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?

Hugetum 13/01/09

I have just discovered this site and l feel so overjoyed to know that there are other mums who feel the same as me. I had my 3rd child last july and it was my 3rd cs. It was only then that l discovered l had this separation of my stomach,even though l continued to have a bigtum after 1st cs. believe me l was huge when l was pregnant ( esp at 5ft 1), my stomach was so big and so low that it was literally hanging even during 2nd trimester. After the last cs,l was referred to a physio, l was measuring 8.5 fingers!! (gap). Unfortunately 6mths later l am still 7 fingers. Having read the reviews, like you mums l am a size 10 but a 16/18 over the stomach, l do look ready to give birth, and the constant remarks from people whether l am pregnant are hurting me. Despite dieting and exercising, l just cannot shift the weight from my stomach, even the Dr thought l was expecting. I am still wearing maternity tops. I am returning to work soon and l am dreading the comments from people of whether l am pregnant. Anyway l have finally been referred to see a specialist, l don't see the physio being that useful. I would like to consider the surgery, but the only problem is that l would like to have another baby, will this make the stomach worse. If surgery is offered immediately, l am tempted to forget having a 4th child, it will be so hard to recuperate with another infant child, apart from my husband l don't have any other help. I don't want to look like this, l don't want a washboard stomach, but l just want to look like a normal mum. If anyone has had the surgery, l would like to hear from you. How long did the recuperation take place?

Hi all. I too have suffered from this condition after my first and second pregnancy. After baby number 2 I was 6 fingers separated and seriously contemplating surgery (the only thing that stopped me was the thought of the scar, plus the cost!). But I finally found some decent exercises to do that really seem to have made a difference, and I am now down to 1 finger separation (6 months after baby number 2) and it has started to close at the top and bottom - hooray! I wanted to share this as I was so depressed before, and maybe what worked for me might work for you.

Initially after baby number 1 I avoided all sit ups and things like that as I was told they would make the separation worse. Instead I followed religiously the exercises in a book called 'How to Lose Your Mummy Tummy', which many women swear by as they say it really reduced their separation. However, it didn't work for me, as by the time I became pregnant with baby number 2 I was still 3 -4 fingers separated and with a protuding pot belly (despite being a small size 10 everywhere else).

I then did the thing which I think made the real difference - I bought another book online called 'Exercise after pregnancy: how to look and feel your best' - and this one is packed full of graded exercises that gradually rebuild your core muscles and bring back together the separation. I liked this one better than the other book because it had a wider range of exercises, and worked on several abdominal muscles and not just the transverse. It was more interesting and varied, and for me it really brought results, as after just 10 mins each morning (ok - for six months) - I am now down to 1 finger separation and in parts it has closed altogether.

The one other thing I did was see a physio, and I took the book along with me. She helped me practise the exercises, and advised which ones I should do first (when my muscles were weaker) and helped give me the confidence to move to the tougher exercises over time by checking that they weren't making the separation worse. The physio was free of charge, as I linked up to her through the hospital after having baby number 2.

I swore I would share this with people on mumsnet because I know how miserable I was before, and how doubting I was that the problem could ever be fixed. Here's hoping it works for some of you!

HI everyone,

I'm so pleased that other people have responded to this thread and thanks for all the great advice with the exercises and positivity! I have just moved house, so put off my surgery for a few months. But I'm stalling really- I just can't face it right now. I know I need the op and get asked every other day when I'm due but want a break from hospitals! I'm just too scared to do it at the moment.I'm often in pain, my back hurts, I still have to wear maternity clothes ( my youngest is nearly 2 now!) and i feel like a fat old bag! I have to get it done soon but it's a big op and the recovery time so long.

But please keep posting with how things are with how people are coping, getting the separation down and it's so so helpful to know I'm not alone. People always say to me- 'oh how awful ,I've never heard of that' and on my bad days my husband gets the brunt of it all-poor love! Getting clothes that are comfortable is a nightmare - I'm size 10-12 top and 14 bottom and with the bump I look so frumpy and fat, even though my frame is small , I look really rotund! Coping with 3 under 5 is bloody hard when living with this condition. I swear my family have got used to me like this now and think I look normal! I'm going to get that book and try some more exercises to see if it helps. I feel really sluggish and slow with this- maybe that's just old age!!

