Abdominal Wall Defect

Hi,
I am a medical student just finishing my surgical rotation and have seen this a few times, if what you are describing is what I am thinking of. If you are talking about the tissue between the two sides of your abdominus rectus muscle (the one that makes the '6 pack'), it is usually a thin line of connective tissue (linea alba) that can stretch which is then called diastasis recti. It may go back on its own as some other posters have mentioned, but if not then surgery is an option. However, unless you develop an umbilical hernia, it is not dangerous, and may respond to PT. It is usually considered a cosmetic surgery, unless there is hernia, however you would need to check with your insurance to be sure. The surgeon will tell you whether or not you have a hernia or simply diastasis. The hernia would need to be repaired, regardless of whether it is causing symptoms, to protect your intestines. Otherwise, lots of people have diastasis, and it isn't harmful in any way. Many people only have it protrude when they are straining or sitting up from lying down. I hope this helps. Feel free to contact me if I can be of further help.
PS. Make sure to ask lots of questions of the surgeon and don't let them rush you into making a decision or let them leave the room until all your questions are answered. Ask how many cases like these they have seen, how yours compares in terms of severity, what their complication rate is, how many have they done that have needed to be revised later or have gotten the mesh infected?

Ah, diastasis. I have it as well, and MUCH worse with the second baby than the first (it was pretty darn bad with the first too). Right now, I'm split from groin to sternum, and you can fit about four fingers width in the space. Yikes!! Since the little guy is only 3 months old, I do expect this to get much better, but I have to face the fact that the "mommy pooch" will never quite go away. It did, however, get MUCH better with my first, right before I got pregnant with the second. Some things that definitely helped me were:

- "Lose your Mummy Tummy" - look for it on Amazon.com. It has some great exercises that are very easy to do.

- A regular ab routine NOT including crunches, which can make the situation worse. I got this routine out of Parents magazine, and wish I could send you the pics. I'll do my best to describe the exercises:

1) Leg Circles - Lie on your back with your arms by your side and your legs out straight on the floor. Pull your belly button toward your spine. Keep it there as you raise your right leg toward the ceiling as far as you can. While holding your abs in toward your spine, make a circle the size of a dinner plate with your pointed foot. Do this 10 times in one direction, then make the circles 10 more times in the opposite direction. Drop your foot (while still holding those abs in) and repeat with the other leg.
2) Head Lifts - Get into the "crunch" position, with your knees bent and your hands behind your head. Pull your belly button in toward your spine, raise your head off the ground, and count to five. Slowly lower down. Repeat 15 times (increase as you get stronger). (Important note - do not lift your shoulders off the floor. This is a 'head lift' not a crunch. Try to focus on pulling your belly button farther in toward your spine with each lift and don't release until your head is back on the floor).
3) Head Lift Twist - Same position as last. Pull your belly button in again, and lift your head. Turn to the right so your right elbow is pointed at the wall on your right and count to five. Come back to the middle (stay up!) and turn to the left. Count to five. Repeat 10 times (adding more when able).
4) Toe Touches - Lie on your back, pull in your belly button, and lift your knees off the floor so your thighs are perpendicular to your body and your lower legs and feet are parallel to the floor. Keeping your belly button pulled in, lower one leg to the ground and tap it with your toe. Count to five as you pull your leg back to the starting position. Repeat with the other leg. Tap each leg 10 times. When you've mastered this, try lengthening your leg out along the floor, keeping it just above the floor but not touching. Don't do this until you're ready!
5) The Plank - Put your body into a push-up position, with your arms under your shoulders. Lower your butt so that your body is as streamlined as possible. Lift one leg and count to five. Repeat with the other leg. Do 5 lifts with each leg.

I hope this helps. These exercises take about 5 minutes per day, and they really do work. They are specifically for helping women pull their muscles back together. The more you do them, they more you'll find that you can hold your abs in better during regular life activities. As the other moms said, surgery is most often considered cosmetic, and will not be covered. Try the exercise route and see how it goes! I'm doing it now and hope it pays off!

Good luck,
Amy K

I might get a second opinion. I had a separation, too, that is vertical down my middle. It's gotten much better on its own since 2 years ago when my son was born. My doctor told me they could fix it, but that it's basically cosmetic. For me, unless its a health issue I'm going to just leave it be.

Hi. I had this happen myself. My muscles split from groin to chest. I ended up getting what is called a ventral hernia from it. That is basically where your intestines are protruding out of your abdomen :P. I saw a surgeon when my son was 5 months old and he sewed my abdominal muscles together. It has now been 2 years since the sugery and I have had no problems and no recurrence of the hernia. I am now pregnant with my second child (9 weeks) so I will have to see if the muscles split again or not. The surgery (for me) was very simple, also, and I had very little pain afterwards. Hope this helps!

Everyones abdominal wall seperates down the center during pregnancy. It does get better but it can take a year or so after a pregnancy and it will never go back to normal or what it was pre-pregnancies. I have one and did a little research and saw doctors and was told that. It's one of those things that makes your stomach never look the same again. I guess there were excercises I could have done the first 6 months post birth that would have helped but I didn't know that 7 years ago. I'm doing them now with my 3rd to have it not get any worse but we'll see the degree of difference it makes.

I was told it could be fixed surgically but that it was a cosmetic surgery and my insurance wouldn't cover it. They basically pull the muscles back together and stitch them back together.

So I'd go see the surgeon if it bothers you but I'd wait till it's been a year post partum to bother. See what nature does on it's own get the surgery after that point if you feel you need it. It will make your stomach look more like it did before birth plus they told me they could do lipo at the same time.