Pregnancy Q & A

“Why didn’t someone tell me this IMPORTANT information when I was pregnant? Or before I was pregnant?” This is the sad lament I hear from many of my members. You want to know why no one told you about diastasis recti (a.k.a. The Grand Canyon in your abs) and you want to know why your surgeon said you could only fix it with surgery (um, because he/she is a surgeon), and you want to know why no one gave you a splint when your belly was hanging down to your knees!

Me, pregnant with my son, modeling my tummy with my daughter.

Well, thanks to some not-so-subtle nudges from my most dedicated and invested members, I’ve created this specialized “Question & Answer” page just for pregnancy and core-related topics. Just scroll down and take a peak at all the questions, answers and links. But first I’d like to admit that I don’t know everything… Golly, three years ago I didn’t even know I still had a diastasis separation in my abs  because the fitness industry teaches and utilizes a test that yields false negatives (i.e. says you don’t have one when you do have one) which is possibly why they remain so silent on the far-reaching consequences of doing situps and crunches with this injury: they don’t realize their clients have them!!! So you’ll find links to many sites and articles as well as my own opinionated, piddly two-cents on each topic. Read on!

1. Does every pregnant woman get Diastais Recti (DR)?

If you don’t know what DR is, click HERE to read these handouts, but here’s the cool thing about diastasis and pregnancy: pregnancy doesn’t cause diastasis. Pressure causes diastasis, and the way we move, eat, breathe, and align our bodies affects the pressure of our bellies. Watch how you stand and notice how different standing postures change how far out your tummy protrudes. Of course, a growing baby can create lots of pressure in your belly, but sometimes women manage to CLOSE their diastasis while pregnant (more on that below).

Read this research abstract and see for yourself how every pregnant woman in their 3rd trimester had diastasis recti.

But then! Read THIS ARTICLE by Katy Bowman of Aligned & Well entitled “Under Pressure” but do not be confused about sucking in: I assure you, I don’t teach the “suck in” method. Far from it.

how to avoid diastasis separation in your abs during pregnancy (pregnancyexercise.co.nz)

Now here’s the kicker: It’s often the pushing phase that makes DR way worse! You can go all pregnancy with little to no DR and then have a traumatic birth with a long, arduous pushing phase where you’re bearing down all wrong, or you might have a surgical birth where your abs get sliced apart, doing major nerve damage, and that’s where the DR happens. More on that below…

2. Can I heal my DR while pregnant?

I’ve witnessed and heard countless stories of many women closing their gaps while pregnant! Kelly Dean, licensed physical therapist and owner of The Tummy Team, presented a couple case studies at her workshop “The Importance of Core Strength in the Prenatal & Postnatal client” regarding women who finished prior pregnancies with 4-6 finger gaps, closed them with physical therapy on their core, then went on to finish subsequent pregnancies with 2 finger gaps that closed within 6 weeks. She’s also had clients close their gaps during pregnancy and I’ve had members report the same, usually during the 1st or 2nd trimester. They find out they have diastasis at the same time they learn they’re pregnant. They start the work of aligning and targeting their transverse, and it closes a bit or all the way. Then baby grows, and belly expands, and maybe it opens up a bit, but then the DR closes right back up again shortly after delivery! Kelly’s research has led her to state that 98% of women who have been pregnant will have diastasis, but about 2% of women don’t have diastasis after pregnancy. But those are studies on women who’ve never had rehab or TummySafe Fitness ;)

“Remember how I said I was starting to feel separation above and below my navel? Well after being very faithful with my alignment, tummy safe workouts and not letting my “guts spill on the floor” everytime I bend over, I am happy to report that I no longer feel any separation! Which is amazing because my baby belly has grown quite a bit in the meantime!” Fit2B in Nebraska, Bethann W. 28 weeks 

3. Should I splint during pregnancy?

No one would deny a cast to a person with a broken leg and tell him, “Oh just stand right, and keep your leg muscles tight, and it will get better all by itself!” Um, no. your belly is truly broken, and it needs that extra support. When the two sides of your abdominal wall have separated to 3 finger-widths or more, your belly will have a really hard time “getting a grip” again. It’s an injury, and it needs support! Kelly Dean of The Tummy Team recommends splinting when a diastasis is 3 finger-widths or wider, and she also made a strong case that splinting can help fight post-partum depression regardless of presence of diastasis recti. It is usually not necessary to splint during the first trimester of pregnancy, but it is often recommended for later stages.

Click HERE to read our Splinting info page and recommendations

4. Should I splint after delivery, even c-section?

YES! You should. Kelly Dean of The Tummy Team and I are working hard to get the word out that no woman should leave the hospital or birth center without a splint and a prescription for abdominal rehab. They’ll give you these things if you merely ask nicely. It’s common practice in many hospitals in my area to provide splints after multiples birth or ceasarean section, but not for vaginal birth; meanwhile some hospitals don’t offer any splinting. There’s no consistency in America, but postnatal belly binding seems more common in other countries.