I had two caesarians and two kids in two years and received (as a special free bonus) an incisional hernia after my muscles were cut badly in the surgery (ironically not in the emergency, but the planned cs) .

I then had a repair - which btw is fucking painful for quite a long time and you can't lift at all - I had it when DS was a month old - was a nightmare. My stomach is now flat, although it doesn't have the definition it once had and my muscles are back together. Once you have a hernia, even without a separation you are always going to be lumpy.

I also have a big scar from the hernia repair. DS is six months old - I have a bigger scar from the hernia than the cs's

My abdominals were assessed recently as I have no sensation at all in my stomach now (thanks to the multiple surgeries) and apparently they are very good. But a week post partum I had four finger separation.

It's hard, but you can get over this. But prepare yourself for the surgery, it's very debilitating.

Hi guys,
Well, I had my surgery. When I arrived at the hosital on the day my muscles had seperated further, all the way up to my ribs! Therefore it was a bigger deal with a bigger scar than they first thought. All went well but when I woke from the anaesthetic I was in AGONY - no joke I'm no wimp (2 vaginal births, no drugs just gas & air and one C-section had one shot of mophine and then onto paracetamol - thats all I needed) they were pumping morphine into the canula in my hand and then gave me a patient-controlled device where I could press a button for more morphine when the green light came on - I felt like I spent the whole night just waiting for this little green light! I'm now 9 weeks after surgery and still struggling, it's been much harder than I inagined. I have a vertical scar from just under my ribs to my c-section scar - it's huge. I think the message I'm trying to get across is that this if not a 'free tummy tuck' it's major surgery and only go ahead if your muscles are really causing you trouble - as mine were. I'd done all the excerises with no effect so surgery was the last option, which is how it should be. I take my hat off to any of you who have been through the same, it's been hell, but I now have my strength back in my muscles, they're together so my tummy is back in a normal shape (although still swollen) and my back pain has all but dissapeared. I'd do it again in a heartbeat. Good luck to you all, much love xxx

Wow, what a lot of horrid experiences here. Hat's off to you tinkerbell for surviving the surgery, and good luck honeydew for yours if you opt for it.

I hadn't heard of this condition before, but I had it straight after my first pregnancy and still struggle with a size 14 belly (and size 10 hips - keeping trousers up is a nightmare!). Ironically, mine seemed to get worse after I left hospital I had an emergency c section and ragins SPD, so I wasn't remotely active for a long time. I seemed to vary from 2-5 or 6 fingers. It gets worse around the time of my period. I had a 9-week pregnancy recently and the gap just relaxed and got huge again almost immediately. I struggle with back pain, but had put that down to a dodgy hip joint and the fact that my LH rib cage is still flared from the pg (over 2 years later!!).

I started a pilates class after 6 months which I still continue with, but I got a pilates video for xmas which, as someone else on here said, does a wider range and more challenging stomach exercises than my class does. I've noticed a real difference - down to 1 finger now. But I remember that pain and feeling of things falling out of you all too well. My pilates teacher is a physio and she says that they probably will never go back together again. I just feel so at the thought of such challenging exercises being required to keep me even remotely fit and well, when everyone else seems to manage it no bother! And my shape is still very belly-heavy....

Good luck to you all. we need to keep going! BBeau - be kind to yourself and take things one baby step at a time. I was in no fit state to do anything serious about it until my lo was 2 - so you are amazing to me.

