What is Diastasis Recti?
Diastasis recti, also called diastasis recti abdominis (DRA), is a condition in which there is a wide gap between the two sides of the rectus abdominis muscle. This is the large muscle on the front of the abdomen, known commonly as the abs, that creates a 6-pack effect when it is very well developed, when it is covered with only a minimal amount of fat, and when there are no mechanical problems, such as excessive stretching. DRA actually is a result of excessive stretching. Like all muscles, the rectus abdominis includes muscle tissue that does the contracting, but also connective tissue, which surrounds and encloses the muscle tissue. DRA is widening of what is called the linea alba, the band of fibrous connective tissue that runs vertically between the left and right sides of the rectus abdominis muscle. The linea alba separates the left three packs from the right three packs. When stretching of the linea alba causes an unusually wide gap between the left and right sides of the muscle, this is defined as DRA. The condition can occur in infants, due to inadequate development of the rectus abdominis muscle, and it can occur during and following pregnancy, due to stretching of the abdomen. It also can occur due to obesity.
How common is DRA during pregnancy?
DRA is extremely common during pregnancy as reports show that it occurs in 30 to 70 percent of pregnant women and the prevalence increases with the number of pregnancies that a woman has. In other words, your chances of developing DRA increase as you have more children. This is due partly to the stretching of the abdomen and also to the fact that the condition occurs more easily in older women.
How is DRA diagnosed?
DRA is diagnosed based on the presence of obvious stretched out areas on the linea alba that tend to protrude as a ridge and on measurements of the width of the linea alba at different locations along the midline of the abdomen. In women who have never given birth, the width of the linea alba is usually 15 mm at the edge of the chest, 22 mm at a point 3 cm above the umbilicus (the navel), and 16 mm at a point 3 cm below the umbilicus. If a point along the linea alba is much wider than it should be (if the gap between the left and right sides of the rectus abdominis muscle is much wider than normal), then your physician can diagnose DRA.
Does DRA cause problems during pregnancy?
There is a different, more serious condition, called an umbilical hernia, which is a hole through the front of the abdomen, and which can be dangerous because a section of intestine can protrude through the hernia, possibly becoming incarcerated (trapped in the hernia), leading to even worse problems, such as obstruction of the intestine, or a cutoff of the intestinal blood supply. Although DRA is not thought to cause umbilical hernias, DRA does increase the chances that an umbilical hernia will recur after it has been repaired. The reason for this is that repair of an umbilical hernia involves sutures that pass through the linea alba and since DRA is basically a weakened area of the linea alba, such a repair may not hold when put under stress, such as during pregnancy. Another possible consequence of DRA is that your anterior (front) abdominal wall is weakened putting additional stress on your lower back during the early phases of pregnancy when your abdominal wall would otherwise be giving you protection against such stress (later in pregnancy, the lower back stress is increased anyway and the anterior abdominal wall isnt helping much, whether or not there is DRA).
Does DRA during pregnancy cause problems for the baby?
No, DRA does not normally cause problems for the baby, unless it causes an umbilical hernia to recur, causing the mother to experience complications.
What to consider about taking medications when you are pregnant:
- The risks to yourself and your baby if you do not treat the DRA. Medications are not part of the treatment for DRA, so this is really not an issue.
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat my DRA during pregnancy?
Medications are not part of the treatment for DRA.
What should I know about choosing a medication for my DRA during pregnancy?
You may find Pregistrys expert reports about a variety of conditions and the individual medications used to treat them here, although DRA does not require medications. Additional information can also be found in the sources listed at the end of this report.
What should I know about taking a medication for my DRA when I am breastfeeding?
The treatment for DRA does not depend on medications. Therefore, there is no particular issue related to breastfeeding in a mother with DRA.
What alternative therapies besides medications can I use to treat my DRA during pregnancy?
In most cases, DRA gets better without any treatment during the period after you give birth. In cases when DRA persists, the next step is conservative management, consists of physiotherapy, which may include certain exercises and certain procedures performed on the abdomen by the therapist during exercise to get the rectus abdominis muscle to tighten. You can learn some of these exercises here. When conservative treatment is not enough and the woman is uncomfortable and especially if there is also a hernia, a surgical procedure called abdominoplasty is available. This involves placation (folding) of the stretched part of the linea alba and sometimes of other parts of the anterior abdominal wall to make it tighter.
What can I do for myself and my baby when I have DRA during pregnancy?
Comply with the recommendations of your obstetrician, your family doctors, your physiotherapist, and (if you are having surgery) your surgeon. Be patient and give your body time to heal.
Resources for DRA in pregnancy:
For more information about DRA during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles: