Why isn’t my stomach flat after pregnancy?

This is one of the most-asked questions I get as a Women’s Health PT and Postnatal Pilates Specialist.  It’s a question I vividly remember asking myself one week after the birth of my first child, when my once flat stomach bubbled up to the surface of the water as I attempted to relax in the tub.  I poked at this flabby skin pouch with a mixture of confusion and fascination.  The body I had once known and had grown to love over the first 28 years of my life (especially as it grew my child for the last 10 months) was…..different…..changed……new, and I quickly realized I would need to make peace with this stranger, more fluid part of myself if I was going to be at peace in my body.

The way our midsections will look after birth is due in large part to genetics.  And this sucks because it’s completely beyond our control.  Some women have collagen that stretches and miraculously finds its way back to its pre-pregnancy configuration, while most of us have collagen that stretches and, well, flounders a bit.  Also of importance is how many pregnancies you have had and how much weight you gained with each pregnancy because this means your collagen has had to stretch and retract more than a woman that had one pregnancy and gained a small basketball in size.

But your current posture and alignment can play a role too.  Finding a neutral pelvic position and making sure your rib cage is not flared up or down, means you are putting all the muscles of your core at their most optimal length tension relationship.  Not only is this the first part of strengthening your core, but it results in a posture that is more flattering than if you “hang” on your ligaments and let everything “spill” out in front of you.

Lastly, if you have a diastasis rectus abdominus (DRA), which is an abnormal separation between the left and right rectus abdominus muscles, there is a chance that excessive intra-abdominal pressure may cause your organs to “pooch” into this region giving the appearance of the dreaded “mummy tummy” or “beer belly”.  While unflattering in an aesthetic sense, there are true health concerns with having a muscle separation that may include alterations in bladder/bowel function, digestive issues, urinary incontinence, pelvic organ prolapse, and low back pain.  Thankfully, this is a condition that can be prevented with the right information, and it can often be rehabilitated with a quality program combining education and exercise.

Our goal should not be the flat stomach we remember from our pre-pregnancy days but rather a strong core that supports our movements and exercise for the rest of our lives.  You spent a long time learning to love your old body and I give you permission to mourn for a moment.  But then it’s time to pick yourselves up by the boot straps, Mamas, and build yourself a body you will love until the end of time!


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