Pregnancy Q & A

Pregnancy Q & A

Here’s the sad lament I hear from many of my members:

“Why didn’t someone tell me this IMPORTANT information when I was pregnant? Or BEFORE I was pregnant?”

You want to know why no one told you about diastasis recti (AKA 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!

Well, thanks to some not-so-subtle nudges from my most dedicated and invested members inside Fit2B, I’ve created this specialized “Question & Answer” page just for pregnancy and core-related topics. It also has info on C-sections!

Just scroll down and take a peek 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!

Learn how to keep your core abs healthy during pregnancy, birth and beyond with this Q & A from!
Me, pregnant with my son, modeling my tummy with my daughter.

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 affect 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).

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…

Helpful Resources:

• If you don’t know what DR is, download my free printable handouts.

• Check out this research abstract titled, “Incidence of diastasis recti abdominis during the childbearing year.” and see for yourself how every pregnant woman in their 3rd trimester had diastasis recti.

• Read this article by Katy Bowman (from Aligned & Well) titled “Under Pressure” (do not be confused about sucking in: I assure you, I don’t teach the “suck in” method… Far from it!)

2. Can I heal my DR while pregnant?

I’ve witnessed and heard countless stories of many women narrowing and even closing their gaps while pregnant! Kelly Dean, a 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!

“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” every time 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!” – Bethann W., 28 weeks pregnant

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. When the fascia of your abs is so strained that it can no longer maintain appropriate pressure or transmit force, I believe it needs some temporary support in conjunction with helpful exercises. When the two sides of your abdominal wall have separated to 3 finger-widths (FW) 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 3FW or wider, and she also made a strong case that splinting can help fight post-partum depression regardless of the 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 once a DR opens past a 3FW. Click here or on the image below to read about our recommendations on Splinting and Wrapping.

Thoughts on Splinting and Wrapping

4. What moves should I avoid while pregnant?

The fast answer is that you should avoid crunches, sit ups and unmodified planks. Top 5 Non-Crunchy Ab Moves - Fit2b.comBut the more detailed, personalized answer is that you should avoid any exercise that increases pressure within your belly, making it bulge out further, and any move where you cannot activate your transverse abdominus 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.

Oh dear, what I just said might have you feeling like you can’t do anything at all. But you can! I know so many ways to train your core without crunches, situps or unmodified planks. It’s not that full planks are bad; you just need to wait to do them if you can’t generate tension and balance pressure in your core which is the main factor in healing a diastasis. You can technically go back to doing all those moves once you can properly recruit your core, but make sure you watch the free video in my “Top 5 Non-Crunchy Ab Moves!” blog post for alternatives to doing crunches.

Helpful Resources:

• Read my “Top 5 Non-Crunchy Ab Moves!” blog post for alternatives to doing crunches (don’t forget to watch the free video!).

• Check out Kelly’s compelling argument against crunches in her “Why Crunches Can Do Damage” article.

• 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 are okay for pregnant women in THIS ISSUE of Certified News. And there is ZERO mention of diastasis recti in that article. Sigh.

• You may also want to be wary of over-squeezing your Kegels during pregnancy. Check out the “No More Kegels During Pregnancy” article from Positively Pregnant.

5. 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, so I’m sharing some resources for you on those topics below.

Everything you need to know about exercise, abs, splinting & diastasis during pregnancy & beyond by
Pin me!

Additional Resouces:

• For maternity workout routines you can do during pregnancy, check out the Fit2B Mom section!

• You can read my article on the 3 best exercises for pregnancy and birth (yes I said exercise because I do LOVE exercise motions 😉 )

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

• Check out one of my fave epic squatting article 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 where you’ll find an affordable online program by my colleague across the drink, Lorraine Scapens in New Zealand. It’s all about moves YOU can do to assure your baby’s correct alignment for birth. Click HERE to learn about her program.

6. 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 products:

• Prepare to Push by Pelvienne Wellness.

The Pink Kit* is an incredible tool that helps you understand your body prior to birth.

• I love the tips in the last half of this “Natural Mama” article by Katy Bowman.

• For any professionals out there, get 7 CEC’s for learning about “The Importance of Core Strength in the Prenatal & Postnatal Client” when you take Kelly Dean’s continuing education course!

• Watch my video on Kelly Dean’s story here.

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

First, you simply must read my “Leaking Urine During {or After} Exercise Isn’t “Normal”” article to learn why leaking is NOT normal and what you can do about it. Second, join us here at Fit2B Studio where we specialize in diastasis-safe, prolapse-safe, maternity-safe, pelvic floor strengthening workouts that work your whole body and are quite 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!

Additional Resources:

• Read my “Leaking Urine During {or After} Exercise Isn’t “Normal”” article.

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

•  Check out our FREE routine on Fit2B called “Totally Transverse” and actually do it! We also have more info on preparing the pelvic floor in another question below if you keep scrolling and reading. 😉

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 with our own styles, and I’ve referred many clients to her when they need more specific programming that incorporates nutrition and running.

“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 🙂 – Alison P.

8. Should I splint after delivery, even over a c-section wound?

YES! You should. 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. I’m not talking about a brace, corset or compression garment. I’m talking about splinting. 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 cesarean 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. Make sure you check out the article I wrote about this called “Binding Your Belly After Birth“.