Here’s the article I wrote about “Binding Your Belly After Birth.” And this is the webinar ALL about splinting that we did with Celeste, creator of the FitSplint!

Julie Tupler cautions against splinting right after a C-section and says to wait for 6 weeks {watch her webinar with Fit2B by clicking here}. Meanwhile, a labor and delivery nurse I spoke to in Connecticut – who is also a perinatal fitness trainer – said, “The incision needs to be open to air in order to heal. I agree that binding is really really beneficial but it’s a secondary priority. The only ones who really do it here are women who come from cultures where it’s the norm. And I always tell them to wait at least two weeks (if they had a section) to start. If I didn’t have some perinatal fitness background and was just an L & D nurse, I’d probably tell you that binding was a bunch of nonsense. But because of my training I know better now. BUT as a nurse I know that not getting an infection is priority #1 and everything else has to come after that.”

So perhaps this is one more reason to avoid c-section if possible: you have to wait longer to to get your tummy muscles going again, and they have also been sliced through which takes them longer to reconnect. I’ve had several members get the BEST results with both splinting and massaging their scar (see video below) as soon as they can after birth. Here’s a great video about scar massage!

5. What moves should I avoid while pregnant?

The fast answer is that you should avoid crunches, sit ups and planks. But the more detailed, personalized answer is that you should avoid any exercise that increases pressure within your belly, any move where you cannot tighten your transverse abdominis against gravity’s pull on your belly, and any move where you cannot maintain good balance and alignment and proper breathing technique… Oh and anything where you lie flat on your stomach once the uterus rises out of the pelvis. But doesn’t that feel a bit like I’m telling you that you can’t do anything at all? Because sometimes you don’t know until you’ve tried, and by then it’s too late and you’ve just made your diastasis worse and maybe even mal-positioned your baby. Believe it or not, there is QUITE a bit you can do on your back well into the 3rd trimester that HELP position your baby! So here’s some articles about why crunches stink, and for fun I’ve also included proof that the fitness industry is still selling sit ups to pregnant women!!! Gah!

 Read THIS ARTICLE by Julie Weibe, physical therapist at Interior Fitness, entitled “dear dr. oz: diastasis and (gasp!) crunches??” 

This article by Katy Bowman makes a strong case for avoiding treadmills and high heels, too! Click HERE to read “4 fast fixes for pelvic floor disorder.”

Want proof that the fitness industry is still teaching that crunches/situps are okay for pregnancy women? Well, the American College of Sports Medicine says situps okay for pregnant women in THIS ISSUE of Certified News. And there is ZERO mention of diastasis recti in that article. Sigh.

SHOCKING NEWS: You may also want to limit the number of kegels you do during pregnancy. READ THIS! 

6. What motions should I focus on while pregnant?

I’m starting to like the word “motion” over the word “exercise” because most people might object to “exercising all day” but they can’t object to being “in motion” all day. We move to live. We live to move. And certain movements are WONDERFANTABULOUSO when you’re preggers. Below this amazing picture there are more articles for you to read :) Basically it boils down to aligning, walking and squatting, though.

Everything you need to know about exercise, abs, splinting & diastasis during pregnancy & beyond by fit2b.com

pin me!

Here’s my article on the 3 best exercises for pregnancy and birth… yeah I said exercise because I do LOVE exercise motions ;)

Here’s a guest article written by Kim Vopni of pelvicfloorwellness.com for Fit2B Studio that details her professional opinions about the best exercises for pregnancy and post-partum. It’s wonderful advice!

Here’s one of my fave epic squatting blogs by Katy Bowman called “What to Expect when You’re Squatting.” Okay, I admit it: I’m a Katy Stalker!

Be sure to check out TurningBaby.com where you’ll find an affordable online program by my colleague across the drink, Lorraine Scapens in New Zealand. Click HERE to learn about her program and take time to watch this webinar that we did with her about how certain exercises and your alignment affect your baby’s position.

7. Do you have any tips for pushing and positioning during labor? 

Yes, but I’m going to defer to the experts on this one and tell you to get your hands on these two products:

  Click here to watch Kelly’s Personal Story 

8. How can I protect my pelvic floor (and not wet myself or get prolapse) during pregnancy and delivery?

Read this abstract of a study showing how the transverse abs co-activate with your pelvic floor.

Learn four things that you can do/don’t to protect your precious pelvic area during pregnancy and beyond by clicking HERE to read “4 fast fixes for pelvic floor disorder by Katy Bowman.

Wendy over at *MuTu System has written some great articles about hernia and prolapse and why kegels aren’t enough (or sometimes too much). Our work is similar yet different, and I’ve referred many clients to her when they need more specific programming that incorporates nutrition and running. She provides DVDs, too, while I don’t yet.

Do Fit2B Studio workouts! We specialize in diastasis-safe, prolapse-safe, maternity-safe workouts that are still very effective. Only I don’t use crunch-like motions or situps or loads of planks without modifications. It’s just kinda my thing and it really works!

