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Every Pregnant Women Should Be Aware of Diastasis Recti After Giving Birth!

Every Pregnant Women Should Be Aware of Diastasis Recti After Giving Birth!

Every mother will agree that giving birth and becoming a mother is the most beautiful thing in the world. It is probably the bravest and most generous role one can accept. Mothers take on the biggest responsibility – giving birth and taking care of another human being. Quite often, this role completely overtakes their life, in a sense that their health and wellbeing becomes of secondary importance. This is why at most mums gatherings, children health and wellbeing are the only topics discussed. Even though there is sometimes not enough time to discuss the topics of post-pregnancy health, it is an important issue that deserves more awareness and attention since it affects a great number of new mums.

One of such post-pregnancy health issues is diastasis recti – a widening of the gap between the two sections of (Rectus Abdominis) abdominal muscle located at the front of the abdomen due to the growth of the uterus. The condition usually develops in the late pregnancy and is most noticeable after delivery. In some cases, the separation of the tissue can lessen in a couple of months after the childbirth, while in some cases the condition may last up to a year or longer.

Aside from health concerns that include weakened muscles and lower back pain, women going through diastasis recti experience a series of other difficulties, such as not being able to wear their usual jeans, as they simply don’t fit, even when they weigh the same as they did before pregnancy; or being frustrated with the fact that they have been able to shed all of the baby weight and still to have to carry a tummy that looks like they are pregnant.

What causes diastasis recti?

Even though it is most common in pregnant women, pregnancy doesn’t actually cause diastasis recti. It is quite possible that a great majority of people struggle with this since 98+ women have diastasis after delivery .

Diastasis recti is in fact, caused by intense intra-abdominal pressure or loading which is heightened by pregnancy, yet can be caused by an injury or surgery, therefore, men and children can also suffer from it.

Similarly to other pelvic and abdominal problems – hernia and prolapse, diastasis recti is directly caused by unsupported intra-abdominal pressure. The reason why most pregnant women face the condition is the weight of the baby that puts additional pressure on the connective abdominal tissue.

Who is more likely to have it?

Even though, as previously mentioned, children and men can suffer from diastasis recti as well, it is most common in women, especially pregnant women. Women are more likely to develop diastasis recti

  • If they have a petite physique
  • If they have had multiple pregnancies
  • If they became pregnant later in life – later than 35
  • If they deliver a baby who has a high birth weight
  • If they have poor muscle tone
  • If they have a sway back posture

How Do You Check If You Have It?

Bear in mind that you should always consult your doctor for a professional medical diagnosis and advice. That being said, there a couple of ways for you to check at home, before consulting a doctor.

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Lie on your back. Bend your knees with your feet flat on the floor.

  1. Lift your head and neck slightly off the floor, and press your fingers above you belly button.
  2. Repeat by pressing over the belly button and below it.
  3. If the gap between the muscles is bigger than 1-2 finger wide, you should consult your doctor about the possible diastasis recti symptoms.

Additionally, pay close attention to the tension in the gap. In the cases of diastasis recti, the tension in the midline is weak to non-existent, which could be one of the symptoms of the condition.

Watch the two videos for more detailed explanation of the self-examination process.

If You Have Diastasis recti, What Are The Do’s and Don’ts

What You Need To Do:

There are a great number of advice on how to treat diastasis recti, and many facts to be aware of if you have been diagnosed with the condition.

Be careful with exercise

Some types of exercises like planks, push-ups, sit-ups, crunches, some yoga poses (downward dog) and swimming can make matters even worse.

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Consult your doctor

Before starting any type of abdominal exercise, before or after pregnancy, make sure to ask your doctor first on how it will affect the possible development of the diastasis.

Treat the condition

Make sure to consult your doctor and find the best solution for you. There are some treatments and exercise programs that have been quite helpful in a majority of cases of diastasis recti. Some of them include the MuTu System, the Tupler technique, Fit2b, and The Tummy Team. Pilates is an other great way to strengthen the core muscles, before or during pregnancy, but make sure to choose a professional trainer who understands diastasis recti so that they can tailor the exercise to meet your specific needs.

What You Shouldn’t Do:

Even though traditional ab exercises can help to keep the abdominal muscles strong and prevent the diastasis recti, once the condition is determined it is suggested not to involve in any type of traditional ab workout.

