Here is what I know to be true: Your postpartum body is remarkable, resilient and strong AF.
It undergoes some seriously heroic shit to produce a baby.
And it deserves to be celebrated. 🎉
But in reality? We pinch folds of skin, we scowl at stretch marks, we yearn for our pre-baby body.
Real talk: Sometimes the childbirth journey involves muscles that separate, organs that droop, and things that tear.
Friend, let me be the first to validate your frustration. But then, I’d also like to broadcast this pep talk:
You are a shape-shifting super-heroine and you’re capable of amazing transformation and healing.
Two things will help you capitalize on your body’s innate ability to heal after childbirth:
1) A little knowledge of what’s really going on.
2) Knowing who to call for help.
Not quite sure where to start?
Here are 5 things I think you should know about your body after baby. Click for a pep talk and your action items, or keep scrolling to read the full post.
◾️Diastasis recti is a normal part of pregnancy. And you don’t need to fear it.
◾️After giving birth, you might feel like something is falling out of your vagina. Lemme tell you what’s “normal”, when to be concerned and who to call for help.
◾️Scars are like fine wine, they improve with age.
◾️It’s common to leak urine after pregnancy, but it’s not normal and you don’t have to live with it.
◾️Many of the aches and pains of postpartum can be improved by making a small tweak to the way you breathe.
I’ll dive deep into each of these, but let’s start with the one everyone always wants to talk about: Diastasis recti.
1) Diastasis Recti Is A Normal Part Of Pregnancy
During pregnancy, your abdominal muscles and the connective tissues that connect them stretched to accommodate a growing fetus.
As the connective tissue between the 6-pack muscles stretches, it gives the appearance that the muscles are separating from one another. Abdominal separation is a completely normal and expected mechanism by which your body makes space to accommodate a growing baby.
Studies have found that up to 100% of pregnant people (that’s everyone!) have a gap of at least 2.2 cm or greater by the end of their pregnancy. Abdominal separation during pregnancy is a totally normal phenomenon that enables your body to carry a baby.
Most of the time, abdominal separation spontaneously resolves by 6-8 weeks postpartum.
Diastasis recti is a specific condition that occurs when the muscles don’t come back together spontaneously, or when the connective tissue doesn’t generate good tension under load.
Your Postpartum Belly Is Impacted By More Than Diastasis Recti
You can find a lot of misinformation online about Diastasis recti.
It gets blamed for “mummy tummy” or “mommy pooch” and is mostly discussed as it relates to the appearance of a postpartum belly.
But, let’s pull Diastasis out from under the bus. It’s not the only reason your belly might look a little different.
Your muscles have also stretched significantly over the past 9 months. It takes significant time for those muscles to regain their former resting length. You may also still retain more abdominal fat than you did pre-pregnancy.
Healing Diastasis Recti Is About More Than The Gap
Healing an abdominal separation has a little do with the width of the gap between the abs and a lot to do with the tension and responsiveness of the tissue in that gap.
Conservative treatment of Diastasis recti consists of physical therapy prescribed from a pelvic floor physical therapist (sometimes called a women’s health physical therapist). Physical therapy and exercises, NOT surgery, are the first-line treatments to treat Diastasis recti.
It is important to understand that even if the gap in your abdominal wall has “healed”, you might still not have a flat tummy because:
- Stretched muscles take time to return to their optimal length and strength.
- Stretched muscles are less efficient at containing your abdominal contents.
- You might be carrying more fat tissue than your previously did, a totally normal part of the pregnancy and postpartum experience.
… which leads us to:
You Don’t Need To Live In Fear Of Diastasis Recti
If you have persistent abdominal separation, it’s worth getting professional guidance.
In MOST cases, there are effective conservative (e.g. non-surgical) treatments to coax your abs back into line.
Please give your body, and that postpartum belly in particular, the grace it deserves and the time it needs to heal after carrying your sweet babe.
Check out these additional resources around Diastasis Recti:
2. You Might Feel Like Something Is Falling Out Of Your Vagina
Not gonna lie: it can be a freaky feeling. Fortunately, there’s a lot you can do to improve this symptom and we’re going to get to that in a sec.
First, lemme explain why you might feel the way you do.
Your pelvic floor muscles work with the rest of your core muscles to support your pelvic organs.
After 9 months of working hard to support a growing fetus and THEN stretching to up to 3 times their length to birth a baby, these muscles are a little fatigued. They need a little R&R.
It’s pretty common for pelvic organs to sit lower during the very early postpartum period than they will later on.
That means, if during the first weeks postpartum (first six weeks or so) you feel symptoms like a tampon is falling out or if you feel heaviness or sagging in your pelvic floor, don’t get too excited. It’s a pretty common experience. Give your body a chance to recoup.
If symptoms persist past the first 6-12 weeks, they might be indicative of a longer term condition known as pelvic organ prolapse.
Pelvic Organ Prolapse Is A Common Postpartum Condition
About half of women who have given birth experience pelvic organ prolapse. While prolapse is more common after vaginal birth than C-section, pregnancy is actually the greatest risk factor.
For the folks in the back: A vaginal delivery is not a pre-req for a prolapse.
A prolapse occurs when the connective tissue that supports the pelvic organs becomes damaged and is insufficient to provide proper support and either the bladder, uterus or rectum descend into the vagina.
Prolapse is not a condition that is typically “healed”, but there is a lot that can be done to manage it.
Managing Pelvic Organ Prolapse
Pelvic organ prolapse is typically treated conservatively (i.e. non-surgically) with physical therapy and/or pessaries.
With physical therapy, the degree of organ descent and the intensity of symptoms can typically be improved.
