With all the changes that take place during pregnancy there are also things you experience after pregnancy that you didn't have before being pregnant. You find your body doesn't feel the same as before. Even after losing weight, your stomach may feel very loose and you may feel like you have a pooch you just can't seem to get rid of. You may even experience low back pain and have pelvic floor issues, like leakage when you jump, cough, sneeze, or laugh. 

I have heard time and time again from clients that ask their doctors about their stomach and they are told that the only thing that will help is having a tummy tuck or there just is no fixing it. I am here to tell you that is absolutely WRONG! 

The symptoms I mentioned above are all signs that you might have Diastasis Recti. This is a separation of the abdominal wall. Some women have no trouble and the abdominal wall goes back together with no problem and others like myself still have some separation or complete separation afterward. This is when continuing a regular workout should be done with caution (no crunches or planks) and you should find a corrective exercise specialist to rehab your diastasis recti back together. 

What is Diastasis Recti? 
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The word diastasis means separation. The recti muscles are the outermost abdominal muscles. So, it is a separation of the outermost abdominal muscles. When the muscles separate the connective tissue (linea alba) joining these muscle stretches sideways. The job of these muscles (called rectus abdominis), is to support your back and your organs. So why should you care if your muscles are separated? Because separated muscles are weak muscles. Separated muscles cannot do their job of supporting your back and organs. To achieve a strong core, your muscles must be close together.  The sideways stretching of the connective tissue causes it to become thinner and weaker.  So, what happens is this weak saran wrap-like connective tissue is NOT effectively supporting your belly button, back and organs. They are only supported when the muscles are close together.

"100% of women have some level of diastasis of the rectus abdominis in the third trimester.(Gilliard and Brown 1996, Diane Lee 2013.)

Importantly, for many women the gap remains widened at 8 weeks, and left untreated, this distance at 8 weeks remains unchanged at 1 year postpartum. (Coldron et al 2008, Liaw et al 2011.)
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66% of women with diastasis recti have some level of pelvic floor dysfunction (Spitznagle et al 2007). Diastasis recti and pelvic floor problems tend to go together." MuTuSystem

How to test for Diastasis Recti
This simple self-test will help you determine if you have diastasis recti.

• Lie on your back with your knees bent, and the soles of your feet on the floor.
• Place one hand behind your head, and the other hand on your abdomen, with your fingertips across your midline-parallel with your waistline- at the level of your belly button.
• With your abdominal wall relaxed, gently press your fingertips into your abdomen.
• Roll your upper body off the floor into a "crunch," making sure that your ribcage moves closer to your pelvis.
• Move your fingertips back and forth across your midline, feeling for the right and left sides of your rectus abdominus muscle. Test for separation at, above, and below your belly button.

You may notice that you have a 1 finger, 2 finger, or even a 3 finger gap. This just means that strengthening of the transverse abdominus needs to be addressed. It doesn't matter how many years postpartum you are either. This can always be corrected. 

Exercises to Avoid

Crunches, planks, bicycles, sit ups, abdominal machines, ball crunches, etc. This is not a comprehensive list, but similar exercises should be avoid. You don't want to put more strain on these muscles that are already very weak. Those types of core exercises are only going to cause more separation instead of strengthening them. 

Exercises for Diastasis Recti

Exercises that will help heal the diastasis recti are pelvic tilts lying on the floor with knees bent, heel slides starting with one leg at a time and making sure that your back remains with a natural arch, exercises that engage the transverse abdominals. 

I am excited to announce that I will be a PostPartum Corrective Exercise Specialist in just a few months and will be able to help other with diastasis recti, leakage, prolapse, and pelvic floor issues. Contact me through my website, www.essentiallyfitpcola.com!

If you live in the southeast United States, it's safe to say that you've heard about the imminent threat from a wandering monster of a hurricane named Irma. There's a meme floating around Facebook that says something along the lines of "you know you're a Floridian if you find out a hurricane is now a category 3 or higher and now you have to care." While winging it *might* be a (sometimes misguided) option for some folks, parents of small children and pregnant women should be especially prepared for whatever emergency situations they might face--especially with the hurricanes, earthquakes, flooding, and wildfires happening around the United States right now.