No crunches

Helene Byrne, a prenatal and postpartum health and fitness expert suggests avoiding crunches, oblique curls, reverse curls, and roll-ups, since, at this point, it is not good for the recovery to involve in exercises that involve twisting the spine or work the abdominal wall against the force of gravity.

Don’t strain

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Any type of activity that involves straining the mid-line, such as sit-ups, planks, or heavy lifting is strictly forbidden since it can strain the connective tissue and make the separation between muscles even bigger, explains Kevin Brenner, M.D., F.A.C.S., a board certified plastic and reconstructive surgeon based in Beverly Hills.

Backbends are off limits

According to Ben Butts, P.T., director of rehabilitation services and Performance Therapy at Providence Saint John’s Health Center in Santa Monica, California, any type of exercises that involve spinal extension movements can put additional pressure on the abdominal tissue and should, therefore be avoided during the healing process.

Can You prevent Diastasis Recti?

Even though so many of us are prone to developing diastasis recti, it is possible to lessen or completely prevent the condition from developing.

Before pregnancy

Health and fitness experts suggest taking care of your body long before planning pregnancy, with special attention to strengthening your core abdominal muscles. This will lessen the chances for the separation of the muscles later during pregnancy.

During pregnancy

Preventive measures you can do during pregnancy include more subtle, yet important actions. One of those includes the log roll maneuver as Ben Butts, P.T., director of rehabilitation services and Performance Therapy at Providence Saint John’s Health Center in Santa Monica, California suggests. The maneuver requires getting out of bed by rolling onto one side, keeping your head and torso aligned, and then using your arms to push yourself up. In this way, you are protecting your muscles from separating.

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There are plenty of workout programs that specifically target the postpartum recovery and women dealing with diastasis recti, one of which is The Dia Method that provides effective exercise plan to help you regain your pre-baby belly and weight.

Do postpartum splints or corset binders really help?

Splinting is considered as a part of postpartum tradition around the world, as a means for women to heal faster and lose the baby tummy sooner. Yet, nowadays there are two opposing views concerning postpartum splinting, both providing facts in their favor.

The pro binding facts include it being great addition to mild and focused exercises, with researches and users showing its effectiveness on healing the diastasis recti problem.

On the other hand, the opposing view suggests that splinting is not only ineffective in resolving diastasis , but it can also be counter-effective and prevent body from healing.

Even though both views are strongly defended, many patients have actually found that the combined approach worked best, as best results were achieved by using the splint to protect the abdominal muscles and to become aware of the muscle they are using, and then doing mild exercises suggested by specialists’ programs.

Exercises you can do after giving birth

There are great post baby workouts you can do at home when you want to get rid of baby belly or to heal the tissue separation caused by diastasis, yet you need to make sure to always consult your doctor for professional advice before starting any workout program. Here are some of the best exercises to do at home after delivery.

Featured photo credit: Pixabay via pixabay.com

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Published on November 30, 2018

Signs of Postnatal Depression And What to Do When It Strikes

Signs of Postnatal Depression And What to Do When It Strikes

Postpartum depression (PPD) strikes about 15% of women around childbirth.[1] Moreover, this mood disorder is estimated to affect 1% to 26% of new fathers.[2] The causes of which are thought to be linked to hormonal changes, genetics, previous mental illness and the obvious change in circumstance.

The stigma of mental health – with or without support from family members and health professionals – often deters women from seeking help for their PPD. In this article, I will show you 10 ways to begin overcoming PPD.

Symptoms of Postnatal Depression

Postnatal depression is defined as depressive disorder, beginning anytime within pregnancy up to the first year of the child’s life. The symptoms of post natal depression are the same as those of depression. In order to receive a diagnosis from the doctor, 5 symptoms must be shown over a two week period. The symptoms and criteria are:

  • Feelings of sadness, emptiness, or hopelessness, nearly every day, for most of the day or the observation of a depressed mood made by others
  • Loss of interest or pleasure in activities
  • Weight loss or decreased appetite
  • Changes in sleep patterns
  • Feelings of restlessness
  • Loss of energy
  • Feelings of worthlessness or guilt
  • Loss of concentration or increased indecisiveness
  • Recurrent thoughts of death, with or without plans of suicide
  • Lack of interest or pleasure in usual activities
  • Low libido
  • Fatigue, decreased energy and motivation
  • Poor self-care
  • Social withdrawal
  • Insomnia or excessive sleep
  • Diminished ability to make decisions and think clearly
  • Lack of concentration and poor memory
  • Fear that you can not care for the baby or fear of the baby
  • Worry about harming self, baby, or partner

Should you, a friend or your partner be showing any of these signs, I recommend you to seek medical advice.

