Many pregnant women worry about separation of their abdominal muscles during pregnancy, so it’s a good idea to understand what it is, why it occurs and how you can manage it.
DRAM stands for diastasis of the rectus abdominis muscles and refers to the separation of the linea alba, or connective tissue, that joins the 2 strips of the rectus abdominis muscles, down the centre of the abdomen.
DRAM has several contributing factors. One is existing abdominal weakness, hence the rationale behind strengthening the muscles of your abdomen prior to falling pregnant. Two is weight gain, providing yet another reason to aim to keep your gestational weight within a healthy range. Three is hormonal changes and the influence of this one varies between different women, just like the degree of morning sickness you experience, or the shape and size of your baby bump. Four is the pressure your growing baby is exerting on your abdominal wall, which can be less or more depending on the size of your bub, where it sits in utero and of course if you are carrying twins. Factors one and two you can manipulate to some extent, three and four are pretty much beyond your control.
Diastasis of the rectus abdominis is both normal – the female body is designed to be able to do this ‘stretching’ if needed, and common, with up to 60% of pregnant women experiencing it to some degree. DRAM only really creates a problem if the separation that has occurred is greater than 2 fingers wide, or continues beyond 4 weeks post natal.
Because of how the different abdominal muscles are interconnected, a significant disruption to the rectus abdominis not only compromises the function of this muscle, but impacts all the other abdominal muscles, creating weakness and instability in the abdomen and pelvis. This destabilising of the trunk may contribute to pelvic floor problems, back and pelvic pain and hernias, both during pregnancy and beyond it.
For these reasons, it is essential to stop traditional abdominal exercises as soon as you find out you are pregnant. Find a specialised trainer or physiotherapist who can show you how to activate your muscles in the correct way for pregnancy and the post natal period. If you do get some separation you will know you are already doing the best exercises to manage it and prevent other complications down the line.