I have a spearated abdomen, also called 'Diastasis Recti'

[honeydew]

After giving birth to my third child a year ago, I have a post partum condtion known as 'Diastasis Recti' which means my abdomen has separated due to pressure on it from my uterus. I have had large babies in quick sucession. I have had 1 vaginal birth and 2 sections (1 emergency) I have to have major surgery next year as my body will not heal anymore by itself. My abdomnen needs stitching back together, my umbilical hernia popped back in and I get a free tummy tuck thrown in! I still look 4 months pregnant, have to wear large flowing tops or maternity clothes and am often in pain.It's not easy when you have three children of four and under to care for! My surgeon says he sees cases like mine every other week. Is there anyone else who suffers from this debilitating problem and what have been your experiences?

I have this!! dd was born a week and a half ago and there is less than a year between them! both vaginal births but I never recovered between pregnancies. midwife has given me exercises to do and I'm being refered to a physio.
It's not affecting my day to day life at the mo, although a couple of months down the line I'll probably feel differently!

I have this after 2 largish babies in quick succession (DD 8lb 8.5oz, now 2, DS 10lb10.5oz now 5months)

Honeydew - at what point do they decide to do something about it?

After DS was born I was 6 fingers separated - he's now 5months & I'm still one and a bit fingers separated (been doing my exercises almost every day...)

I'm not in pain with it, but I HATE my belly & still look about 5months pregnant even though I weigh less now than before I got pregnant...

I went to my doctor once I realised that something was wrong - my tummy was just not returning to a normal shape. This must have been about 4 months after the birth. I've had 3 babies in 3 1/2 years ( 8lbs, 10lbs and 9lbs) and was advised to have an elective section for my third because of complications during the birth of DS.

I'm not sure sure how many fingers separated I am but the plastic surgeon told me that I'll be left with a permanently large pregnant looking belly if I don't have the operation. Having a hernia too probably doesn't help.

I feel the same as you BetsyBoop- I absolutely loathe my huge belly and finding suitable clothes is a nightmare. I have to wear jeans under the bump and large tops which cover it- mostly maternity wear.

I get really down sometimes knowing that surgery is the only option as exercising will not make any difference in my case- my abdominal muscles have parted company!

My surgeon wants me to have it done now but my children are 1, 2 1/2 and just 4. I'm going to wait a year until my DD is at school and my youngest a little less dependent before I have the op.

I think it wil be nice to get a free tummy tuck ( my section overhang is like a wrinkly udder ), but I don't think the other problems have been worth it. I can feel the weakness in my abdominal muscles pulling on my lungs and shoulders which gives me a poor posture. I'm just soooooooo pissed off. I'm only 36 and I feel really old and fat. I can't loose anymore weight and although I'm back to a size 10/12 everywhere else, I'm a 14/16 round my tummy and I feel my figure has been ruined by this condition. I know a 14 isn't big, it's just that my tummy really protrudes out in front!

People keep asking me if I'm expecting again! I know I'm bonkas having three children so close together but I wasn't expecting to have such a long term complication. My husband has been very supportive and says he isn't bothered about my diastasis but I bloody well am! It's just horrible so it's comforting to know I'm not alone in suffering this. My abdomen does still hurt from time to time although generally the pain has been much reduced.

Yes I had this too - so I kindof know what you're going through.... AND you are not alone - here is another MN thread about it and what you can do about it. thread on diastasis and cesarean overhang here

The pain eventually goes down - but there are nights when I look like I'm preggo again - especially if I've been eating all the pies / tortilla chips! My diastasis closed cos of the exercises in the book How to lose your mummy tummy by Julie Tupler - details in other thread HTH.

My stomach is a mess as well. I have 3 children (not as close together as you) and am 33 weeks pregnant with my 4th. My stomach muscles never joined back together either and my belly button kind of flops out . Most of my stomach looks like Jabba the Hutt and I am very self-conscious about it. When I had my 3rd child I couldn't use a baby sling (which I'd used with the other 2) as my stomach just couldn't support my back properly, and I found it too exhausting. So you're not alone and I know how demoralising it is.

I haven't taken any medical advice about it as I knew I hadn't completed my family and I assume you need to have done so before having the surgery (is that right?). And I have the idea in my head that I wanted to do as much as possible myself before seeking invasive treatment, ie physio/pilates/healthy diet etc, which I have never quite managed to do as thoroughly as I hoped.