Causes of Post Natal Depression

It is worth noting here that there is a difference between what is commonly known as ‘The Baby Blues’ and post natal depression.

Postpartum blues, commonly known as “baby blues,” is a transient postpartum mood disorder characterized by milder depressive symptoms than postpartum depression. This type of depression can occur in up to 80% of all mothers following delivery. The Baby Blues should clear within 14 days, if not it is likely an indicator of something more in depth.

It is not known exactly what causes post natal depression, however there are some correlating factors. These factors have a close correlation and haven’t been shown to cause PPD:

  • Prenatal depression or anxiety
  • A personal or family history of depression
  • Moderate to severe premenstrual symptoms
  • Stressful life events experienced during pregnancy
  • Maternity blues
  • Birth-related psychological trauma
  • Birth-related physical trauma
  • Previous stillbirth or miscarriage
  • Formula-feeding rather than breast-feeding
  • Cigarette smoking
  • Low self-esteem
  • Childcare or life stress
  • Low social support
  • Poor marital relationship or single marital status
  • Low socioeconomic status
  • Infant temperament problems/colic
  • Unplanned/unwanted pregnancy
  • Elevated prolactin levels
  • Oxytocin depletion

One of the strongest predictors of paternal PPD is having a partner who has PPD, with fathers developing PPD 50% of the time when their female partner has PPD. [3]

Ways to Overcome Post Natal Depression

1. Seek Medical Help

As knowledge of PPD grows, more and more physicians are becoming aware of the indicators and risk factors. This means that health care providers are looking for signs as early as their first prenatal care visit.

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If you are at risk, letting your provider know early in your pregnancy means that you’ll be given extra support and care throughout the process. It is best to seek treatment as soon as possible.

If it’s detected late or not at all, the condition may worsen. Experts have also found that children can be affected by a parent’s untreated PPD. Such children may be more prone to sleep disturbances, impaired cognitive development, insecurity, and frequent temper tantrums.

2. Therapy

This is the first line of defence against post natal depression and will commonly be prescribed alongside medication. Around 90% of post natal depression cases in women are treated with a combination of the two treatments.

You don’t need to do anything special to prepare. Your counselor will ask questions about your life, and it’s important you answer honestly. You won’t be judged for what you tell, and whatever you talk about will be just between the two of you. Your counselor will teach you how to look at some things differently, and how to change certain habits to help yourself feel better.

Therapy is personalized for everyone, but women in counselling for postpartum depression often discuss topics including; who you’re feeling, your behaviour, your actions and your life. (If you need immediate support please call the San Diego Access and Crisis Line at (888) 724-7240. The toll-free call is available 24 hours a day, seven days a week.)

3. Medication

There have been a few studies of medications for treating PPD, however, the sample sizes were small, thus evidence is generally weak.

Some evidence suggests that mothers with PPD will respond similarly to people with major depressive disorder. There is evidence which suggests that selective serotonin reuptake inhibitors (SSRIs) are effective treatment for PPD.

However, a recent study has found that adding sertraline, an SSRI, to psychotherapy does not appear to confer any additional benefit. Therefore, it is not completely clear which antidepressants are most effective for treatment of PPD.

There are currently no antidepressants that are FDA approved for use during lactation. Most antidepressants are excreted in breast milk. However, there are limited studies showing the effects and safety of these antidepressants on breastfed babies.

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4. Communication with Partner

Don’t blame yourself, your partner, close friends or relatives. Life is tough at this time, and tiredness and irritability can lead to quarrels.

‘Having a go’ at your partner can weaken your relationship when it needs to be at its strongest. It can be a huge relief to talk to someone understanding.

By spending time with your partner doing activities that you both enjoy, like going for a walk, can really help. This change of state, from moving location, can significantly elevate mood whilst providing ‘neutral ground’ in which to open up communication.

