![]() ![]() ![]() In a much smaller study, Gilleard & Brown (1996) found that 100% of their six subjects showed separation of the recti by 30 weeks gestation. Boissonnault & Blaschak (1988) followed 71 primiparous women for one year and note that 66% had a DRA in the third trimester of their pregnancy and that 36% of these remained abnormally wide at seven weeks postpartum. Pregnancy-related Diastasis Rectus Abdominisįew studies have investigated the prevalence of DRA during and after pregnancy. ![]() Clinical observations suggest that suboptimal abdominal wall strategies can impact bowel, bladder and sexual function immediately, and for many years, after pregnancy and delivery. The long-term impact of poor abdominal wall strategies on bowel, bladder and sexual function has not been investigated in a longitudinal study. While evidence is limited with respect to the changes in structure and function of the abdominal wall during and after pregnancy, it appears that for some recovery is not spontaneous without intervention. In addition to LB & PGP, motor control changes of the abdominal wall and DRA are common both during and after pregnancy. It is well accepted that pregnancy and delivery present huge challenges not only for the pelvic floor but also for the abdominal wall. In a much smaller study, Pool-Goudzwaard et al (2005) note that 52% of women report a combination of LB & PGP together with some form of pelvic floor dysfunction, such as incontinence, sexual dysfunction and/or constipation. Sixty-six percent of women with DRA have at least one support related pelvic floor dysfunction, such as UI, fecal incontinence or POP. The Australian Longitudinal Study on Women’s Health surveyed 28,000 women and found that pregnant women experienced more back pain than non-pregnant women as well as more incontinence (Smith et al 2008). The evidence clearly shows a relationship between pregnancy, back pain and incontinence, thoracic posture and pelvic organ prolapse, as well as a strong association of breathing and continence disorders with back pain. Impairments of abdominal wall function have been implicated in multiple conditions associated with pregnancy and delivery including low back and pelvic girdle pain (LB & PGP), urinary incontinence (UI), pelvic organ prolapse (POP) and diastasis rectus abdominis (DRA). Diane has added some ‘lay language explanations’ at key points in the article. The following article is adapted from a presentation on Diastasis Rectus Abdominis (DRA) Diane did at the World Congress for Low Back and Pelvic Pain, in Singapore 2016. ![]()
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