If, after having this baby, things are still bad and if I feel relaxed about it being my last child, then I expect I'll seek advice about it.

oh lord, i think am going down this road too

dd1 was 10lb4 vb, stomach never same
dd2 was 11lb1

dc3 on way and no idea what weight will be but look full term and am only 26wks

well surpisingly my surgeon said that if I want more children after the op then I will be able to but we don't want any more, so for me the surgery is the right way forward. Three is plenty and I couldn't face another pregnancy, especially as I'd have to have third section which carries more risk.

Many thanks for the other thread reference- I'll read it tonight.

Hi honeydew, I suffer the same as you.. Last year I went to see my doc who recognised straight away what I had and I got an appt with a consultant. Who said that I could have surgery. I am fairly slim, size 10/12 most places apart from tummy - need size 14. He said he would sew them together and I would have a have vertical scar down my middle tho. I spoke about delaying until my youngest was older he was 1 last year at the time. (I had 2 boys (9lb 2) and (9lb 10) vaginally, 3 years apart) However, my back has been getting worse and I still have to roll out of bed, cant just sit up from lying down. .. I went back to be re refered and have appt this Monday to see surgeon again to ask more questions and possibly go thru with it this time. (My youngest will be 2 soon) I am scared and wonder if I am doing the right thing. Like you I look pregnant all the time and hate it ! My back is sore, mainly the left side, get pain also across the tummy sometimes.. I am not sporty anymore, cause trying anything gives me back ache and pain at the front of my tummy. Cant go down any playarea slide that spirals with my kids as it feels like something wants to pop thru my tummy and is painful, so I just dont do it..I have looked on the internet and cant seem to find anything about a vertical scar operation.. Everything seems to report about Tummy tuck (horizonal scar) I believe and muscle repair for diastasis recti. What did you surgeon say? and does anyone have any experience of having gone thru this op? Vertical or otherwise ?

Hi everyone. I desperately need some advice. I have this condition and so far the treatment I've had has been useless. After being told time again I was just fat after the birth of my little one, doctor finally admitted there was a problem. I pretty much self diagnosed split muscles as I have a 5/6 finger gap still 5 months after the birth plus my belly button is protuding at an odd angle. My tummy constantly aches though it helps if I wear support pants. I've finally seen a Physio but she was rubbish and wasn't even a specialist. She basically told me I should be grateful I've got a lovely little boy and just accept my body will never be the same again. I look about 5 months pregnant. My belly looks odd with humps either side and a protruding belly button (hernia?). Surgery hasn't been even suggested but don't see how this is going to get better. I've been doing exercises on my own for past couple of months and has helped but don't know how much more it can help. I got told off by the physio for wearing support knickers "your muscles need to work for themselves" - I explained if I didn't wear them my tummy constantly ached and she just tutted. I feel so depressed. I'm only 28 and this is my first baby. People keep making comments on when the new little one is due?etc. I feel so upset. What can I do to help. How did any of you get to see a decent consultant. I can't bear the thought of looking like this forever but am made to feel like I'm just being vain. Please help me. I can't afford to go private. Alaine x

Thanks for all the messages. My experience is that my surgeon has said my operation will involve a horizontal scar. They have to lift up my flesh, stitch the separated muscles and put my hernia back in. Then give me an abdomioplasty. I've put it off as it's major surgery but I am HUGE and look so pregnant. I hate it now. It stops me exercising, running around, lifting and my back aches. As far as I know I am getting the operation on the NHS because my muscles have herniated through the abdominal wall and most hernia's require repair surgery. I was a petit woman ( size 8) before I had children and stretched my muscles out too far with my big babies. I just looks so horrid and like Alaine I can't bear the thought of looking like this for the rest of my life. My advice would be to discuss you concerns with a GP who may refer you to a specialist. I have a apron overhang as well which is vile.

I just wish I had known this was a complication of pregnancy. In all the books, medical advice and media,I can find very little on the subject. It's awful and if I 'd known I was going to get this I'd have left a mush bigger gap between babies.

Hi

I'm 34 weeks pg now and have been told i have a separated abdomen and am pretty much in constant pain, it's a niggling stingy type pain. The MW said i was 2 inches separated?

I don't look all that big and it's really only in the last 2-3 weeks that i've "popped" as someone put it

I'm now really worried by what i've read here. Is there anything i can do now to prevent this getting worse and is it something that normally happens this early?

