Can I Have More Children After Diastasis Recti Repair?

Question

I delveloped diastasis recti after my first pregnancy. Since, I've had 2 more children. I have a 2 finger separation, and lots of loose skin, though i am relatively thin. Im not that concerned about the skin as i am about my tummy bulging out...i miss my flat abs. First, does this need to be sergically repaired or can it be fixed through exercises, and second, if it does need surgery, would i be able to have more kids, or do i need to wait until I'm done having kids to repair?

Jose Perez-Gurri, MD, FACS · Answer

The separation between your rectus muscles is often a result of pregnancy. The degree of separation will vary but excersise will not correct it. Abdominal strengthening excersises will effectively increase muscle tone and should be part of any post-pregnancy routine. This condition requires a "plication", or suturing the musces together in the midline, in order to oblitirate the gap that occurs after pregnancy. If you are currently seeking another child I would certainly wait. However, if you are not, then by all means consider a tummy tuck with plication of the msucles. This operation does not prclude you from subsequently getting pregnant and going on to have an uneventful pregnancy and a healthy baby.

John J. Corey, MD · Answer

Exercise will strengthen your muscles but it will not get them to move closer together. That requires surgery and yes you can have kids after the repair....but....There is the chance that it might stretch out again and then your surgery might have been for nothing. It's always better to do a tummy tuck when you know you are done with kids!!!

Richard H. Lee, MD · Answer

Diastasis recti is the stretching out of the rectus abdominis muscles (6-pack muscles) which occurs with pregnancy. It cannot be improved with exercise and it is a permanent change that occurs with pregnancies. This is what gives women who have had children a doughy appearance especially to their lower abdomen. It is usually repaired and tightened in conjunction with a tummy tuck. You can have more children after a tummy tuck and diastasis repair but most likely you will have the loosening again after child bearing and you will need some sort of surgical tightening again although you probably won't need another full tummy tuck.

Robert W. Kessler, MD, FACS · Answer

The abdominal muscles are together in the midline of the abdomen to directly balance the opposing muscles of the back. Our abdominal muscles are encased in a fibrous layer which stretches during pregnancy and weight gain. After pregnancy or significant weight loss the strength layer investing the muscle does not tighten and so the muscles do not return to their original position. No amount of exercise will reposition those muscles and so surgery is necessary to do that. This strength layer has the ability to stretch again if a subsequent pregnancy or weight gain happens the tissue will stretch. This will not compromise a pregnancy but will compromise the appearance of  the abdomen and can lead to a recurrence of the diastasis. This why we recommend waiting until after completing the family.

	Good luck and I hope this was helpful

Paul Gill, MD · Answer

Strengthening Exercises will not help correct the muscle separation, only increase the muscle fibers.    Muscle Plication surgery is the only way to repair this problem.  

	
	As with previous pregnancies, the muscle will be loosened by each pregnancy.   Therefore, I would recommend waiting until you complete your child bearing years, then reward yourself with a well deserved tummy tuck to regain your youthful appearance!!
	
	I wish you a safe recovery and amazing result!!
	 

	Dr. Gill

Tom J. Pousti, MD · Answer

Thank you for your question.

	Yes, it would require a surgical procedure to correct the muscle separation (cannot be fixed with just diet and exercise).  Yes, you can have children after this repair BUT pregnancy may cause this to reoccur, so I recommend that patients have the surgery once they know that they are finished having children.

	Best wishes.

Milind K. Ambe, MD · Answer

As others have suggested, you could still have more children after diastasis recti repair with a tummy tuck but your end result would be compromised. The additional pregnancies after the repair would stretch out the abdominal muscles and fascia again so you could very likely need another surgery. Therefore it is generally advised to wait until your family is complete (unless money is no issue and you do not mind having a secondary surgery if needed).

Scott E. Kasden, MD, FACS · Answer

Sounds like you need surgical tightening of the strength layer with removal of excess skin/fat.  Exercise may help the muscle, but not the lax strength layer.

	 

	After tummy tuck, you may have more children, but it will likely loosen the repair.  It is best to wait until you are done child rearing.

Jourdan Gottlieb, MD · Answer

Thank you for your questions. 

	
		The diastasis was caused by stretching your abdominal cavity during pregnancy. Surgery is the only way of correcting this. No amount of exercise will reposition the 2 muscles back to the midline. 
	
		It is certainly possible to have more children after diastasis repair, however the separation of the muscles is likely to recur. If you know you're planning to have another child in the near future it might be wise to delay surgery until you have completed your family.


	Best wishes.

Robert M. Grenley, MD (retired) · Answer

The only way of repairing the separation of your muscles and stretching of your abdominal fascia (diastasis recti) is by surgical repair at the time of a tummy tuck...you can not exercise the diastasis recti away. Future pregnancy after a tummy tuck will cause the muscles and fascia to separate again, and you would likely need another full tummy tuck to repair this. We therefore recommend waiting until your childbearing is completed before proceeding to a tummy tuck.

Can I Have More Children After Diastasis Recti Repair?

Answers (10)

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