Meanwhile, a labor and delivery nurse I spoke to in Connecticut, who is also a perinatal fitness trainer, said the following:

“The incision needs to be open to the air in order to heal. We agree that binding is really really beneficial but it’s secondary to caring for a wound which takes priority, so always ask your surgeon. 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 get your tummy muscles going again, and there is often nerve damage from the cutting and pulling which translates to them taking longer to reconnect. Scar massage can help break up fascial adhesions so that the muscles begin to “slide” back and forth again like they’re supposed to, plus it also helps reduce numb sensations. Here’s a great video about scar massage!

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. 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!

Here are some ways to do that:

• Re-activate your pelvic floor and transverse abdominus with the gentle, easy breath-based exercises within 3 days after vaginal birth or 10 days after surgical birth in this free video. I suggest doing it sitting down the first few times. Since your TVA co-activates with your pelvic floor muscles, this simple step can dramatically reduce your recovery has a DVD coming to Amazon! Are you on the notification list for the special sale day?

• As soon as you feel able, take a short, slow walk: 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).

• Use a carrier that wraps your belly firmly but gently like a hug, 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) and think about engaging your transverse while you carry your babe.

• 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.

• Utilize Fit2B Studio’s pathway of workouts just for pregnant and post-partum moms. The workouts in Fit2B’s New Mom section are gentle, gentle, gentle and full of oh-so healing and feel-good moves. We also have DVDs now on Amazon!!

10. What do I really need to know about exercising post-Cesarean section?

The following is a direct quote from my fellow favorite pregnancy exercise expert Lorraine Scapens who contributed on the topic of C-sections and diastasis for our Experts on Diastasis Recti eCourse which you can purchase here.

Lorraine stated the following:

“For moms who have had a csection — be that elective or emergency — rest is the most powerful form of recovery. This does not mean moms who have had a csection shouldn’t or can’t exercise because they can. Specific rehabilitation exercises will improve recovery, make daily tasks easy and improve mom’s emotional wellbeing.

I would suggest that directly following a Csection Mums use a specific Csection binder (I promote ABDOMEND) and ensure good nutrition. From 2 weeks onwards I suggest a daily program of TA and PFM activation exercises when the mom is lying on the floor, standing, sitting, breastfeeding and holding baby. Once a 2-week activation program is followed rehabilitation exercises can be added. Moms generally start following our Birth2FItMum program from 4-5 weeks post a Csection.”

And I would add that Lorraine’s programming complements mine quite well if you’re looking for some variety from the other side of the world! Love her!

11. I’ve had a Cesarean Section, but I want to have a vaginal birth (VBAC) this next time. How can I prepare my pelvic floor for that?

The answer to this comes from my Canadian colleague, Experts in Diastasis Recti - ecourse on fit2b.comKim Vopni, also known as The Fitness Doula. She has an excellent “Prepare To Push” program which I linked above, and she’s also the contributing pelvic floor pro in our Experts on Diastasis Recti eCourse!

Here’s Kim’s answer to this question:

“When you are planning a VBAC the preparation for your pelvic floor is essentially the same as you would do if this was your first or subsequent vaginal birth.

Here are some free tips:

  • Ensure your pelvic floor is optimized by paying attention to your alignment, posture, breathing etc.
  • See a pelvic floor physio – They will not typically do internal work when you are pregnant unless there is something key to work on, but they can help align and balance the pelvis and help you work on your posture and breathing. They’ll also help mobilize the scar tissue from your cesarean birth to ensure your core is working well for your pregnancy and your birth.
  • Ensure you are doing functional pelvic floor exercise – first learn to contract and release your pelvic floor and then choose movements that incorporate the pelvic floor like squats, lunges and bridges. (Again, her program is excellent, and Fit2B also has this routine you can utilize if you’re a member.)
  • Perineal massage in the last 3-5 weeks.
  • Learn different birth positions so you can practice them ahead of time.

Kim also went on to say the following:

“Cesarean births are major abdominal surgery and can leave a woman’s core a bit out of sorts. The muscles and tissues in the abdominal wall have been displaced, cut, and stretched. The nerves have been stretched and compressed as well and this often results in a lack of sensation or feeling in the abdomen and pelvic floor. The nerves are responsible for communicating with the muscles and when they have been injured, it can affect the ability of the muscles to work properly.  Also, the adhesions that are left behind after the surgery can affect the muscles as well if they happen to be pulling them out of alignment or ‘sticking’ to somewhere they shouldn’t be. The best bet is to work with a pelvic floor physiotherapist who can help release the scar tissue and adhesions as well as help you connect with your pelvic floor again. Biofeedback can often be helpful as it will allow you to ‘see’ even if you can’t ‘feel’. In an ideal world, pelvic floor activation and breath work is done ASAP after the surgery is ideal to help regenerate the nerves and lessen the long-term challenges. In an ideal world, women have learned how to activate their pelvic floor properly before pregnancy and birth so that even if they lose some sensation, they still know how to activate it and have a better chance of regenerating the muscles and nerves.”

More Q&A Coming Soon!

Stay tuned to see more on this page!


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