Any advice would be really welcome! Thanks

I don't think there is anything you can do whilst pregnant - pelvic floors might help as they'll somewhat strengthen your core muscles which can, in turn, help with building abdominal strength afterwards. You certainly can't do any exercises to remedy the situation at this stage. But pelvic floors certainly wouldn't hurt.

My advice is not to worry about it (really! Truthfully!) because you can't do anything about it until after your baby is born so you may as well relax and enjoy the rest of your pregnancy. Plus, this thread shows that there ARE things that you can do about it afterwards and as yours has already been diagnosed then you won't have a large delay - you can push for a physio referral for after the birth of your baby. Equally, it might be worth talking to your hospital physio right now (your antenatal clinic would be able to refer you to them if you called them) as you could discuss things and get flagged for care afterwards.

Hope this helps.
Kx

Thanks so much for your response, i know i shouldn't worry and thanks for the advice. T x

When i was pregnant I had physio for spd and whilst there they told me i had diastis.

The physio held a hand on my bump and asked me to pull in my tummy and try to make a gap between it and her hand - that was the exercise to do whilst pregnant.

i am 41 weeks pg with second baby and my tummy muscles seperated with my first causing really bad back problems and then a hernia when my ds was 2. hernia was repaired as it got stuck but no other treatment was offered. this time it has happened again but midwives more aware of it due to uterus falling forward as muscles not strong enough to support. been refered to physio and have also been given the advice as littlemisstwinks, but will prob be in the same boat as everyone else. all hail the support pants!!!!!

Alaine79 I'm so sorry you've had so little help and support - dreadful as it's not just the physical impact but the pain too. It can cause major back pain (lack of support from the abdominal muscles and core). They CAN close again, or with excercises you can certainly close them to a large degree and so it is worth perservering with the exercises as it sounds like they have made a small difference. The downside to these exercises is that they take time - at least three months before you start to see results - and they need to be done a few times a day. Time is in short supply when you have a baby so I know from experience that it's not always possible to fling yourself on the floor for pelvic work.

Have you looked at the Tupler Technique? This is specifically targeted for people with diastasis recti and made a big difference to me:
www.maternalfitness.com/prgdes/midwifery_spring95.htm

As for your physio (who sounds useless - all very well her tutting, but some constructive advice would have been more helpful!!!) I would go back to your GP and push for another referral. Ask to see another physio. YOu are ALLOWED to do this. It is NOT making a fuss. It's important that you get this sorted out as aside from how you look (which I personally think is important and valid and not at all self-indulgent and vain. A drastic change in body image post-pregnancy can be hugely upsetting for people) it will give you serious back problems if it goes unchecked. YOu are basically doing without key support from your abdominal muscles which will put a huge strain on your lower back (and probably refer pain further up into your back as it struggles to take the 'load' off the lumber region). It's important that you get care for this and you are entitled to it.

The support pants are good for every day and helping with the ache and getting on with things, but at the same time you do need to do abdominal exercises every day, and usually a few sessions. I know it's hard, but when you get up and go to bed and once during your baby's nap at lunchtime would be hugely beneficial. Plus do lots of pelvic floor exercises as these will all help. IT will be really slow progress and you won't feel like you are getting anywhere but it will make a difference. The gap will close. And chase your GP. Chase for a better/different physio. There are good ones out there and they aren't just the reserve of private medicine.

Hope this helps and hang in there. THis isn't the end and your tummy will improve.
Kx

this thread is making interesting reading. My tummy muscles never went back properly after my DS 6 years ago and I've had core staility problems ever since. It separated further after DD was born last June, and I got pregnant again when she was 8months and now at 29 weeks, I have a 2finger gap and am suffereing from pulled muscles and ligaments and back ache.

I've been doing some pilates core stability exercises which seem to be helping, but I can feel a small lump just to the left and above my tummy button which I assume is some sort of hernia?

I've been referred to the obstetric physios so will make sure I get them to check it out, although it will be a group appointment so not sure how much individual attention I will get. am worried about the after effects now.

I think you're doing the right thing - the pilates core exercises will help as will the obstetric physio. Even if it's a group class he/she will presumably look at individual cases. YOu could always hang back at the end of the session and ask to have a quick chat or see if he/she can arrange an individual appointment.