Hello everyone Well how good it is to find all your info and comments on parted stomach muscles after birth. I have 2 boys - 6 and nearly 2. I had 2 emergency c sections and second ending in a gen anasthetic. My stomach went back reasonably well after my first boy (8lb 2oz) - infact very well when I compare myself now. After having my second little boy (8lb 13oz) my muscles separated a lot. I was referred to the hospital physio whilst I was still in after the c section. I went a couple of times and was told to keep doing the exercises. I was pretty good with the exercise but looking back I should have never stopped them. After a few months I went to see the doctor. I couldn't understand why I still had such a 'baby pod' which wasn't at all saggy but instead it was/is really firm. I lost all my pregnancy weight really quickly and am actually less now than when I became pregnant (I would love to put on more weight but it doesn't happen - lots of rushing around after 2 boys I guess). Anyway, the doctor just said that she thought it was likely that the cause was having had a large baby and me being very small framed. I accepted that as was feeling a bit vain about going to the doctors about this in the first place. I've only just gone back to the doctors about this again as I just knew my stomach wasn't right and started panicking that it could be down to all sorts of things. Different doctor immediately said it's because of my muscle separation in my stomach - you can fit 4/5 fingers in. I also have a small rupture to my belly button which protrudes. He told me there may be an option of plastic surgery and he would refer me if I wanted. I said I would think about it as the idea of surgery and gen anasthetic again scares me. I've done pilates for about 9 years but stopped a bit before each birth and it took me a year and a half after my second son to go back. Some days my tummy doesn't feel too bad and if I wear the right clothes, I feel OK. Other days (like today) and most evenings it feels so big and I look about 4/5 months pregnant in the wrong clothes or without clothes. It makes me feel quite squeamish to think whats going on under there because sometimes my tummy feels quite uncomfortable. It also probably explains why running 5/6/7 months after 2nd baby felt so uncomfortable (like my insides had no support). Anyway, I feel inspired by kitstwins comments and I am going to look into the Tupler technique. I'm a bit worried that some of my Pilates tummy exercise might have done more harm than good. Anyway - thats my long story!

Hi OTR, l can absolutely relate to you , exactly the same order of events for me as well. I had 3rd cs and whilst in hospital was refered to their physio's. I had 6mths of physio measuring 8 finger gap, no improvement( maybe down to 6.5 fingers), went to Dr, and she has referred me to see consultant as she thinks l have umbilical hernia. I have appt on 11/2 and l can't wait. I have been reading up alot on this area, and specially on Diastasis Recti (DR) and hernia. It appears that DR on its own, they tend not to push for surgery, because it is seen more of a cosmetic purpose.and so the only option then is to go private. However if it is hernia and it needs to be treated they tend to sort out the stomach as well, either by putting a "mesh" over the parted muscles and then fixing the hernia OR they may actually repair the DR by cutting and sewing the muscles back again and then repairing the hernia. I don't know whether it would be a vertical or horizontal scar, quite frankly l don't care!!. I am at that point in my life that l have decided not to have a 4th child and therefore surgery is the only option. Its been a few weeks but my back and belly button area has really started to hurt me and l am in agony...so bring on the surgery l say. Whats more l look like 8mths pregnant, l feel the stomach has gone bigger, despite me being petite. Also l don't think l can handle feeling mentally traumatised of carrying a huge bulge and constantly wearing maternity tops and constantly having to tell people l am not pregnant, it really hurts. Some people are in disbelief that l am not pregnant and question me further ...how insensitive. Will let you know what the consultant says. Its really good to speak to people l can really relate to, l mean it, l have read everyone's stories and all l can say is that l understand what you are all going through..god bless.

Hello Bigtum . So sorry its taken a long time to reply - I was so pleased to see a response to my message. How did your appointment go? Since I posted my message, I have been following the Tupler technique (I got the book from Amazon). I am very dedicated and do the exercises every day. I feel determined to rectify my DR but then today at work I had a blow to my confidence when the cleaner asked if I was pregnant. I felt I had to justify why I had a pregnant looking stomach - it is very upsetting. The gap has closed by about 1 finger in the last 21/2 weeks but right now my stomach looks as big as ever. When I first get up, I feel really hopeful because my stomach is definitely smaller. I'm not sure about the rupture situation with my belly button - I'm wondering whether whilst I have this my belly will always protrude to some extent - i think I need to find out more. I've read loads about DR but still a bit unsure about the whole hernia aspect and how do you know if you have one. Anyway, I'd love to know how you got on at your appointment and what the next step is for you. Thanks so much for responding to my message. Take care.

