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Welcome to Birth, Baby!, your go-to podcast hosted by Ciarra Morgan and Samantha Kelly, seasoned birth doulas and childbirth educators from Austin, Texas. Join us as we navigate the intricate journey of pregnancy, childbirth, and postpartum care, offering invaluable insights and expert advice. Through candid interviews, personal anecdotes, and evidence-backed content, we aim to empower families with the knowledge they need to make informed decisions. Whether you're seeking guidance on prenatal care, birth planning, or navigating the early days with your newborn, we've got you covered. Tune in to Birth, Baby! and embark on your parenthood journey with confidence.
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Welcome, this is Birth, Baby.
Your hosts are Ciarra Morgan and Samantha Kelly.
Ciarra is a BirthDula, Hypnobirthing Educator, and Pediatric Sleep Consultant.
Samantha is a BirthDula, Childbirth Educator, and Lactation Counselor.
Join us as we guide you through your options for your pregnancy, birth, and postpartum maturing.
Everyone, today we are here with Dr.
Melo.
You guys have probably heard her on our podcast before, and if you haven't, you need to go back to our episode about why chiropractic care can be helpful in pregnancy.
We have a series on defeating diastasis that we're going to do with her.
She actually had so many ideas that we couldn't just fit it into other episodes.
And we're really excited to share them with you guys.
So today we are just going to give you an intro into diastasis.
So let's get started.
I'm super excited to talk about all of this with you and learn from you.
I remember the first time I ever heard about diastasis was actually the day I found out I was pregnant with my second baby.
I had a pelvic floor therapist come into my mom's group and was talking all about it.
And one of my friends jokingly was like, oh, what if you're pregnant?
I was like, oh, gosh, yep, there it is.
That was where I learned about diastasis the first time.
And so I'm excited to hear more about it because I really don't know a whole lot about it.
So can you tell us a little bit about who you are and how did you get into treating diastasis?
Yeah, of course.
First of all, thank you so much for having me on.
This is such a fun topic.
And I found kind of like your story, a lot of people don't hear about it before childbirth or even during their first or second childbirth.
It's usually like later on that this topic comes up.
And oftentimes it comes up when people are already having an issue and they don't know what it is.
So it can be kind of confusing and a little bit scary because you don't know exactly what's going on with your body.
So I'm so excited to get some of this information out there to everyone that's listening.
So a little bit about me.
I am a prenatal and pediatric chiropractor actually.
And my journey started in pediatric chiropractic.
That's what I thought that I was gonna really specialize in and be passionate about when I was in school.
And as I learned more about pediatric chiropractic, I got really into prenatal chiropractic.
And that transition happened when I realized the importance of the birthing process in a child's health, as well as mom's health.
So I put those two together, married them.
I started practicing and I was heavily focused in those two areas.
So I saw a lot of pregnant women.
I saw a lot of kids.
But it wasn't until COVID hit.
So it was about 2020, where people were getting a lot less care postpartum, that I started to realize it was kind of my duty to integrate in more postpartum care in the form of rehab into my clinic.
So what was happening is people were coming in to get their adjustment, but then they would put off going to like a pelvic floor PT, or they would put off, because they were trying to consolidate as many appointments as possible.
And we would allow them to bring their kids into our office.
And that wasn't always true in other offices, especially during COVID times.
So I got really nerdy into diastasis and pelvic floor, and I kind of married the rehab side of things with my chiropractic side of things in my clinic BirthCo.
And so now we offer a full on program called Defeat Diastasis that specifically treats core and pelvic floor dysfunction.
It makes me laugh a little bit because I remember when I first heard this term, and I was like, you hear people say everything a lot of different ways.
Samantha and I joke about the word perineal or perennial or whatever.
Like she and I did one episode and we had to keep recording because somebody was saying it wrong.
But diastasis, so many people say like diastasis or whatever.
So people are starting to learn about it, but there's not a whole lot of knowledge about what it really is.
