Who is at risk of developing diastasis recti during pregnancy? You are more likely to get it if you are older than 35 while pregnant, are petite, have poor muscle tone, are pregnant with twins or are carrying a large baby (thank you, my little chubster baby). Women who have had a diastasis in a previous pregnancy are more likely to get a diastasis in a subsequent pregnancy as well. Women with a history of umbilical or ventral hernia are at greater risk of developing it as well.
Can I prevent it? The best way to prevent it is to have strong core strength prior to pregnancy (1,000 situps per day should do it..just kidding, there are some great guides online, though, including at Mayo Clinic). During pregnancy try to stay active. Don't strain while pregnant: constipation and lifting heavy things can cause strain on the linea alba and make the gap between your abdominal muscles worse. It doesn’t mean you can’t work out while pregnant, but it’s probably not the time to lift 500 lbs over your head either.
How do I know if I have it? Your doctor can diagnose diastasis with ultrasound or by measuring how far apart your abdominal muscles have separated with measuring tape or more commonly with finger lengths. Most patients can also perform a self test: lie on your back with your knees bent and place one hand at your navel and bring your head up into a crunch like position and you should be able to feel the sides of your rectus abdominus muscles and feel how far apart they are separated. Normally, the separation is less than 2.7cm, or not much over an inch. There are some videos online demonstrating this technique.
How can I treat it? Restrengthening your core and resuming cardiovascular exercise postpartum should help. Make sure you get the green light from your doctor before resuming your exercise routine. However, for a lot of women they are unable to regain the elasticity of their connective tissue and so despite how hard they work out they are unable to get rid of that pooch”- for these women diastasis may only be corrected with surgery- a tummy tuck, often with excess skin removal. If you are considering surgery, please wait until you are done having children, otherwise, the diastasis may (will probably) return.
In general, time and resumption of exercise can make a big difference, especially if you worked those muscles going into pregnancy, but if you feel like the symptoms are persistent despite your conservative measures, then you can discuss referral for surgery with your doctor. Just remember that in order to have the best results, the gap should generally be wider than two fingers, childbearing should be completed, and you will have to devote adequate time to the recovery process.