Be honest with your partner and show ways in which they can support you best through this time, even if it’s just talking or letting you have time to go take a shower.

5. Self Care and Rest

Don’t try to be ‘superwoman’. Try to do less and make sure that you don’t get over-tired. It’s common that women are the experts at ‘being busy’ and ‘doing it all’.

Rest whilst the baby is sleeping, and really take time to prioritise yourself. Throughout life, if you’re constantly giving out energy, you will be left feeling unbalanced. It’s important to become aware of one’s energy and making sure to give yourself energy first, before giving out is imperative.

Your body has just been through the trauma of the birth, which is very stressful. It therefore needs time to recover so taking time to yourself is important. Things as simple as a cup of tea, or shower or listening to music will really help.

6. Supplementation (especially DHA)

St John’s Wort is a herbal remedy available from chemists. There is evidence that it is effective in mild to moderate depression. It seems to work in much the same way as some antidepressants, but some people find that it has fewer side-effects.

One problem is that St John’s Wort can interfere with the way other medications work. If you are taking other medication, you should discuss it with your doctor. This is very important if you are taking the oral contraceptive pill. St John’s Wort might stop your pill working. This can lead to an unplanned pregnancy.

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It is also worth noting that fish oil (containing DHA) is being shown to correlate with lower instances of PPD. DHA consumption during pregnancy — at levels that are reasonably attained from foods — has the potential to decrease symptoms of postpartum depression,” conclude study researchers led by Michelle Price Judge, PhD, RD, a faculty member at the University of Connecticut School of Nursing.

7. Movement

Before starting any exercise program, you should consult with your doctor and find a fully qualified pre and post natal specialist. That being said, there is plenty of movement that can be done prior to ‘hitting the gym’, such as walking.

Not only does being outside positively benefit you by getting some fresh air and vitamin D. The same is said for your baby, who will likely sleep better once they’ve been outside. Exercise gets your endorphins going, which helps alleviate depression symptoms, It can also get you focused on something for yourself. In an analysis of data from 1996 to 2016, researchers discovered that moms who stayed physically active after birth experienced fewer depressive symptoms.[4] In contrast, one study found women who led a more sedentary lifestyle were, in general, more likely to experience postpartum depression in the first place. [5]

The type of workout doesn’t matter much. Yoga for pregnant women, stretching, and cardio are essentially equal in terms of making you feel better.

8. Socializing and Support Groups

Do go to local groups for new mothers or postnatal support groups. Your health visitor can tell you about groups in your area. You may not feel like going to these groups if your are depressed.

See if someone can go with you. You may find the support of other new mothers helpful. You may find some women who feel the same way as you do.

9. Accept Help

Some cultures believe that the symptoms of postpartum depression or similar illnesses can be avoided through protective rituals in the period after birth. Chinese women participate in a ritual that is known as “doing the month” (confinement) in which they spend the first 30 days after giving birth resting in bed, while the mother or mother-in-law takes care of domestic duties and childcare.

Whilst this may seem extreme, it’s worth noting that being able to accept help from your friends, partner and family can be extremely beneficial.

10. Avoid Smoking, Drink and Drugs

Which may seem common sense, however you may be tempted by the short term ‘fix’.

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Don’t use alcohol or drugs. They may make you feel better for a short time, but it doesn’t last. Alcohol and drugs can make depression worse. They are also bad for your physical health.

Final Thoughts

Most women will get better without any treatment within 3 to 6 months. One in four mothers with PND are still depressed when their child is one-year-old. However, this can mean a lot of suffering.

PND can spoil the experience of new motherhood. It can strain your relationship with your baby and partner. You may not look after your baby, or yourself, as well as you would when you are well.

PND can affect your child’s development and behaviour even after the depression has ended. So the shorter it lasts, the better.

Sometimes there is an obvious reason for PND, but not always. You may feel distressed, or guilty for feeling like this, as you expected to be happy about having a baby. However, PND can happen to anyone and it is not your fault.

It’s never too late to seek help. Even if you have been depressed for a while, you can get better. The help you need depends on how severe your illness is. Mild PND can be helped by increased support from family and friends.

Featured photo credit: Derek Thomson via unsplash.com

Reference

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