Why you’re struggling to lose your post-baby tummy: diastasis recti

Why you’re struggling to lose your post-baby tummy: diastasis recti

Post pregnancy, you expect a little tummy pooch until your uterus contracts to its pre-pregnancy size. What you don’t expect, though, is a condition called diastasis recti, which causes the so-called “mummy tummy” to never go away. This is a separation of the abdominal muscles. The muscles on the left and right side of the belly become stretched by the constant pressure of the growing baby and they are unable to retain their shape. It is what makes your high waist jeans that fit great before, never fit again even though you return to your pre-pregnancy weight.

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SYMPTOMS & CAUSES

Diastasis can cause a host of problems beyond the mummy tummy such as lower back pain, constipation, and urine leakage. The muscle should return to normal after birth but most women report this ongoing condition to at least some extent. Having multiple pregnancies, surgeries, or other abdominal issues raises your chance of having it.

AVOID ABDOMINAL EXERCISE WHILE PREGNANT AND POSTPARTUM

To keep a toned stomach, I often did exercises like crunches and planks before and soon after pregnancy. These muscles are already strained during pregnancy and when done wrong, exercises like these can make matters worse. Although I was one of the few who escaped permanent damage, I have friends who weren’t so lucky. They went on to have protruding stomachs, abdominal issues, and even a hernia (a condition when organs start poking out of the thin band of connective tissue that is left when the abdominal muscles have separated).

A SIMPLE TEST CAN TELL

You can get a good idea of whether or not you have diastasis recti through a simple, at-home test. Diastasis is measured by a gap of more than 2.7 cm between the muscles. Lie on your back with your knees bent and your feet flat on the floor and place your fingers palms down on your belly button. Lift your head and neck up a little while you press down with your fingers. If there is a gap between the muscles you feel, that is the diastasis.

TREATMENT OPTIONS

There are some specific treatment options to help. If you suspect that you have this condition talk to your doctor. They can tell you whether your case is manageable through postpartum exercise or if you need surgery. If you go to a trainer, make sure they are familiar with diastasis or they could make your condition worse. Your doctor might recommend some gentle, at-home exercises or refer you to a physical therapist.

An operation called abdominoplasty or a tummy tuck may be recommended if your condition is bad enough to cause additional problems. The surgery involves stitching together the weakened central ridge. There is a device called a splint or binder that you can ask your doctor about but it’s still up in the air as to whether it is helpful or not.

There are programs online and that provide postpartum exercises that you can do at home to strengthen your core and try to close up that diastasis recti.

PREVENTION

If you know that you’re planning to get pregnant, the best thing is to start strengthening your core before getting pregnant to prevent diastasis recti. While pregnant, it’s best to avoid movements that isolate abdominal muscles like sit-ups and instead focusing on overall body strengthening.

5 tips for healing vaginal tearing

5 tips for healing vaginal tearing

The birthing process comes with many unexpected realities. We expect pain, joy, and even the unknown. One less known fact of delivery is vaginal tearing. Vaginal tearing occurs most commonly because the baby’s head is too large for the opening. Other factors can also raise your risks, such as being a first-time mother, having a larger baby, longer delivery, or the use of birthing assistance like forceps or the vacuum.

Vaginal tearing is often a natural part of the birthing process and should not be feared. In many cases, it heals back quickly, usually within ten days. The healing process for natural vaginal tearing also tends to be quicker than that of an episiotomy. Episiotomy is a surgical cut to the vaginal opening to prevent uncontrolled tearing during birth.

Birthing Process, Vaginal Tearing Healing and Treatment

FOUR DEGREES OF VAGINAL TEARING

There are four different degrees of vaginal tears. Depending on the severity of the tear, you may require stitches. For a higher degree tear, your recovery time could be a bit longer and you might experience more pain or discomfort. With some of my children’s births, I hardly noticed the vaginal tearing. With others, it was significant and took patience.

VAGINAL TEARING TREATMENT

There were some vaginal tearing treatment methods that my doctor recommended that really did work well.

1. REST

Your body cannot heal unless you rest. You have your hands full trying to take care of your baby so rest as often as you can and allow your body to naturally go through the process of healing. There are certain activities that I found aggravated the stitches or just prolonged healing. Walking too much, sitting too long, and lifting anything heavier than my baby were a bad idea. My doctor recommended no exercise or sexual activity until after the six-week checkup to ensure that everything did heal properly. In the meantime, take naps often, even short ones. Try to eat healthy and drink lots of fluids to prevent constipation.

