Pregnancy, places a significant strain on the muscles at the front of the abdomen. These muscles , which are called the rectus muscles are stretched and also separated from each other. This separation of the rectus muscles is called diastasis.

Normally the two Rectus muscles appose in the midline and are held together by a fascial strip called the Linea Alba.In diastasis the recti move sidewards and the linea are stretched and become very thin.

 The gap between the two  Rectus muscles I diastasis is evident by simple examination and better defined by an ultrasound scan test.

The Rectus Abdominis muscles have to be in the midline in apposition with each other for  proper functioning. If they get separated from each other they cannot function efficiently , and extra strain is put on other muscles which can lead to conditions like backache.

Its only recently that diastasis recti has gained importance. However the data on the prevalence of diastasis recti during pregnancy is scanty, and we do not have studies on the prevalence in Indian women. A paper from Sweden has reported that more than 30% of women who are first time pregnant develop a diastasis during their first pregnancy.

Risk factors for diastasis recti during pregnancy :

During pregnancy there is an increase of the hormones estrogen and progesterone which softens the joints and ligaments allowing these to stretch. This is normal physiological process to accommodate the growing baby, but can have unwanted effects at certain sites. When the ligaments are already lax further aggravating factors increase the normal physiologic variance and predisposes to pathological conditions.

Some of these factors predisposing to diastasis during pregnancy are :

• Multiple pregnancies, especially back to back
• Twins or triplet pregnancy
• The baby being bigger than normal
• Being older than 35 years
• Difficult vaginal delivery, especially when prolonged pushing is needed
• Obesity
• Diabetes Mellitus
• Smoking
• Concept of core health

The abdominal muscles not only contain the intestines and other organs inside the abdominal cavity, but play a key role in maintaining  “ core health “ .

Core health can be compared to the tree of life. The roots are the core that give life to the whole tree. Similarly the abdominal muscles are the core for the health of the whole body

Core health  is a relatively new concept .It indicates the core functions of your body namely breathing, back strength, pelvic floor muscle strength.All these functions are to a large extent dependant on your core abdominal muscles.

Hence if the core muscles are weak, it can predispose to chronic backache. Weakness of pelvic floor muscles can predispose to urinary incontinence and also varying degrees of vaginal or uterine prolapse.These core abdominal muscles also have a vital role in efficient breathing and their dysfunction can affect breathing.

A number of muscles make up the core of the body and the Rectus Abdominis is one of the key muscles.Pregnancy maximally affects these Rectus abdominis muscles by spreading them apart, and at times even after delivery these muscles may never regain their normal position and tone.

Importance of paying attention to Diastasis Recti:

Diastasis Recti can affect the core health. It is one of the commonest causes for poor body image with a bulging abdomen

It can predispose to hernias

Umbilical hernias even small when associated with Diastasis can increase significantly and could even lead to life threatening situations

 Diastasis Recti prevention and detection: 

There has been much work done on this and as yet there are no clear answers. However avoidance of known risk factors will help. More importantly it is important to screen for diastasis during pregnancy, especially if there is a known risk factor. Diastasis can be detected by simple clinical examination by your Doctor, or best is to be screened by a Surgeon who may also do an ultrasound scan. It has been shown that women who have an active lifestyle before and during pregnancy are less prone to diastasis.

There are specific exercises that can be done to prevent or even treat to a certain extent Diastasis Recti. These exercises are started during pregnancy and continued after delivery. An important point to note is that the usual gym exercises, abdominal crunches etc can worsen Diastasis.

In conclusion: prevent diastasis, and avoid bulging, disfigurement, and core health weakness.