Saturday, February 27, 2016

Diastasis Recti or: How I Learned To Stop Worrying And Love My Belly

You don't appreciate the structural integrity of your belly button until you lose it.

That's not a juvenile sarlacc or a terminally grumpy cat; it's what I have now instead of a traditional belly button.

This condition, called diastasis recti, is actually a pretty common side effect of pregnancy, but good luck ever hearing about it until you've got one yourself. For some reason, although everyone knows that growing a new human can cause morning (or not-so-morning) sickness, few are aware that it can also cause your abdominal muscles to flee each other's company, leaving only connective tissue and skin to contain your organs.

Plenty of helpful blog posts have addressed the postpartum challenge of closing a diastasis with abdominal splints, physical therapy, tailored workouts, &c. What I'm going to address here is the partum challenge presented by diastasis recti--which turns out to have a straightforward engineering solution.

To be clear, I'm talking about a major separation here. Plenty of women may have and heal a minor diastasis of a few centimeters without ever being aware of it. However, if you are short (like me) and have big babies (like me) and maybe some other contributing factors no one is sure of, you may find yourself with a whopping great diastasis of 30+ centimeters.

There are certain advantages to this massive muscular gap, first among which is physical comedy. My protuberant belly would operate the touch-sensitive oven controls if I so much as tried to put the kettle on.

It's also an ideal "teaching belly," as one doctor charmingly put it, since there's no pesky muscle layer between hands and baby. At one of my prenatal visits, a midwife in training tried to ascertain the baby's position, and her eyes lit up. "I can feel everything!" she exclaimed.

Despite the situation's value for humor and education, though, it can really throw a wrench into labor and delivery.

I was in early labor with my first baby for most of a day, relaxing at home with my husband and doula until I started to throw up. When we got to the hospital, my cervix was seven centimeters dilated. That's up from zero and aiming at ten--a pretty good number, often just a couple hours from delivery.

Instead, some excruciating amount of time later, my normally-cheery British midwife bustled in to explain that I hadn't progressed much further. "Let's talk about the angle of dangle," she said. Somehow, between contractions, she got me to understand that this is what it's supposed to look like in a normal belly:

But this is what it looked like inside my belly (drawing babies in utero is hard, okay?):

Because my split abdominal muscles weren't holding the baby in, she was flopped out far in front of me, and her head wasn't exerting enough pressure to convince my cervix to keep opening. At this point, a lot of folks would have packed me off to the OR for a C-section, but the midwife just fetched a bedsheet.

She stretched the sheet under my belly and hauled it up from behind, while the doula pushed on my belly from the front. This made my already rather intense contractions overwhelmingly stronger, which they kept telling me was a good thing.

It was, of course, because with the help of those gnarly contractions we eventually managed to get the baby out through the traditional orifice. Even so, at the back of my cervix where the baby's head never fully pressed down, the tissue never completely thinned out, so when she came through it ripped. This cervical tear--and the stitching thereof--stand out in my memory even against the backdrop of general labor pains.

Anyway, then there was my daughter, with much joy, happiness, &c.

Still, you can imagine I was determined not to repeat that labor experience. So when I got pregnant with baby the second, I kitted myself out with a heavy-duty maternity belt, which acted as a nice shelf for my growing belly.

But for labor I knew I'd need more than a shelf. In the ninth month, I improvised a sling from a long piece of cloth that I had used to carry my daughter (ex utero). With three layers of wrapping, I hauled my torpedo belly up and in until it looked about the size and shape of an ordinary pregnancy.

When I went into labor this time, the midwife didn't need to deploy her sheet, and she stayed cheery. And the doula had to spend all her timing convincing me that it was going better than last time and seriously just stop thinking about last time already.

After a much shorter (but still excruciating) amount of time, without me having to throw up or tear anything, there was my son, with much joy, happiness, &c.

Now I'm in the postpartum healing game. Abdominal splints, physical therapy, and tailored workouts are all well and good, but even more helpful is my daughter's earnest three-year-old perspective.

"I love your belly," she says, kissing it. "It's soft like sand that's wet with water."

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