Buzz
Among the many challenges of having a baby—the delivery, breastfeeding, and the uncomfortable mesh underwear that made me feel like a giant, injured sea creature caught in a tiny net—the postpartum belly bulge stands out as one of the most frustrating. For many, the swollen abdomen shrinks over time with some exercise and patience. However, for others, the bulge stubbornly persists, a lingering reminder of a tough period, much like Paul Wolfowitz. This condition, known as diastasis recti, occurs when the abdominal muscles separate, making you look several months pregnant long after giving birth.
If you search for 'diastasis recti' on Google, you'll uncover a wealth of exercise routines designed to help reconnect those muscles. The Internet claims these exercises work for many, but for me, they did nothing (despite my best efforts). My OB, who isn’t quick to recommend surgery, mentioned that she had never seen a gap as large as mine close with exercise alone. Unfortunately, there isn't much information about the recovery process, and most of what’s out there consists of blog horror stories. So, here’s what to expect after undergoing surgery for diastasis recti.
1. Your abdomen post-surgery won’t resemble your pre-kids abdomen.
My surgery, which included a repair for an umbilical hernia and an abdominal wall reconstruction, left me with a thin scar stretching from one hip to the other, and a smaller scar around my belly button. It’s not exactly beautiful. So, if you have a small pooch that doesn’t bother you physically and isn’t noticeable under clothing, I’d suggest skipping the surgery. You’d just be swapping one bare-skin issue for another. It’s only worth it if you want to feel better (and look better in your clothes).
2. Your insurance might cover it.
In my case, it did, after my OB wrote a letter to the surgeon explaining that the condition was interfering with my daily activities (like lifting things, including my kids), and that exercise hadn’t helped.
3. Ask thoughtful questions if your surgeon suggests a tummy tuck.
As soon as I heard the words 'ten thousand dollars out of pocket,' I declined the tummy tuck (I’m vain, but not that vain). But after seeing tummy tuck photos online, I woke up in recovery, looked at my stomach, and asked the nurse (a very cheerful man who once had an acting career), 'how is this not a tummy tuck?' He did jazz hands and joyfully said, 'fuuuh-reeee tummy tuck!' So maybe it’s just impossible to do an abdominal wall reconstruction without performing something that resembles a tummy tuck. Or at least something so close to it that you won’t care. Be sure to ask your surgeon about it.
4. Shed any extra pounds before undergoing surgery.
This step ensures that any excess skin can be removed during the operation. I admit, it sounds a bit gross, but honestly, I didn’t even attempt to lose the post-pregnancy weight ahead of the procedure. I figured I'd just put it back on anyway. I'm fine being a bit heavier than I was before kids, but I couldn’t handle the bulge.
5. You need to be finished with having children.
Once you’ve had the surgery, you can’t risk damaging your abdominal wall again with another pregnancy. It's essential to consider a foolproof method of contraception before thinking about the surgery.
6. The recovery process isn’t easy.
It’s even worse than a C-section. You’ll be in the hospital for at least one night, and then go home with drains, which, in my case, stayed in for ten days, requiring some pretty unpleasant upkeep. But what’s worse than the drains is the back pain: Because your abdominal muscles are stitched so tightly (imagine a corset laced at the front), your back will be forced into a hunch. The hunching in my back was way more painful than the incision, though after a day or two, I managed the pain with just Advil and Tylenol. It’s hard to describe, but the sensation of having your ab muscles pulled so tightly together is deeply unsettling, and it persists for about six to eight weeks. A year later, there are still areas on my abdomen that are just now starting to regain feeling.
7. You’ll need time off work and for childcare.
Lifting your kids (or anything else) is off-limits for eight weeks. The surgery PA at the hospital shared that she planned to wait until her youngest was four before tackling her own surgery. I waited until my youngest was two and a half, and that was cutting it close. My husband took over most of the childcare, and I refrained from lifting him, but every time he tripped or jumped off something (which happens every few minutes with a two-year-old), I found myself instinctively reaching for him, which was incredibly painful. (By the way, you really don’t want a toddler accidentally kicking you in the abdomen while you’re sitting or reading together, unless you want to teach them a few choice curse words.)
As for work, I took one week off and then worked remotely for another week. Ideally, though, I would recommend a schedule of at least one week off, followed by two to three weeks working from home, depending on how bumpy your commute is and how fatigued you feel. I took a bus and subway ride two weeks post-surgery, and the jostling felt unbearable. Since your core isn’t functioning properly until it heals, even minor physical effort will leave you drained, and you’ll need to rest often.
8. Avoid scheduling during allergy season.
If you suffer from seasonal allergies, it's best to wait until the season is over. I had my surgery in March and almost took too much Claritin because I was so worried about coughing or sneezing during recovery.
9. It’s definitely worth it.
If your separation and/or hernia is as uncomfortable as mine was—affecting my ability to build core strength, messing with my posture, making me slow and clumsy while running, and leaving my stomach as the first thing to touch my husband during a hug or a dance—and if you’re still struggling with how your post-pregnancy body looks, the surgery is absolutely worth it. I had mine done for a mix of 50% physical discomfort and 50% vanity, but physical and vanity issues often go hand in hand: I can run effortlessly now (no more sluggish movement), and weight training and yoga now feel like they’re actually working, so I feel better about my body. Of course, your experience may vary. Make sure to consult your OB and do your own cost-benefit analysis. And don't forget to stock up on Claritin.