Hi OTR,

I saw the PS on tues and l am just waiting for a dater for the Op in the nxt 2 mths. That will be for the repair of the hernia and DR and abdominplasty (tummy tuck!!) PS said DR can re occur again...although l do not intend to have any more kids. I hope they stitch me up using wire!!!! no l am not joking...l hope they also put in a mesh....we will c. Will let u know date of surgery.

Hi again OTR

Continue with this tuplar method, if u can close the gap then go for it. If u have a hernia, u should c dr bcoz left unattended it can cause complications in the future. If it needs surgery to repair it, then have it done. What l have learnt is that DR on its own, it is considered cosmetic for NHS to repair it and give u a tummy tuck. they will never touch u unless u go private. However having hernia is gives u a passport to getting ur DR repaired at the same time with a tummy tuck thrown in. I too have had the same conversation with the cleaner, security , staff and members of the public, it is upsetting. I do look 8mths pregnant and apart from my belly l am skinny.

Hi hugetum!
Great to hear that you are now waiting for the op - I know it must be a bit scary but its also positive and hopefully its given you a big boost.
I've been wearing a tummy splint since Saturday - which is just a long strip of fabric which you use to pull in each side of the separated stomach muscles and then secure firmly at the back. I'm wearing it all the time for the first week and then when doing any exercise/house work etc. It will be 4 weeks on Saturday that I have been following the Tupler technique and I've resisted measuring my diastasis and distance round my middle for about 2 weeks. I'm going to check on Saturday whether I've managed to close the gap any more (I am feeling a little bit hopeful I have to say as my stomach is definitely looking different but don't want to get too excited incase the gap is still the same!). Anyway - its good to hear from you - keep me posted!

Hi
What a relief hear from mums with the same complaint as me!!!!
I have Diastasis Recti, following the birth of my 6+ pound twins in Feb last year. I have been to see a private plastic surgeon who recommended the repair operation. My separation is about 5 fingers. I have contacted my private medical insurance who have refused to cover it on the grounds that it is for cosmetic reasons. I would like to see them care for two active and HEAVY twins whilst suffering with a bad back! Has anyone had any luck with a claim? I would love to hear from you and any advice re the operation itself

Well, I've put myself on the waiting list for my surgery again so I might get it it in July/ August.

I sometimes wear a tummy/abdomen belt- like bit like a corset with velcro which pulls me all together but it's only of limited use. I still look pregnant in it and after a while it really hurts because of my hernia. I can only wear it for about 3-4 hours but then have to take it off. I look absolutely huge today. I looked at myself in the train window reflection on the way home today and thought why me?! I was only a size 6-8 before kids and now with this tummy I look like a pregnant hefer. I really did feel sorry for myself, I have to say . Other women have 3 kids and don't get this!It's so ugly and debilitating. It really is a disfigurement and I do get down some days.

I saw my surgeon last week and he told me my linea alba and abdominal muscles are far to far apart for any exercise to help and that my hernia is large. he said there was nothing I could have done to have prevented this, but having 3 big babies in 3 years did not help! So I know it was my fault, although I didn't know this could happen as a result. I didn't have it giving birth to my 10lb son by emergency C Section- only after my 3rd did it show.

This big bump looks so weird on my little frame as well and perhaps I should look forward to the surgery instead of dreading it, I don't know. my tummy is all mishapen too and feel very uncomfortable, let alone the stretch marks and section overhang! It's truly horrid,debilitating and really disgusting . I really do look about 6 months gone. It stops me doing things like running, keeping fit through any vigorous exercise, making love is problematical , I can't lift because of the hernia etc etc etc.

People moan about episiotomy's, baby flab and all the general woes of having babies like saggy boobs, but I can;t help thinking- 'well at least you haven't got a huge distended pregnant looking abdomen, a hernia, a general feeling of discomfort, stuck in maternity clothes and facing major surgery to have a normal body again'! I know I sound unkind, but no one I know has ever even heard of this before. Most people I know are used to me looking like this now and think I'm forever pregnant! My self esteem is really low some days as my body has been ruined by this condition.