Two fingers is within what is considered the 'acceptable' range and something that you can live with, however even two fingers separation will lead to abdominal weakness, core strength issues and back pain - in fact all the issues you have mentioned you suffer from, so the IDEAL is to get the separation to close. It can be done - mine is about half a finger (slightly less according to my pilates teacher) which is a big improvement on my 2 fingers of five months ago. It doesn't sound much but steady progress is the key.

And don't worry about the after effects. The fact that you KNOW that there is an issue and a potential for larger separation post-birth means that you'll be able to push for the relevant treatment/physio and tackle the issue with the relevent exercises. The issues really arise when people don't realise that they have a separation. It took me nearly a year to twig that I had a separation as my GP said that I was "fine" at my check up. I was 'on paper' as I was around 2 fingers separation, which they (lazily, in my opinion) consider okay, but actually my back has been MUCH better as the separation has narrowed and my stomach is much flatter.

Kx

thanks for that kitstwins

I think once I've had the group appointment then I can self refer myself to them for an individual appointment.

My main concern is that as most of the damage stemmed from my pregnancy with DS, I've left it far too long (will be 6.5 years after this DC) to do anything positive about it. But, I will do my very best to get things back to something like normal through exercise once this DC has been born in November.

I'll keep this on my watch list in the meantime; it would be good if it could morph into a mutual support thread

Hi there,
I too have diastasis recti, I have three children, the youngest two are just a year apart. I called a local 'physio direct' service to see if they could offer any help and was told that they were not specialists in 'womens physio' they gave me a contact number for a specialist physio based in the womens unit of my local hospital, but I could not contact her, so went to see my GP. My GP referred me to the hospital ante-natal clinic who said that my muscles would never go back no matter how many exercises they gave me and so surgery was the only way to go. I'm booked in for 27th November 2008. I'm scared stiff!!! The consultant told me he could put in mesh to cover the gap between my muscles with keyhole surgery or he could cut and sew my muscles back together, I chose the latter as it is a permanent fix, although he has said that I will have a vertical scar. Khappy - have you had your surgery?

Hello everyone,
I am so relieved to have found this site. I honestly thought i was the only person ever with this condition. I had my little boy in 2006, he has just turned 2. 5 months ago i had twin girls (there is 16 months gap). Pre pregnancy i was a size 10 with very firm stomach muscles. I got large with my little boy and got this seperation then but the muscles went back far enough not to worry about it. I then got rediculously huge with the twins, to the point where i could not walk at 30 weeks at all. My muscles are now 6 fingers apart and the girls are 5 months old. I have gone back to my pre size everywhere except my stomach where i easily look the size of a 5 month pregnant lady. Its so bad that my bowels and intestines peep through when i eat as they are not protected by the muscles. They kept saying its too early to tell what will happen but now 5 months on i have finally got an appointment with a consultant tomorrow (he was the man that did my c sec). I dont know what he will say although reading these posts i now have more of an idea. My births were horrendous. I had a natural for the 1st twin then emergency c sec for the 2nd, i heamorrhaged in the operation room so then had to be put out for delivery (even though id had a spinal) as there was no time). A week later in the hospital ward i heamorrhaged again, turned out they left placenta bits in my uterus following c sec so i got an infection which made me heamorrhaged. I then had to have another operation for them to remove the bits. I got pre-eclampsia after the birth as well. I went down to 50% blood but they never gave me a transfusion so it took weeks before i could stand up without feeling like i was goin to pass out. Now i am still in pain because of my stomach and the doctors just dont understand. I have to wear big knickers to go right over my bump as i have got so much excess skin which hangs right over my scar (which is still sore as well). My husband and i are at our wits end, we literally have no help with the children, luckily he is self employed so has had lots of time of work to help me but obviously he doesnt get paid for that. All my friends just cant understand why i keep moaning as they have all had text book births. Im getting to the point where i dont want to socialise with them anymore as im sure they think i exaggerate. I can find nothing to wear and am still in my maternity clothes (im easy a 16 around my waist and 10 every where else). I too am worried about this op as we have no help but how can i carry on like this, its rediculous. Somebody said that they make you feel like your being vein - thats so true, i get this all the time. All i want is to be comfortable and well to look after my children, its not too much to ask is it. I will see what he says tomorrow i guess.