2. STOOL SOFTENER

I got stool softeners after the delivery to prevent strain during a bowel movement as constipation is common during postpartum recovery. My doctor recommended using them for a couple of weeks, which I think is a great idea.

3. SQUATTY POTTY

Another great way to avoid putting pressure on the perineum while recovering from a vaginal tearing delivery is to use a squatty potty to empty your bowels. It keeps you in a squatting position that doesn’t compress the rectal canal. This shortens the time you spend on the toilet and minimizes the pressure on the perineum.

4. APPLYING COLD PACKS

The best way I found to relieve the discomfort was by using cold packs. In the hospital, the nurses used ice cubes in a sealed plastic bag and wrapped in a cloth or a baby diaper. The sharp corners on the ice cubes can be really painful against the tear, even through a diaper. Luckily, there are softer perineal cold packs filled with gel that can be applied without any discomfort. In the days following the delivery, I applied cold packs for 20 minutes at a time every few hours and it really helped with the swelling, bruising, and pain. Don’t apply too long as it can do damage.

5. SITZ BATH

My nurse at the hospital recommended soaking the perineum in a warm sitz bath at least twice a day. There are many different sitz bath devices that can be placed in the toilet to help with this. You can also just sit in a tub with water up to your hips. In fact, sitz bath got its name from the German “Sitzbad”, which just means sitting in a bath.

For me, taking a sitz bath never really worked in the stressful first weeks of taking care of my newborn and I think my perineum recovery suffered as a result. I’ve heard from a couple of friends who tried it that this is an effective technique and I regret not taking the time to make it work.

6. PERINEAL MASSAGE 

Keeping muscles healthy and strong can help avoid complications. Perineal massage can be beneficial both in preparation for and recovery from delivery. Make sure to consult with a pelvic floor physical therapist before doing perineal massage. My physical therapist didn’t recommend perineal massage until my vaginal tear stitches had properly healed.

7.  KEGELS

Kegel exercises is another way to prepare the pelvic muscles for delivery and recover the muscles after birth. But it’s actually really hard to do kegels correctly. Some 25% of women do them wrong! A physical therapist can help you learn how to do kegels right and determine whether it’s the right fit for you. Some women have an overly tense pelvic floor and so should not do kegels.

CONTACT YOUR DOCTOR

A few months after my delivery, I discovered a painful pink spot in the stitched part of my perineum. I showed it to a number of doctors, before one of them figured out that it was granulation tissue and burned it off with silver nitrate. She explained that I was essentially “healing too well.” And eventually, the pink spot disappeared. But the road there was painful and frustrating. One of the doctors that I saw speculated that the area was too moist to heal and gave me the completely impractical advice to go commando!

But that’s not to say that you shouldn’t see a doctor if you’re not healing well. If you see any larger blood clots on your pad, any foul-smelling discharge, or your symptoms get worse, call your doctor as you could have an infection or other complications.

Pelvic organ prolapse – why you should pay attention to that pelvic pressure

Pelvic organ prolapse – why you should pay attention to that pelvic pressure

I was told over and over again that my body would snap back into shape like a rubber band after giving birth. Well, that turned out to be far from the truth for me. I wasn’t diagnosed with postpartum prolapse until I was 9 months postpartum; before my diagnosis, I had never heard of the condition. My OB referred me to a pelvic floor physical therapist. I was so completely mortified at the thought that I never had the courage to go.

Pelvic Organ Prolapse - why you should pay attention to that pelvic pressure

Pelvic Organ Prolapse Symptoms

What had caused my prolapse? Well apart from the fact that pregnancy stretches out the pelvic floor (the muscle hammock that holds the internal organs in place), I had donned my running shoes at 6 weeks postpartum and completed 2 half marathons by the time my baby was 9 months old. When I finally mustered up the courage to go to the doctor I was experiencing nearly every symptom of pelvic organ prolapse (POP):

  • Lower back pain and increased pelvic pressure
  • Irregular spotting
  • Frequent urinary incontinence, especially while I was running.
  • Painful sex
  • A heavy dragging sensation in the vagina
  • The feeling of incomplete bowel movements and constipation. (Liquid stools and other changes in bowel movements are also common.)

In fact, the only symptom that I didn’t have was my organs visibly bulging out of my body!

