Abdominal Separation in Pregnancy and Post-Partum

Tom Hol
Engadine and Sutherland, NSW, Physio Inq Licensee

Summary

  • Abdominal separation (DRA) occurs when the tissue between abdominal muscles stretches during pregnancy.
  • Small separation is normal, but significant separation can cause bulging, weakness, and pain.
  • Issues surrounding Untreated DRA.
  • How to reduce risk and strain.
  • Treatment includes wearing compression garments, maintaining good posture, and doing specific exercises under guidance from a Women’s Health Physiotherapist.

Topics covered in this article:

As a Women’s Health Physiotherapist, one of the most common concerns I hear from mums and pregnant women is how to reduce the risk of developing abdominal separation or how to recover from it. In this Part 1 article, you’ll find out what is “normal” and “not-normal” abdominal separation, the risks of leaving it untreated, what to avoid to reduce the risk of getting it, and how to resolve it.


What actually is abdominal separation?

During pregnancy, the abdomen has to make room for growing baby, which means that the abdominal muscles have to stretch! Abdominal separation – also known as Diastasis Rectus Abdominus (DRA) - occurs when the linea alba between the rectus abdominus muscles separates more than “normal”. 

The linea alba is the connective tissue that connects the rectus abdominus muscles (the 6 pack) into the midline of the tummy and once stretched can cause a bulging/doming appearance of the tummy.


But isn’t abdominal separation “normal”?

100% of women have some degree of separation during or immediately after pregnancy. So a small abdominal separation (2 finger width) is considered “normal”! A “normal" separation doesn’t bulge and allows you to function well without pain or discomfort.

Signs associated with “not-normal” abdominal separation:

  • Belly bulge or doming appearance in the middle of tummy
  • Feeling of “core” weakness
  • Low back or pelvic pain
  • Pelvic floor weakness or incontinence

What are the risks of leaving abdominal separation untreated?

It is important to retrain the abdominal wall to recover function in between pregnancies, not only for cosmetic purposes but to support the growing uterus, minimize associated musculoskeletal discomforts and prevent a worsening abdominal separation. Multiple pregnancies without recovery of abdominal muscles in between increases the risk for developing DRA due to repeated and prolonged stretch on the abdominal wall.

If you think you may have abdominal separation, whether you are pregnant or have just had your baby, Women’s Health Physiotherapy can determine which activities and exercises can help to increase strength and support, and which things you may need to limit and avoid. 

What should I avoid to reduce the risk of developing abdominal separation?

Generally, through pregnancy and early postpartum it is best to avoid: 

  • Sit up type motions i.e. when getting out of bed (try rolling to the side and then pushing up as a safer alternative)
  • Constipation and straining on the toilet
  • Heavy lifting
  • Crunches or sit ups 

What can I do to resolve abdominal separation?

  • Wear compression garments over the abdomen. A Women’s Health Physiotherapist can prescribe and provide tubigrip bandages or maternity compression garments.
  • Practice good standing position. You should be upright and tall, with a small curve in your lower back. Try to reduce excessive sway in the lower back and try not to push your hips forward. 
  • Pelvic floor and specific abdominal exercises.

Stay tuned for the Part 2 article, where you’ll find great, safe core-exercises to get started after delivery and help reduce the symptoms and appearance of abdominal separation.

At Physio Inq Sutherland, we are ready to provide you with the advice, training, and garments to reduce the risk of abdominal separation in pregnancy, or help you mums recover; weakness and pain is not “normal” and you can do something about it! Contact us today for a Women’s Health Physio appointment in our private room.

Date Published: Friday, November 13, 2020
Date Modified: Tuesday, July 2, 2024

Tom Hol

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About The Author

Hi! I'm Tom Hol

Tom brings a fresh approach to business ownership, focusing on keeping his staff happy.  He does this partly because he knows it keeps his clients happy, and partly because he gets real pleasure out of making sure his team are stimulated and progressing in whatever area of the business interests them. Tom has always put his whole self into what he is passionate about, and is one of those fortunate people whose passion, and work, are one and the same. An almost 10-year career as a chef saw him running a well-known hatted restaurant in Potts Point, appearing on the TV show, Iron Chef, and working with some of Sydney’s most respected and innovative Executive Chefs.  However, when his passion for human movement and mobility took over, Tom orchestrated a career change and retrained as a physiotherapist. Graduating from Australian Catholic University in 2016 with a Bachelor of Physiotherapy, Tom sought out the game-changers in the physiotherapy field and found an instant fit with Physio Inq.  Tom started work at the Engadine clinic in January 2017 and within a short period of time, was managing the clinic, and enjoying his new profession. Tom, with his wife and business partner, Laura, purchased the Physio Inq Engadine clinic in 2018.  Under their guidance, the clinic grew, and in 2022 it was relocated across Station Street, to a commercial property three times the original clinic's size.   In 2019 Tom and Laura opened their second clinic, Physio Inq Sutherland: a huge undertaking, but nothing too daunting for the Hols. Tom leads by example and encourages people to maximise their achievements.  He is always thinking about getting the best results out of the efforts that are put in.

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