Ps - Tinkerbell - did you have your op? How are you feeling? x

BBeau you POOR thing. It sounds like you've had a really rough time. Looking after twins is not easy (I know - mine have just turned two and I don't have an older child to look after as well so total respect to you for that!!) and if you throw in a really weakened stomach and all issues with back pain, etc. that come with that then it's no wonder that you are wiped out.

It also sounds like the birth was really difficult and it can take a long time to get over a haemorrhage. I had a small one during the delivery of my twins (also under GA as they bodged my epidural and the spinal failed) and was supposed to have a transfusion as the bleed came on the back of placenta praevia and a pregnancy of recurrant bleeding. However, the transfusion never happened due to "confusion over my notes" and so I went home badly anaemic.

Given your situation (anaemic/diastasis/twins/toddler) I'm not surprised you're feeling fed up and exhausted. Unless people are in your situation or similar they're just NOT going to get it, which can make you feel even more isolated. If it's any consolation, things will get better. You can close a separation (either by surgery or physio/specifically tailored abdominal exercises) and you won't always look like this. And it's not vain to want your body back post-children. It can be hugely upsetting to be 'ravaged' post-birth and I found it very difficult in the first few months following my twins delivery. I had awful twin skin, a (small) separation that caused pouching around my belly button. And pre-babies I'd had a washboard stomach and had been a size 8 runner. It was hard. But I did my exercises and slowly things came back together again. My stomach will never be what it was as it has carried twins and the skin has lost a lot of it's elasticity, but if you didn't know me you wouldn't know and I'm happy with that.

So this is a waffling way of saying don't despair and don't be fobbed off. Push for help from your consultant and push and push for physio referrals. You may not need surgery - I saw a physio after my c section to break down my awful scar tissue (I had big problems with this due to healing issues and a haematoma) and she told me that she saw a lot of women with this problem and, through phsyio and specific, tailored exercises, saw really good results. It took time - a good six months she said - but she had closed six finger separations to less than two, which is a huge difference.

I hope you got on okay with your consultant and try not to feel blue. The first six months with twins is really hard and adding heavy blood loss and a weakened stomach and all the back pain issues that come with that mean that you're having a really tough time at the moment. You will get through it though so take heart.

Kx

Hello K, thank you for your message. I saw my consultant and he said he is referring me to a plastic surgeon as the muscles will need gauze put over them and a tummy tuck too as the skin is hanging right over my c sec scar. Its interesting what you have said though about the physio. I didnt really think that my physio was any good, in fact she didnt really give me any different excercises to the ones they gave me in hospital - just for bog standard c-sec's. I only saw her twice before she referred back to consultant. You can get about 5 or 6 fingers between my muscles when im relaxed but the weird thing is they close when i tense. I may try to look for a second physio's opinion. As i said before its so good to hear other people have these problems (not that id wish this on anyone), its just good to talk to people that understand. Most people just look at me as if to say 'well you had the kids'. Which i did but i was as shocked as hell when i fell with twins - of cause i wouldnt change it for the world now but it just annoys me when people think you have 'planned' twins???? My little boy is 2 and i think he is going through the terrible 2's as well! God knows what its going to be like when the twins are 2! x

Hi BBeau. Well that's good your consultant is referring you. It may well be that your seperation is quite severe (some are - nothing you've done to make that happen; just one of those unlucky things) and surgery is really the thing that will make the biggest difference. If the seperation is severe then the side effects can be huge - as you know. Aside from the issue of how you look (and the mental effect this can have) there's also the issue of referred pain from weakened abdominals. The risk of hernia is high and chronic back pain can occur as the abdominal muscles aren't in place to offer support. It is not to be underestimated.

It may well be that your referral takes a while to come through, in which case it might be worth asking your consultant to also refer you to an alternative physio as the one you had sounds pretty useless. You could also google the Tupler technique as this has fantastic results. I did these exercises to close my seperation. They are tiny movements that you do several times a day but they're quite intense and over the course of a few months they make a huge difference. There's a book (I bought mine off Amazon) but there's also websites that explain the movements and exercises. I've pasted a link here that's really useful: -

www.medicinenet.com/script/main/art.asp?articlekey=56021

If you're feeling the seperation close when you tense then that's a good sign as your muscles are responding to movement. It may well be worth doing some of these exercises whilst you wait for your referral. They will help and it's also good for general stomach tone and pelvic floor strength, which is a bonus.

Hang in there BBeau. You're amazing for coping so well with toddler and twins!!

Kx