I also learned that there were several factors that could increase the risk of pelvic organ prolapse:

  • Having a weak pelvic floor. Before my pregnancy I didn’t have any symptoms of a weak pelvic floor, but after it was definitely stretched out.
  • Having a vaginal birth, especially if it was assisted with forceps, a vacuum or had a particularly long pushing stage. Big babies can also stretch the pelvic floor more than normal. My labor was short, sweet, and unassisted. But my baby was nearly 9 pounds!
  • High impact exercise, excessive baby carrying, or constant straining (from constipation) can make the condition worse. I was more than guilty of this. The constant pounding created by running increased the pressure of my internal organs on the pelvic floor.

Pelvic Organ Prolapse Treatment

As I found, there isn’t a “one size fits all” approach to healing from POP. And since there are different stages in terms of POP severity, there are also different intensity levels when it comes to healing:

  • Some women undergo surgery where a mesh hammock is placed under the internal organs to help hold them in place.
  • Visiting a physical therapist is also an option. There they will make sure that you are doing your pelvic floor exercises correctly and help you learn other ways to activate and stimulate your pelvic floor muscle.
  • A pessary can help. A pessary is a ring that is inserted into the vagina. It increases passive support of the internal organs.

Regardless of the severity of the condition, it’s good to keep toilet visits short and unstrained to avoid putting pressure on the pelvic floor. One way to do this is to use a squatty potty. A squatty potty prevents compression of the rectal canal by keeping you in a squatting position. It helps to move bowel movement quickly.

Exercises That Are Gentle on the Pelvic Floor

Your pelvic floor is part of your core. As such, any low impact core-strengthening exercises are advised for healing when it comes to POP:

  • Yoga
  • Pilates
  • Spinning
  • Swimming
  • Stair walking

These are all great ways to strengthen your core, including your pelvic floor without risking your pelvic organs falling out of your body. Personally, I found complete healing through Pilates.

 

How to exercise after childbirth

How to exercise after childbirth

There is something special and beautiful about the pregnant body. It is a wonder and a miracle and during each of my six pregnancies, I often found myself feeling like I was “glowing”. This glow quickly faded in the shadow of my post pregnancy body. What a letdown!

The body that had served me well and brought life to each of my precious children, struggle postpartum. With each consecutive pregnancy, it became more evident that my pelvic floor was weakening. There was a constant feeling of pressure and a feeling that the baby was simply going to drop out while I was pregnant.

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TALK TO YOUR DOCTOR ABOUT EXERCISE AFTER CHILDBIRTH

After my first baby was born I consulted my doctor about recovery options. Thankfully, my case was not considered severe and my doctor assured me that with the proper post pregnancy exercise and care for my body, I would soon feel like myself again (though, I was skeptical that this was even possible).

Doctors recommend that you wait six weeks before resuming exercises after childbirth to allow your body to heal. At six weeks, my condition had not improved and I was anxious to get started. As with everything else in life, I dove in.

SLOW AND EASY IN THE BEGINNING

I have always enjoyed yoga and I eased back into it carefully. My doctor recommended low impact exercises that targeted the core such as Kegel exercises, pelvic tilts, and the plank. I started very slowly with just the Kegel exercises and in a couple of weeks, worked my way to include the others in a ten-minute routine a day.

WALKING IS AN EASY CHOICE

One of my favorite activities to do with my newborn is walking. I just put her in a stroller and head out. Although walking is uncomfortable with a weakened pelvic floor and I had to start with just minutes at a time, my condition did begin to improve after a couple of months of kegel exercises and yoga. I walked slow and gradually built up to a half hour by the time my baby was three months old.

EXERCISES THAT CAN HELP

There are other exercises that can be of great benefit, too. Pilates, stair walking, and swimming are all low impact exercises that are recommended for postpartum. As you advance, spinning is a wonderful way to get back into shape, especially after a postpartum prolapsed.

A LITTLE SUPPORT

Postpartum prolapsed is a when the organs in the pelvis drop because of weakened muscles to hold them in place. Pessary can be used to add support to the pelvic organs when doing certain exercises. This is a removable plastic ring that acts like a brace, holding up the pelvic wall. It can aid in healing and help with the discomfort until you are healed.

WHY EXERCISE AFTER CHILDBIRTH IS IMPORTANT

Finally, when my baby was five months old, I went out for a walk one day and noticed that the discomfort had lessened significantly, my hard work had paid off and I was beginning to heal. It was not the end of my journey and I had to continue to exercise, eat right, and care for myself but my body did return.

For me, the key element to full recovery was hope. Yes, you can get your life and your body back. Be diligent and don’t give up and in the meantime, enjoy your precious little one and your yoga. Time flies and before you know it they’ll be doing yoga with you.