diastasis

 

Yoga is a great way to help your body and mind heal from the physical and mental stresses of childbirth. Just as every woman has different needs while pregnant and uses different prenatal yoga modifications based on her own body’s needs, recovery from childbirth is a very individual thing as well. Women recover from childbirth at different rates depending on their labor experience, length of pushing, trauma to the perineum, physical condition before childbirth and type of birth (vaginal or cesarean).

Diastasis Recti/Abdominal Separation

Diastasis Recti is the separation of the Rectus Abdominis muscles (also known as the 6 pack muscles). This separation does not occur in every pregnant woman but it is not uncommon to see it postpartum. The hormone Relaxin that is responsible for lubricating and loosening the connective tissue of the pelvis and allowing it to open up for the baby to pass though, also loosens and lubricates the connective tissue of the Rectus Abdominis muscles allowing them to stretch more and potentially leading to their separation.

It is very important that a postpartum woman not do any abdominal exercises until she has checked her rectus abdominis muscles for diastasis!
If she strengthens the muscles too much while they are separated they may not come back together effectively.

Here is how to test for abdominal separation (diastasis recti):

  1. Have her lie on her back with her feet on the ground and knees up.
  2. One hand should be behind the head to support the neck
  3. With the other hand place two fingers on the Linea Alba (the midline connective tissue that links to the Rectus Abdominis muscles) at the waistline, three fingertips above the navel
  4. Gently lift just the head until you feel the abdominal muscles engage and notice how much space is between the muscles
  5. Repeat this with the fingers one to two inches below the navel as well
  6. The gap your fingers are in should be no more than 2 fingertips wide otherwise she probably has diastasis recti.
  7. If you suspect she has diastasis recti have her check with her health care provider before doing ANY abdominal exercises.

If diastasis recti has been diagnosed her are a few guidelines to follow:

  1. DO NOT do crunches or any other aggressive abdominal strengthening exercises until abdominals come back together to two fingertips apart or less.
  2. Stay away from backbends including wheel, supported wheel with a ball, full cobra, upward dog, or any other poses that drastically stretch the abdominals
  3. Twisting while engaging abdominal muscles
  4. Lifting anything heavy

Returning to Yoga

Here are some guidelines for practicing yoga after giving birth.

  • Only gentle stretching should be done until there is a substantial decrease in bleeding. (Usually about 2 to 4 weeks postpartum after a vaginal delivery)
  • If bleeding increases with activity, the woman should decrease intensity
  • If a woman has diastasis recti, she should consult a health care provider and avoid poses that will make it worse
  • She should start off doing five to fifteen minutes a day and gradually build up her practice
  • If a woman has had a cesarean birth additional consideration should be taken. Here are some guidelines for yoga after a cesarean birth:
    • It is best to abstain from all but gentle stretching until 6 to 8 weeks after cesarean.
    • Poses that stretch the area of the incision should be avoided until incision is healed. (i.e., backbends)
    • As with all prenatal and postnatal yoga if a pose doesn’t feel good, it should be avoided.
    • The woman should remember that although cesareans are a type of birthing, they are still major abdominal surgery and the body’s healing process should be observed and respected.
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