Hi There! Co-founder Melissa here continuing a great chat with Mary Barnes, director of Baby&Me yoga at PURE Yoga in New York City. In my practice, I was frequently asked about pelvic floor strength and diastasis recti at postpartum visits. I found that these concerns were best addressed by a multi-disciplinary approach, which is why so happy to get Mary's expert take on these common concerns.
gbgm: In my midwifery practice, I am often asked about how to prevent or treat diastasis recti. What yoga poses or practice can you recommend to help. Is there anything you recommend against that would aggravate the separation?
M: During Prenatal Yoga we do a number of transverse abdominal exercises to help try to minimize diastsis recti. I ask the students to cough once or twice in order to define this deepest layer of the abs. Then we do a thirty-second hug, inhaling to expand expand the abdomen, then exhaling to hug their baby to the spine; holding the abs as we count out loud to 30 (counting so they don’t hold their breath.) I tell them that I’m going to ask them to hug their baby to the spine when we’re doing a pose that works against gravity, such as plank pose, to make sure they don’t inadvertently push out against their abdominal wall, and to help support their back. At the end of class we do one more exercise, hugging the baby to the spine, and then adding a slow, repetitive pulse on each exhale. I suggest the moms do 100 everyday until they have their babies, picturing how much circulation is moving into all the layers of muscles as well as their organs and glands. The muscles stay healthy and strong rather than atrophying for 9+ months. I ask them to picture how their top layer of muscle, the rectus abs, which often separate during pregnancy (diastasis recti) are being patterned back together on each exhale. Ultimately I suggest that some of them will be able to access this muscle memory when it’s time to push their babies during stage 2 of labor, if they deliver vaginally. Lastly, I suggest they work at reconnecting their kegel muscles and their transverse within 24 hour of giving birth in order to help the healing process and help them regain their inner strength from the start (“do it every time you feed your baby”) instead of waiting 6-weeks+ until they get back to class. I also tell the women not to “jack knife” onto their backs and up, because everyone tends to push out against their abs, which can cause more separation. Instead I ask them to roll onto their side and then onto their back...coming up from the side and using their hands to press up. They can also hug their baby while they transition in and out of poses, or out of bed going to the bathroom in the middle of the night, or when they are picking up their toddler, etc.
gbgm: In many other countries, like France, women are allotted pelvic floor physical therapy after a delivery. Unfortunately in the USA, many insurances do not cover this treatment. What poses can women do to aid in pelvic floor strengthening?
M: Kegel exercises, engaging from the tailbone in back to the pubis in front, so they try to engage and lift their whole PF, are important. Some women find that being in a position with the hips lifted, like a supported bridge pose, taking the weight off the PF can be helpful. They can do an “elevator” variation, lifting the PF upward for 4 counts on an exhale. Holding, then releasing down the elevator on an inhale. In class we sometime do “toe-ga” in order to strengthen the arches of the feet which have weakened during pregnancy (PF and arches of the feet have a connection: try standing up in tadasana, lift and spread your toes and become aware of your inner body/pelvic floor and lower abs. Then let your feet collapse and see what happens...
If someone has pelvic floor discomfort or can’t tell if they’re lifting their PF or not, I refer them to Physical Therapists who special in this.
Come join us December 11 at PURE West at noon. Link to sign up here:
Can't wait to see you!