Sorry- having a rant as I feel so isolated and miserable about it.

hugetum- please keep us all up to date with your op. Mine will be at Guy's hospitial- are you in London?

I still find it odd that this condition is so not really well known and I was not informed about it before I had children or in any leaflet given me by my doctor.

Thanks all for not being to harsh on me- just a bad day!

Hugetum- if you're in London or if any one else is then please post on how things go.

My other problem is sorting childcare- what a nightmare!It's only really mad people who can cope with a five, 3 and 2 year old and my husband only gets 2 weeks off!

Just for info about hernia's- you know if you have one because it protrudes through your belly button and is very painful when pressed. It can go from not being that noticable to being very uncomfortable, depending on the day. You can really hear your intestines digesting food as well becasue part of your gut is in the wrong place. If the abdominal separation is wide enough ,it acts an open door and the intestine falls through the gap and towards the front of your tummy. Long term the condition has bad side effects as the lack of abdominal strenth pulls constantly on your back, causing pain and bad posture. Well it does mine anyway!

If you have Diastasis Recti and a hernia, the NHS will repair it and give you a free tummy tuck.

Sooo many people ask if I'm pregnant- does my head in. I say 'yes' to shut them up otherwise I have explain what is the matter with me! I do actually look very pregnant through so i don't blame them.

I've just read this post and it's obvious I really must go ahead with this operation to get my life back!

Honeydew

Hi, unfortuntately l am still waiting for a date for the surgery, the problem is trying to get the plastic and General surgeon together on the same date! Now they are saying it could be sometime in June, but l have no date yet. My gap is really wide and yes the intestines fall out and l look 8mths pregnant.

I too am having nightmares about childcare and l am trying my best to avoid having the in laws here!!. It is really hard.

I work with the public and when asked when l am due, l just say "not for a while",it is depressing not able to wear nice fitting clothes. Hey on the bright side, there is a light at the end of the tunnel, l have the operation to look forward to.

Honeydew,

Please don't despair, you are not alone, believe me ask me!!!! I know exactly what you are feeling, down to the last emotion!!. I too have a very small frame, all you can see is this huge tummy. I too have three kids 7, 3, and 9mths and l do not intend to have anymore, not after the operation!!!! no way, l would like to have my body back. You see this condition looks worse on a person with a small frame. I am in London. I am looking forward to going for a big shopping spree after getting a new body, l hope they do abit of liposuction at the same time. Hang in there, it is hard, l know.

A few of you have mentioned seeing the physio to learn some exercises- did you need to be referred by the GP for this? Sorry to be so clueless , I've just never seen one before...

Is it possible to have this condition and the doctors to to have noticed. I had never heard of this and just accepted that my stomach was wrecked after having a 11lb 7oz baby, then a little 9lb 4oz.
How do you know it is this condition and not just a saggy belly, how do they measure it.

I asked my GP a few years ago about surgery and he just laughed it off. Even if I lose weight I am left with a distended flop over belly and it gives me no incentive to lose weight as is still just hangs there.

Here is an easy way to check whether you have diastesis recti and not just a post-baby jelly-belly like me:

Lie on your back, put one hand one your "midline" above your belly-button and lift your head off the floor/bed. If you can feel a gap of more than 1 or 2 finger widths between your left and right side and are uncomfortable, get yourself checked out.

The rectus muscles run up and down the front of your abdomen and are connected/separated by a gristly ligament which can get overstretched/tear in pregnancy.
Overhanging belly is more to do with wt gain/loss. Much as things do contract with time (and exercises) a true rectus gap will not just heal on its own.

Thanks Mummyfor3 tried that and I don't feel a gap or discomfort.
Mine must just be stretched from having a big baby. Always hoped it would shrink a bit but after 12 years and a second baby it looks much the same. I relly need to do my exercises more regularly I think the pilates type ones might help to firm my tummy a bit but never going to lose the over hang I think.

