I had my six week post-partum follow up with Dr Wong last week.  Everything checked out okay.  My uterus is back to its original size and position – damn, so my excess belly has nothing to do with the uterus and is just excess flab left over from the pregnancy?  Perhaps I should have gone for the urut sessions my MIL suggested after all.

Aside from the belly, I’m still 7 kgs above my pre-pregnancy weight – pre-Gareth weight as opposed to pre-Gavin weight, of which, I am 12 kgs over.  Personally, I’ve stopped caring about how much I weigh, but I do care about the fact that there is still nothing I can wear in my closet that doesn’t make me look like I’m still pregnant.  I’m pretty sure that by this time after Gavin’s delivery, I was looking pretty decent in my old clothes.  Since I didn’t go for the urut sessions like I should have, my only hope now is to start exercising again.

There is are two muscles (rectus abdominis) that encase the abdomen on either side of the belly button.  During pregnancy, these muscles can become separated to allow for expansion of the belly to accommodate the growing foetus.  As far as I remember from my post-natal workouts at Fitfor2 with Gavin, you are supposed to wait until the gap closes before engaging in the more strenuous abdominal workouts or you could risk causing a hernia.  The instructors at Fitfor2 would always check the gap in all postnatal mothers exercising for the first time.

Since I’m not sure if I’ll be going back to Fitfor2 for a while, I thought I’d better check with Dr Wong regarding my abdominal muscles.  Although you can still exercise, there are certain exercises you have to be careful about.  I wasn’t sure how to check the gap myself, so I asked Dr Wong.

The way to feel for the gap between your rectus abdominis is to lie down on your back and lift your head off the ground.  Place your palm against your belly around the belly button area and feel for the gap between two firm ridges.  Alternatively, you can follow the more detailed instructions from BeFitMom:

1. Lie on your back with your knees bent, and the soles of your feet on the floor.
2. Place one hand behind your head, and the other hand on your abdomen, with your fingertips across your midline—parallel with your waistline— at the level of your belly button.
3. With your abdominal wall relaxed, gently press your fingertips into your abdomen.
4. Roll your upper body off the floor into a “crunch,” making sure that your ribcage moves closer to your pelvis.
5. Move your fingertips back and forth across your midline, feeling for the right and left sides of your Rectus Abdominis muscle.

My gap is about the width of my palm – which explains why my belly is still protruding so much because a small mound protruding at your midline is one of the signs of a separated rectus abdominis.  Generally anything greater than two and half finger widths is considered a separation.

So what are the dos and don’ts if you have a separated rectus abdominis?

• Avoid any exercises or activities that place stress on your midline, and that stretch or overly expand the abdominal wall.
• When exercising, avoid movements where the upper body twists and the arm on that side reaches backward, such as during a tennis serve.
• Avoid exercises that require lying backward over a large exercise ball.
• Avoid yoga postures that stretch the abs, such as “cow pose,” “up-dog,” all backbends, and “belly breathing.”
• Avoid traditional abdominal exercises that work the exterior abdominal muscles, such as crunches and oblique curls.
• Avoid all exercises that cause your abdominal wall to bulge out upon exertion.
• Avoid rising from a supine position by rolling up and twisting at the same time. Instead, roll first onto your side, and then use your arms to help push yourself up to a sitting position.
• Avoid lifting and carrying very heavy objects (according to Dr Wong, the heaviest thing you should carry is your baby – oops!  I’ve been carrying Gavin around and more).
• Avoid intense coughing while your muscles are unsupported – again oops.  To support your muscles when coughing, place your hands across your belly and manually splint your abdomen together during coughing episodes. This will provide needed additional support, and prevent further separation of your midline.

Oh dear, oh dear, oh dear…  Looks like it’s a good thing I checked all this up because I’ve been breaking all the rules playing games with Gavin – swinging him around, carrying him, etc.

There are exercises that you can do to help speed up midline closure.  Ideally, you should start on these as soon as possible after the delivery.  According to BeFitMom, if you wait longer than six months, it is unlikely that you will be able to close the gap.  Looks like it’s time for me to get started…

Next post: Getting started on postnatal exercises.

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