“For those of you dealing with prolapse/leaking issues I just wanted to share my story.  I have had 7 babies and had a cervical prolapse after #5 was born. When I first started running before I as working on my core I could barely make it 10-15 minutes without stopping to use the bathroom, even if I had just used it before starting to exercise. Today I ran for over an hour and had absolutely no issues. I can do jumping jacks, too! I remember being in that place where I thought I was doomed to a life of having to wear a pad when I exercised, but after healing my diastasis and focusing on alignment and strengthening my pelvic floor it got better. I started Fit2B in May 2012 and I would say the problem was nearly resolved after about 5-6 months. It’s not a quick fix, but I truly believe that as long as I keep core strength as a priority it will be a permanent fix :) ” -Fit2B in Texas, Alison P.

9. How soon after I give birth should I start exercising?

If you define exercise as strenuous, weight-lifting or cardio-style movements that elevate your heart rate for longer than 15-20 minutes at a time… Um, isn’t that motherhood? Ha! But seriously, I’m a big fan of letting most of your muscles TAKE IT EASY for 6-12 weeks after you give birth. There are two muscles you need to reclaim as soon as possible: your tranverse abdominus and your pubococcygeus {spell check doesn’t like muscle names}. Overall, though, you need to rest and replenish in a cocoon of support and nurturance. You just made a baby, delivered a baby, and now you’re feeding and caring for that baby (all on very little sleep) so it’s NOT the time to go back to long, heart-pumping workouts. It’s time to put your body back together first! And here are some ways to do that:

  1. Re-activate your transverse abdominus within 3 days after vaginal birth or 10 days after surgical birth with this video (CLICK). I suggest doing it sitting down the first few days or weeks. Since your TVA co-activates with your PC muscle, this simple step can dramatically reduce your recovery time. Grandmas who have deflated cores and are peeing their pants are still in post-partum recovery… think about that.
  2. As soon as you feel able, take a short, slow walk – preferably with your baby in stroller or diastasis-safe carrier.
  3. Use a carrier that wraps your belly firmly like a splint, not allowing baby’s weight to rest on your recently traumatized tummy. Use a side carrier or moby (put it around your waist a few times before baby is slid inside) or back carrier, and think about engaging your transverse while you carry your babe.
  4. Did I mention walking? Walking is the best. It will flex and stretch your pelvic floor in a natural way. Nothing is more romantic than walking hand-in-hand with your partner, slowly around your neighborhood while smelling your newborn’s head and showing off to the neighbors. {Queue sigh of happy memories
  5. If you have good insurance, and you remembered to get a Rx for abdominal rehab from your midwife or OB, set up your appointment with a local pelvic floor physiotherapist or diastasis rehab specialist. You’ll be so grateful you did, because you’ll get your body back without hurting yourself and without loads of hard work.
  6. Utilize Fit2B Studio’s pathway of workouts just for pregnant and post-partum mums. They are gentle, gentle, gentle and full of oh-so healing and feel-good moves. Click here to see those! 

TESTIMONIES…

“I am not the biggest fan of working out at home but you just make it so comfortable for me and it has just become a part of my day. Nothing too fancy, just turn it on, do my work out, and go about my day. You make me feel like you’re a friend, just hanging out in the living room with me in our comfortable “mommy clothes” and that is strangely what attracts me to your work outs.” Fit2B in Pennsylvania, April S.

“I just joined fit to be us. I am a stay at home mommy of four little boys. My youngest is 3 months and my oldest is 7 years. I am joining you all in hopes of finding a routine for myself. I focus so much on my children’s routine that I feel I have neglected what my own body needs over the last seven years. I have been doing the totally tummy safe routine for 4 days now and I am already noticing myself being more aware of my core as I go throughout my day. And believe it or not, after a couple core workouts I can finally fit back into my pre-pregnancy pants. I had lost a bunch of weight really fast through nursing, but I still couldn’t fit in my pants because my hips had spread during labor. Now, suddenly they are back together! Bethany, does this have something to do with the core stuff I’ve been doing? Because, seriously last week I could not button my pants that sit on my hips and now they button with ease!” -Fit2B in Michigan, S. Walker

“I found out about Fit2B last fall and signed up in December, AFTER I found out I was pregnant. I am not exactly sure how wide my diastasis was at the beginning, but I do know that it is completely closed above and below my navel. I am still working on the middle.  I was very consistent at the beginning and for the first month or so. I also was very diligent about wearing my splint. (I am getting back to that again also. At 18 weeks pregnant, I am only marginally bigger than when I first got pregnant! My tummy actually SHRANK in the first few months! I have been so impressed by the results that I have been telling everyone I meet if there is an opportunity. I even told the receptionist at my chiropractor about the site this morning when she commented on how small I am. And just so you know, this is my 10th baby, so that is really saying something!”

*NOTICE: This page contains affiliate links that earn the founders of Fit2B Studio a commission if you choose to purchase them. Not every item linked earns us a commission. This is one more way you can support the families running this business. Thank you!

 

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