Dear Dr. Bell, My abdominal muscles are splitting right down the middle. I am 8 months pregnant and my doctor says it is not unusual. What can I do to correct this?

Your doctor is correct. You have Diastasis Recti. This a separation of the left and right side of the Rectus Abdominis Muscle at the Linea Alba (the white line of the connective tissue that runs from the sternum to pubis, right down the middle of the abdomen). This condition is not unusual with pregnancy and is considered benign (not recurrent, progressive or malignant) in pregnancy.

You may find Diastasis Recti somewhat disconcerting, but it will return to normal post pregnancy.

I’ve had patients that experienced so much separation in the Linea Alba that you could take your fingers and place them into the stomach several inches! As worrisome as this may be, it will return to normal with physical activity, exercise, healthy eating and lifestyle habits.

When possible, try to get in shape prior to pregnancy and stay in shape throughout your pregnancy. In most cases, women can continue to be physically active and exercise as long as a Doctor approves the exercise program.

There are exceptions when your doctor discovers conditions that make exercise contraindicated. There are even more serious conditions when a pregnant patient is required to avoid physical activity to the point of bed rest, for a large portion on the pregnancy.

Assuming you have approval from your doctor to continue your exercises program, you need to be aware of all American College Of Obstetricians and Gynecologists (A.C.O.G.) Guidelines on Exercise during Pregnancy.

You should also adhere to all your doctors orders post-pregnancy as well. Assuming your pregnancy is normal and the doctor recommends exercise Post-Pregnancy, the typical abdominal exercises will aid you in getting your Rectus Abdominis to return to normal. Crunches and crunch variations are the most popular exercises you should use to achieve your goals. Begin with a manageable level of Frequency, Intensity, Time (Volume), Type and Range Of Motion. Use the Gradual Progressive Overload Principe as you get in better shape to increase your exercise progression and challenge.

Work closely with your doctor on your weight gain during pregnancy. There is no logical reason for a woman to put on 50 pounds during pregnancy, to give birth to a 7-pound baby.

Your doctor will inform you that in a normal sized women, you can expect a 2 to 5 pound (1 to 2.3 kg) / month weight gain, in the first trimester (total: 6 to 15 pounds) of pregnancy. During the second and third trimesters, the weekly weight gain is approximately 1 pound (0.4 kg)/week.

The average weight gain for a women who presents at standard height, weight and age, will gain between 25-35 pounds (11.5 to 15.9 kg).

The women who presents as underweight, will have the optimal weight gain between 28-40 pounds (12.5-18 kg).

The women who presents as obese, who becomes pregnant, should not diet during pregnancy. Recommended weight gain is 15-25 pounds (7-11.5 kg).

Any weight gain beyond these recommendations could increase the risk of Diastasis Recti and slow the return to normal, post pregnancy.

Please remember that what is good for the body, is good for the baby growing inside of you. Exercise, nutrition, and healthy lifestyle: Non-smoker, limited alcoholic beverages consumption (one drink/day for a non-pregnant women, NONE for a pregnant women), 7-8 hours sleep/night, etc. The healthier you are, the healthier your baby will be. The healthier you are, the easier your pregnancy will be.

Good Luck & Best Regards,

Dr. Jim Bell

For more information on this topic, the IFPA has developed a Pre & Post Natal Instructor Pregnancy Course for you to gain additional knowledge, skills and abilities on how to have the healthiest pregnancy and the safest and most effective post-pregnancy recovery!

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