Hi

Just wondering if anyone can help me? I have DR and a hernia after having twins 10 months ago. I went to the doctors about it about 2 months after having my boys and the doctor just laughed and said to do some sit ups.... I asked her to refer me to a physio which she reluctantly did and I have been doing exercises 4-5 times a week ever since (not sit ups!). The exercises have helped - I'm now down to a 2 finger separation instead of 6 fingers but I still look at least 4 months pregnant and am just getting really really sick of it; both the way it looks and feeling so weak in my stomach. Also I keep getting trapped wind - something that I am sure is related to the hernia as it was never a problem before....

Anyway reading this post has made me decide to see the doctor again as I'd really like to find out about the surgery. My question is - to those who have been successful in getting referred on - what did you say to your GP?! I really don't want her just laughing again...

Also another question - a stupid one really - can I lie on my stomach?! I have never dared to incase my intestines got trapped or something! If anyone knows I'd really love to know! Thanks

Hi, Kim,
easy answer first: yes, you can safely lie on your front as long as you are comfortable in that position.
As you have let time pass since your twins (congratulations, I am amazed that you have time/energy/inclination to do stomach exercises ) AND have done physio advised exercises with some success, I think it would be very reasonable to see GP again and ask for referral to plastic surgeon for assessment. Technically what you are after is an abdominoplasty or tummy tuck and is offered on the NHS only under special rules which vary considerable from health board to health board.
Where I work (Scotland) you would certainly be seen, but would have to meet psychological criteria as well as surgical ones before offered surgery. A full abdominoplasty involving skin, subcutaneous fat, several layers of muscle is quite big surgery with potentially long recovery times and will leave you with a big scar - below the bikini line, though. Make sure you get all the info before you commit.
What should you say to your GP? - Personally I respond well to people telling me what bothers them and asking to be referred. From what you are describing, as I said, IMO referring you for further assessment would be v reasonable. Everything further is then up to the surgeon...
If your GP was laughing the last time you saw her, can you see another dr in the same surgery or even change surgery? Or was it a sympathetic smile? - we get saggy jelly bellies too...

Good luck!

Hi everyone on Mumsnet!

I have read your notes in a breath and have felt both relieved and saddened at the same time seeing there are so many women out there who share my prob!

I am 40 and have 2 kids of 10 years & 2 years of age.

My prob is also a "protruding belly" which I call a "divine heritage" after the 2nd baby that came with an unplanned c-sec opposed to the all-natural birth I had had with the 1st baby...

I had had no prob going back into my usual slim self and flat-tummy after the 1st baby... but this one cmae with a high price in my mid section... I am sick of looking still pregnant almost 2 years after the delivery...

My tummy is not too bad in the mornings (I can pull it in and fit into my jeans okey..) but it gets bloated feeling and looking and gets hard as soon as I eat something and will stay so all day long making me look 4/5 months pregnant... Once my tummy gets bloated, NO strength of pulling in will help... I just need to go around looking bloated and pregnant... This has ben so ever since the c-section day... in fact, the few days following the birth, the nurses at the hospital thought may be another baby was still in there looking at my still-7-month-pregnant-looking stomach... It has gone down substantially since, but just not down to where I can say "yes, I'm back"...

NO, I am not back... I am still looking 5 months pregnant majority of the day... And I feel depressed and desparate... Especially since I have always been a very slim person who never knew what it means to restrict herself from wearing what she just likes without worrying about any part of her body to pop out...

The strange thing is that I do not have abdominal seperation (I have tested it several times... it is less than 2 fingers width) so what is the reason of my protruding bloated pot belly?

Could anyone answer whether my case could be "extremely weak stomach muscles" and that I need to get them strengthened with very dedicated and very long-term specific exercise?

I have read about bowel adhesion stories, IBS stories, etc. but not sure what...

I have been doing pilates (1-to-1) for the last 5-6 weeks but cannot see any improvement yet... and since I have read so much I know I am doing the exercises correctly and I know which movements to avoid in order to focus only on the TAs for now...

Any ideas, suggestions, comments...?

Desparate Mom of 2...

I had this after having twins...when they were about 8 months old I had it repaired...since it was classified as a hernia I could have it done on my health insurance. It made a huge difference and gave me a waist again...but still have loads of skin etc..basically the dr just sewed my sixpack muscles back together...