What makes you more likely to have DRA?
Here’s the good news: there has been a LOT of new research on diastasis rectus abdominis (DRA) within the last few years. The bad news is that the studies are all so different from one another, and many can’t even agree on what the cut-off is to diagnose DRA, or how even to measure it in the first place! This makes it incredibly hard to generalize results, as you can imagine! But, some trends are emerging, including data on risk factors for developing DRA.
What are the most common risk factors for DRA?
Here's a short-ish list:
- Pregnancy, and especially more than one pregnancy (this is a big one that shows up consistently across the board)
- C-sections, especially more than one
- Diabetes
- Larger babies, >9lbs
- Excessive amniotic fluid
- Age (interestingly, most studies show a HIGHER incidence of DRA with increasing age, while others show LOWER)
- And of course, everyone's love-to-hate: BMI. This really relates not to BMI generally, but to the theory that carrying increased weight in your midsection will put more pressure against the abdominal wall. I might consider buying into this once I see 1) research that specifically correlates higher waist circumference with DRA, and 2) that decreasing waist circumference actually helps improve DRA. So far we don't have evidence for either of those things.
Childcare responsibilities and repeated heavy lifting may also play a role, but the jury is still out on those two.
If I have a lot of these risk factors, will my DRA never heal?
Absolutely not! And let’s be clear: everyone who is pregnant will develop a DRA by week 35 of pregnancy. Everyone. The key here really is how long it takes your body to recover from that DR after the baby is out of your belly.
I am hopeful that this knowledge may help some people who are struggling with DRA and have these risk factors realize that it's not their fault! And, may eventually lead us to figure out why some people struggle with DRA for so long after birth, while others do not.
References (most are open access!):
Cavalli, M., Aiolfi, A., Bruni, P. G., Manfredini, L., Lombardo, F., Bonfanti, M. T., Bona, D., & Campanelli, G. (2021). Prevalence and risk factors for diastasis recti abdominis: a review and proposal of a new anatomical variation. Hernia : the journal of hernias and abdominal wall surgery, 25(4), 883–890. https://doi.org/10.1007/s10029-021-02468-8
Iqbal, M., Hussain, T., Khalid, F., Ali, M., Ashraf, I., & Nazir, T. (2020). DIASTASIS RECTI ABDOMINIS AND ITS ASSOCIATED RISK FACTORS IN POSTPARTUM WOMEN. PAFMJ, 70(5), 1535-38. Retrieved from https://pafmj.org/index.php/PAFMJ/article/view/5600
Kaufmann, R. L., Reiner, C. S., Dietz, U. A., Clavien, P. A., Vonlanthen, R., & Käser, S. A. (2022). Normal width of the linea alba, prevalence, and risk factors for diastasis recti abdominis in adults, a cross-sectional study. Hernia : the journal of hernias and abdominal wall surgery, 26(2), 609–618. https://doi.org/10.1007/s10029-021-02493-7
Sperstad, J. B., Tennfjord, M. K., Hilde, G., Ellström-Engh, M., & Bø, K. (2016). Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. British journal of sports medicine, 50(17), 1092–1096. https://doi.org/10.1136/bjsports-2016-096065
Wu, L., Gu, Y., Gu, Y., Wang, Y., Lu, X., Zhu, C., Lu, Z., & Xu, H. (2021). Diastasis recti abdominis in adult women based on abdominal computed tomography imaging: Prevalence, risk factors and its impact on life. Journal of clinical nursing, 30(3-4), 518–527. https://doi.org/10.1111/jocn.15568
