Ashley Gammon had three babies back-to-back, with little time for recovery. She had her first cesarean in 2008, her second in 2010, and her third in 2012. After, her body just didn’t feel right. Sex was painful. She felt constantly bloated. Her lower back hurt. People asked her if she was pregnant months after she gave birth.
“I went to the doctor and was basically told, ‘This is motherhood. What did you expect after having three C-sections?’” recalled Gammon, who is now 36.
After putting up with the bloating and discomfort for nearly three years, Gammon stumbled across a Facebook video about diastasis recti, a condition that occurs when the large parallel bands of muscle that connect at the middle of the belly separate. Pregnancy puts major pressure on the belly, and the rectus abdominal muscles stretch apart. For some women, they come back together again after. For others, they don’t.
It was the answer Gammon had been hunting for years. “I thought, that’s me!” she said. While she was never officially diagnosed by a doctor, Gammon, like many women, used the internet to find communities that discussed similar symptoms and offered treatment advice.
It’s difficult to pinpoint exactly how many women experience diastasis recti postpartum, simply because it’s not a condition that doctors have paid much attention to until recent years, even though it is arguably one of the most common side effects of pregnancy. The lowest estimates suggest it affects at least 30% of women after they have their babies, and higher estimates say it’s more like 55%.
That matters because of the significant complications diastasis recti can bring. Yes, one major effect of this kind of ab separation is that women feel like they still look pregnant when their little ones are already out of diapers. But women aren’t just driven to seek help because of self-consciousness over their “mom pooch” (a term often used in diastasis circles). The condition can also significantly hamper a woman’s ability to function, day-to-day. Core strength affects so much, and when the ab muscles stretch so significantly, it can contribute to chronic back pain, constipation and even urinary incontinence.
“After you’re not pregnant, you want your body to come back together, and it’s not because women are vain,” Dr. Geeta Sharma, an assistant clinical professor in Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai in New York City, told HuffPost. She added that if it was a condition that affected a large number of men, “It would be big news. It would get a lot of attention.”
“After you’re done being pregnant, you want your body to come back together, and it’s not because women are vain.”
– Dr. Geeta Sharma
Julie Tupler, a New York-based medical trainer and registered nurse, is one of the pioneers of diastasis treatment. She developed her eponymous rehab technique, which is basically, a combination of targeted exercises and regularly wearing a splint. Tupler told HuffPost she has been banging the drum about the importance—and ubiquity—of diastasis since 1990. There’s more attention being paid to the issue now than 30 years ago, but there’s still not nearly enough education or support for moms as far as she is concerned.
“I feel like a salmon swimming upstream,” Tupler said. “There’s a little bit more awareness in the general public, but professionals are still not checking people for diastisis. They’re not checking, but midwives and OBs should be checking everybody.”
Of course, now most women get only a relatively brief six-week check-up with their provider after they give birth, during which they run through everything from infant feeding to postpartum depression. All too often, diastasis isn’t even a talking point or a box on a checklist.
Which means new (or new-ish) moms often end up trying to diagnose themselves. The general screen is pretty simple: lie on your back, lift your head slightly, and press down with your fingers on your belly. If there’s a gap, that is a sign of likely diastasis—often measured in terms of fingers. As in, she had a three-finger gap. But there are nuances that women miss.
“Most people don’t know how to check correctly,” said Tupler, who has seen many women who thought they didn’t have ab separation, but who would have benefitted from finding a physical therapist years before.
Furthermore, there just aren’t many research studies women and experts can turn to say whether a specific technique or set of exercises offer the best results. A 2014 review of the existing studies at that point said there is a real need for high-quality, randomized studies looking specifically at particular methods. The few pilot studies that have been done are relatively small, though both Tupler and Sharma mentioned research they’re working on to change that.
And yet the experts said that doesn’t mean that women should just sit around and wait. Programs like Tupler’s have internal data supporting their success, and Sharma pointed to paid, online subscription exercise and education services, like Mutusystem (the program Gammon ultimately used, and now works for) and Every Mother, as being potential resources for women who may not have easy access to a trained therapist in their area.
There’s also a growing community of women posting about diastasis on Instagram using hashtags like #diastasisrecti and #diastasis under workout videos and before and after shots. That online activity reflects what Sharma called a welcome paradigm shift, where women no longer accept they must simply live with postpartum pain and are seeking answers. Though if possible, she recommends women see a physical therapist or someone trained in recognizing and treating diastasis, who can guide them on proper form for exercises before they forge out on their own.
Ultimately, what women and experts who focus on diastasis want to make known is that condition isn’t simply about women wanting to look a certain way, and nor should they have to accept ab separation as a necessary price for pregnancy and childbirth.
“I think it’s important for women to know it’s never too late,” said Gammon, who has blogged about her experience working to heal her diastasis, a process that began three years after her last baby.
“I think we’re kind of told that this is normal, and it’s just something you have to deal with,” she added. “Which is crazy! It can be different.”