Evacuation
Usually evacuation wouldn't be the first thing on the list of things to consider, but this may be on the top of the list for pregnant moms who are especially vulnerable in situations where access to emergency services, basic utilities, or safe travel cannot be guaranteed. For instance, a strong hurricane can produce extremely low barometric pressure, which in turn can produce labor (even prematurely). Being caught in a situation where the baby might be born without access to emergency services, the hospital, or even electricity is certainly not the safest option--especially if there are birth complications. So what is a mom to do if she needs to evacuate for emergency reasons, especially if her due date is looming?

• Get access to your medical records. Most hospitals and care providers now provide remote access to records, virtually. Contact your provider and hospital to find out how to get access so that you can "take" your records with you wherever you go. Some hospitals are now part of a care network--meaning that if you go to another hospital elsewhere within that same network, the providers there would have immediate access to your records (i.e., the Ascension Network that Sacred Heart Hospital is now a member of). Call your hospital to find out if they have network partner facilities and where they are. 
• Plan your destination. Go where you will have the most support if you do go into labor, and find out what your birthing options are where you're going in case labor does start while you're away. Calling facilities ahead and speaking to labor and delivery about your situation will help you get a feel for what it would look like if you walked in laboring without any prior care history there. (If you need help connecting to resources where you're heading, please contact us!)
• Take your hospital bag, and supplies for a baby for 7 days. Packing for your baby seems to ward off the evil emergency spirits--hopefully you'll never need it, just like insurance! (Don't forget the car seat and sleeping arrangements for baby!)
• Make sure that you have all your important documents--ID, birth certificate, social security card, insurance cards, and birth preferences with you to make any prenatal or birth care as seamless as possible.
• Leave ahead of the crowd. Generally, the last 48 hours before a storm or fire requires mandatory evacuations is the worst time to leave. Deciding on evacuation sooner rather than later helps you avoid bumper-to-bumper traffic and reduces your stress levels. If nothing else, it just gives you more relaxation time!

If You Stay...
For some, staying put may be the only option. If you do, consider the following, with the understanding that emergency services and utilities may still be spotty or nonexistent for hours, days, or even weeks after a disaster. Most local government agencies recommend preparing just like you will be on a camping trip in a remote area for at least 72 hours, if not longer.

• Check with your doctor or midwife to see if your birthplace offers a shelter of some kind for pregnant women and their families. One of our local facilities provides this for women who are 36+ weeks pregnant and planning to give birth there.
• Having a well-stocked emergency kit is absolutely necessary. Overstock it if needed. Here is a great kit list!
• Water. Pregnant women need more water than the average joe, so stock up on more water than you ever thought you'd need. The usual recommendation is 1 gallon of water per person per day for drinking, 1 gallon per person per day for hygienic needs and cooking. Definitely stock that much if not more! You can fill up your bathtubs and sinks as well and use that water for bathing, or for drinking if you boil it. The waterBoB is fantastic for this! Also consider filling empty milk jugs or soda bottles almost all the way full (leave some room for expansion) and filling all the empty spots in your freezer with them. This will extend how long your freezer remains cold and then the water in the bottles can be drunk when the ice thaws.
• Food. This is somewhat obvious, but considering what to stock is even more important since a lack of electricity may impact how you will be able to prepare food. Having a grill and propane, sterno cans, or simply food that needs no preparation will make life easier.
• Light. Stock up on batteries and flashlights, and consider getting solar powered lights (the garden variety) or solar powered hand-crank lanterns.
• Emergency birth kit. Whether or not you ever need it, having an emergency birth kit could be invaluable in an emergency situation. Emergency birth kits can be purchased at www.preciousarrows.com.
• Supplies for baby. Go ahead and have a few baby supplies on hand--just in case. This would include diapers, wipes, and even some premade formula in the event that baby is born and breastfeeding isn't going well for some reason--you would at least have something to fall back on! And remember that not all water, even bottled, is safe for formula prep, so having premade formula insures that it is sterile.
• Radio. Keeping up to date with the weather when the electricity goes out is imperative. A hand-crank radio is a necessity for this.
• Support. Don't sit a disaster out alone if you can avoid it! No matter who you are, pregnant or not, pairing up to ride out an emergency with someone else can be a literal life saver.

And always remember--don't be scared, just be prepared!!