Pelvic floor therapists use a combination of manual therapy, pelvic floor exercises and breathing strategies to manage prolapse. They teach you to manage your intra-abdominal pressure (a fancy term for the pressure generated in your abdomen whenever you do ANYTHING) to minimize your symptoms.
Specialized providers (typically specially-trained OBs, Nurse Practitioners and Urogynecologists) can fit devices called “pessaries” to help support your organs and reduce symptoms. Pessaries are like an orthotic for your vagina and no more difficult to use than a tampon.
Prolapse Is NOT A Roadblock On Your Postpartum Recovery Journey
Think of it as a speed bump. Or a detour.
Prolapse may sound like a scary thing, and granted, it’s not something you’d go try and score on purpose.
But receiving a pelvic organ prolapse diagnosis is NOT a death-sentence for your fitness routine, your daily routine, your sex life or anything else.
Check out these additional resources around prolapse:
3. Scars Are Like Fine Wine, They Improve With Age
Your C-section scar or perineal scar might look angry now, it might feel zingy or tight, but it’s going to get better.
If you gave birth by C-section, received an episiotomy or experienced a severe vaginal tear, you’ll need to give your scar some love.
It’s a damn amazing thing that all of these mechanisms exist to help safely deliver your new baby.
And it is equally remarkable that our bodies have so much potential to heal from such significant physical traumas.
In some cases, scars will heal nicely on their own. In many cases, you’ll want to get a little bit of assistance from a pelvic floor physio to work on scar desensitization and scar mobility through massage.
If your scar burns, itches, generates pain, or is otherwise uncomfortable, make sure you talk to your doctor.
Check out this additional resource to help you manage your scars:
4) It’s Common To Leak Urine After Pregnancy…
…but it’s not normal you don’t have to live with it.
After giving birth, your bladder might seem like it has a mind of its own.
Don’t let it fool you. I guarantee you that your bladder is firmly under the control of your brain and your pelvic muscles.
Often times, the pelvic floor remains weak after pregnancy or it sling-shots in the other direction and can become overly-tight.
Either condition can lead to unwanted drips (or floods). But each condition takes a different approach to treat.
Kegel exercises aren’t always gonna cut it.
I urge you to consult a pelvic health physical therapist. Physical therapists can assess the specific cause of your leaks and prescribe the most appropriate course of treatment.
If you are trying to workout while you are learning to manage your leaking, a postnatal fitness coach can also help by teaching you strategies to stay dry while you workout.
Check out this additional resource to help you DIY your leaks:
5) Many Of The Aches And Pains Of Postpartum Can Be Improved By Making A Small Tweak To The Way You Breathe
A growing fetus throws a massive wrench in your previously well-oiled deep core “machine”.
Your deep core consists of your diaphragm, pelvic floor, deepest abdominals and a few back extensors.
It function best when they work together in a coordinated fashion. They’re a team.
But when you’re pregnant, that coordination is disrupted.
This has implications for stress management, healing of the pelvic floor and abdominal wall and all kinds of common postpartum aches and pains (like a sore or tense upper back and shoulders).
Fortunately, the easiest way to RESTORE coordination to your core muscles is by bringing intention back to your breath. Learn to breathe in a way that recruits these muscles and retrains their optimal function.
I’ve written extensively on retraining the core using a technique called the Connection Breath and I’ll direct you to my favorite one:
Who Ya Gonna Call??
So, now you have the info- who are you going to call when you need professional support?
There are three things I want you to know:
1) Your midwife or OB/GYN likely does not have specific training in pelvic floor and core assessment and rehabilitation.
They’re not going to know how to properly assess you and they won’ have the most up-to-date knowledge of rehabilitation tools.
I know, it’s weird. They’re all up in your bits and you expect them to have answers. They have a lot of answers! But for core and pelvic floor help, you’ve got to go to the experts:
2) Pelvic floor physical therapists are the first-line medical professionals to manage your core and pelvic floor conditions.
If you are experiencing any of the symptoms or conditions discussed in this post, book an appointment with a pelvic health physical therapist.
Click here for resources to help you locate a pelvic floor physical therapist or contact me if you need help locating one.
3) Appropriately trained postpartum personal trainers can be a real asset when managing any kind of postpartum body ish.
While we can’t diagnose or treat, we can help you manage symptoms during exercise or activities of daily living. We also help bridge the gap (ha-ha!) between physical therapy and higher level exercise.
Returning to exercise with a diastasis or prolapse? Contact me!
Go Forth And Thrive!
A lot of the changes that characterize postpartum bodies are perfectly predictable adaptations to having a baby. In fact, it is an exception rather than the rule when someone goes through the trials of pregnancy and childbirth and has nothing but a baby to show for it!
It can take a lot of time (sometimes, years!) for our bodies to return to something that feels “normal,” but please do not assume that you’ll need to live with abdominal separation, symptomatic prolapse, burny scars, urinary leaking or any other postpartum ailment long-term.
Lemme say it again: Your postpartum body is remarkable, resilient and strong AF.
Everyday I work with folks who are thriving in their postpartum bodies. You can too.
Feel stronger and more supported in your exercise.
Kick-start your postpartum recovery.
Manage your pelvic health.
Download a copy of
The No B.S. Guide to a Stronger, Drier Pregnancy and Postpartum.
My mission is to make sure that having a baby is not a reason why you can’t do all the things.
Contact me if you have questions about exercise or pelvic health pertaining to pregnancy or postpartum. I work with people locally (Seattle’s Eastside: Redmond, Bellevue, Kirkland and surrounding areas) and online to develop personalized pregnancy and postpartum personal training plans. I also offer labor support (birth doula services) within the greater Seattle-Metro Area.