Ever heard of the 'pregnancy belly'?
For a lot of women, one of the 'not so joyful' aspects of recent motherhood is trying to get back to the same size and shape you were before pregnancy and childbirth.
Changes During Pregnancy
Many times, the changes to the body during pregnancy are controlled by important chemical substances known as hormones.
Hormones are produced by the body to ease the process of carrying the pregnancy through the antenatal period, childbirth/delivery and immediate time after childbirth.
After childbirth, the hormone levels gradually start to reduce but in some cases, some of the changes they brought with them persist - to the frustration of many mothers!
How Pregnancy Belly develops
By far among the most common is the effect of the hormones on the womb and abdomen during pregnancy.
This is because, as the pregnancy progresses and the baby grows bigger, the womb, which is a muscular organ, stretches to accommodate it.
And, to accommodate the enlarging womb and preserve the other vital organs in the woman’s abdomen, the walls of the abdomen to the front also stretch forward and outward.
Pregnancy Belly aka Abdominal Separation, Rectus Abdominis Diastasis (RAD); or Rectus Diastasis.
First, let's talk about 'boring' medical terms!
The front of the 'tummy', i.e. the area from the bottom of your ribs to the top of the pubis is covered by sheets or layers of body tissue.
From the outside going inwards, there are skin, fat, muscles, and other layers.
They protect vital organs including bowels, liver, womb, bladder, etc.
The rectus abdominis is the first muscle sheet in these layers.
It runs from the bottom of the ribs to the top of the pubis.
It is divided into two halves and popularly referred to as the ‘six-pack’.
You will appreciate this best in the physiques of slim, muscular people and/or athletes.
The body tissue separating the two halves of the muscles is known as the Linea Alba (white line).
When the muscle stretches, it becomes easy to split along its middle (linea alba).
This leads to what we know as the ‘Pregnancy Belly’.
This condition does not only occur to pregnant women; it can happen in men, too.
In this case, it's usually from yo-yo dieting, doing sit-ups or weightlifting the wrong way etc.
Why does Pregnancy Belly Happen?
Not all pregnant women get Pregnancy Belly, but it is very common in pregnancy.
Some pregnant women may not realise they have it as it can happen in different degrees and small separations are easily missed.
For those who do develop it, the most common reasons are:
Multiple pregnancies (twins, triplets, etc. that significantly make the womb bigger and therefore create more tension on the muscle sheet)
- Carrying a large-sized baby
- Having weak 'stomach' (abdominal) muscles prior to pregnancy
- Having a narrow pelvis - usually in petite, small frame women
- Poor posture; and
- having been pregnant in the past.
In addition, any other condition which ‘strains’ the top abdominal muscles would worsen the separation.
These can include being overweight, constipation, lifting heavy objects, and (if not done properly?), the process of pushing or bearing down during labour.
Next, there are certain types of exercise that can increase the weakness or slackness of the muscles and the risk of the separation.
They are moves like
- Abdominal crunches,
- and front planks, all of which can make abdominal separation worse.
It is also important to be careful with swimming and some yoga poses (like downward dog).
Dealing with usual Post-Pregnancy tummy
Generally, after birth, pregnancy hormones can linger for 6 months.
As a rule, the more fit you were before pregnancy, the quicker your pre-pregnancy shape or size returns afterwards.
The hormone changes cause the tummy to reduce in size – aided by exercise, healthy diet, (and breast-feeding for some ladies).
While some ladies can regain their pre-pregnancy weight/body within weeks, for most women it takes months (and longer) to do so.
This should not be surprising – if it takes 9 months to stretch the muscles to accommodate the womb, we should not expect the muscles to shrink to former size straight away.
How quickly the muscles of the 'tummy' (in the absence of RAD) tighten up varies.
It can depend on: the amount of weight gained during pregnancy, how active you are after birth; and your eating habits as well as – your genes!
So, while it may be challenging for some ladies to deal with post-pregnancy weight gain and belly fat, for others it can be straight forward.
In the case of the Pregnancy belly however, remember the problem is that the outer muscle layer (Rectus Abdominis) is overstretched and slack, and the Linea Alba is damaged.
It can remain so despite exercise because the separation of the muscles makes them weaker, and more difficult to return to their usual form.
This allows the appearance of a hanging or protruding 'tummy' pouch which happens in women with pregnancy belly.
It can be quite distressing to many women, affecting their confidence in their appearance and relationships with their partners.
Treating the Pregnancy Belly.
The treatment depends on the degrees/severity of the separation.
In most cases,
- regular pelvic floor exercises,
- appropriate deep abdominal exercises (avoiding strain to the upper muscles)
- and maintaining a good posture can correct the separation.
Remember! - your 'belly' muscles should have fully recovered and come together before the next pregnancy to avoid more injury.
This is especially important after a caesarean section (CS).
What are Pelvic Floor Exercises?
Pelvic floor exercises are moves that tighten the muscle of the pelvic floor.
To do this, imagine you are urinating - and then squeeze to stop the urine flow.
This squeeze action is the contraction of the pelvic floor.
It is thought that this helps to maintain your core.
To keep the belly muscles from separating further, it would be useful to have an abdominal support or belly splint while continuing to exercise and strengthen the deeper muscles.
This also allows the connective tissue/Linea Alba to heal.
There is the Tupler technique, which is a series of exercises that aims to treat significant abdominal separation with some success reports.
In some cases of severe separation that have not responded to exercise and moderating issues like weight, constipation, etc., surgery is an option.
The surgeon can repair (sew together) the weak, central connective Linea Alba and this closes the abdominal separation.
Preventing pregnancy belly
If you do not have a Pregnancy Belly, you can reduce the risk of developing one by strengthening the abdominal core muscles and avoiding some of the conditions mentioned earlier.
If you already have one, first talk to your doctor so the degree of the severity can be assessed and treatment options discussed.
Remember, avoid doing just any type of exercise because some types can worsen the condition.
Editing by AskAwayHealth Team
All AskAwayHealth articles are written by practising Medical Practitioners on a wide range of health care conditions to provide evidence-based guidance and to help promote quality health care.
The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
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