organ prolapse, hernia, and cosmetic defects.1
Let's start with the most basic reasoning behind why you should check for diastasis during pregnancy. It is easy, non-invasive, and can typically be done solely by observation. Especially into the third trimester, you will want to keep an eye out for coning during your day and especially during exercises. Coning or bulging indicates improper intra abdominal pressure which presses outward through the separation and may indicate a diastasis. In my day to day work, coaching pregnant and postpartum moms, I refer to this separation as just that, a separation. It it in my opinion, only a true diastasis recti if the separation has not healed by eight weeks postpartum. If coning occurs, step back from what you are doing since this can cause further separation. Working with a coach (ahem) specifically trained in how to properly engage intra abdominal pressure through movement will ensure coning is avoided and proper core healing is under way. Another possible way to visually observe a diastasis is by your belly button. Sometimes an “outy” belly button or bulging belly button can suggest an umbilical hernia and or diastasis in late pregnancy.
If you were to get checked for diastasis by myself or another professional, you normally would lie in a supine position and lift your head and shoulders as if you were performing a crunch. While holding that position, your coach would run their fingers up and down your rectus abdominis, checking the depth and integrity of the linea alba and noting whether they noticed any areas of separation more than one/two fingers. However, while your bellies are growing in size, sometimes this supine position becomes ineffective and uncomfortable. Laying on your side may bring about better test results than on your back.
Diastasis recti occurs in roughly one-third to two-thirds of women while pregnant and the good news is it is not only reversible, but it is preventable! Which leads me to the second reason why you should check for diastasis recti during pregnancy - prevention. While a separation will typically occur towards the third trimester, if you have the opportunity to check for separation regularly throughout your pregnancy journey, you have the chance to spot any form of separation and proceed in a new direction to prevent from separating further. For example, because you observed, you have seen you have coning while performing kneeling planks and you are 33 weeks pregnant. You are at an advantage that you have caught this core dysfunction so soon and will work to heal and prevent it from separating further.
On that note, reason number three for checking for diastasis recti during pregnancy is programming! You have checked for diastasis recti and it appears you have a separation. Working with your corrective exercise coach, proper programming can be prescribed for not only for the diastasis prevention but also healing.
With all this in mind, you can see why it is crucial to check for a separation/ diastasis recti during pregnancy. With barely doing anything but observing you can simply prevent any further separation by utilizing programming as a time to heal and reverse. If you are pregnant and interested in working with a trained Fit For Birth Corrective Exercise Specialist please check out my Work With Me tab. What is your experience with diastasis recti? Did you know you were separating during your pregnancy and if so, what did you do about it? Or, did you not find out until post baby? What steps did you take then? Thanks so much for reading.
1. See: Fit For Birth Corrective Exercise Specialist Manual, Section 3: Common Pregnancy Considerations, Page 5