And when I started posting on my social media about this program, because I think it's really amazing.
I have a friend that lives in Florida and she's been my friend since I was four years old.
Don't do the math.
And she was like, I might have that.
Do you think that I could have that?
I was like, yeah, you've had three kids for sure.
And she was like, my husband says he doesn't think that I do.
He thinks like it's not really a thing.
I'm like, she works out every day.
She's like constantly on it.
And she still has issues with that gap in her stomach.
So can you tell us what the heck is diastasis?
And what does that mean?
Yeah, just what does it mean?
Yeah, for sure.
So diastasis simply means that you have a separation of your abs.
So if you can picture your six pack abs, they are the abs that run on the very outside of your body.
And they have a fascial or connective tissue connections between both sides of them.
So you've got muscles on the outside, connective tissue in the middle.
And so these muscles, they don't tend to be stabilizer muscles.
So they're there just to help us with flexion or to give us that nice definition that we all love.
What happens is during pregnancy, sometimes we see those starts separate as your belly gets bigger, there's a little bit of separation that happens.
And a little bit of separation can be very normal during pregnancy.
But oftentimes, it gets wide enough that it becomes abnormal.
And you start to deal with dysfunction of the core and the pelvic floor.
And you start to develop imbalances between how your muscles are firing.
Because when there's that much separation and you don't have stability, your body tries to create stability by firing your hip flexors on.
So you might have hip pain or flicking or your low back.
Those are the two common areas that your body tries to tap into to create stability because your core and your pelvic floor are being stressed to the max and they don't have enough stability as you're growing this baby.
Yeah, that makes a lot of sense.
You hear, I mean, there's so many things in that phase of life that feel off and you're bending over and holding babies and doing all these weird things, but then also your body just went through this crazy thing.
So it's hard to kind of figure out what's happening to me.
How do people get diastasis?
Yeah, like if they're not pregnant, what if somebody can't have it without even having ever been pregnant?
Yeah, yeah, just to touch on what Samantha said.
Yes, when you have diastasis, it feels weird in your body.
Like it feels like you're not stable, like things could get out at any moment.
And that is usually what people feel right before they start exploring what's happening and learn that they have diastasis.
And there's lots of reasons why diastasis could be caused.
I specialize in prenatal, so I'm going to talk a little bit about the prenatal causes first.
That's the most common way that we see diastasis is after a pregnancy.
And that makes sense because during a pregnancy, your body is under a lot of stress and it's growing in a way that's different than any other point in our lives.
And so if you're not adapting, if your body's not properly adapting to that stress of baby growing, then you often have separation.
So separation can be caused by having core weakness, specifically your transverse core, which it wraps around your whole body.
That's kind of your stabilizer core.
So if that's not very strong, you don't have a whole lot of stabilization.
And so when you're moving throughout your day, you are more likely to have separation.
Separation can also be caused by your anatomy.
So let's say that you're a small human and you're growing a big baby, there's not a lot of space in there.
So in that case, you're way more likely to have separation because that baby's got to, you got to make room for that baby.
If baby's in an abnormal position, that's going to cause abnormal stress on your body.
So let's say baby's transverse, which is a sideways position.
Our bodies are not meant to hold babies sideways, especially for long periods of time.
That's going to stretch your belly out.
And that positioning can cause or make diastasis worse.
Diastasis can also be caused if your muscles are too tight.
So we find that you don't want to be too weak.
We also don't want to be too tight because in that case, everything is so tight that you also can't relax muscles enough for baby to grow in that space.
So instead your belly just separates.
So I find it's very common that people who don't work out at all during pregnancy, they have separation or people who work out heavily and not in a safe way.
Like someone who does CrossFit in a very intense way and they don't understand how their body is changing and how to adapt the way that they're holding the bar.
They often have too tight of abs and they often end up with a little bit of separation.
Okay, you have like pinged so many things in my head and if I don't interrupt you, I'm gonna forget.
One is, and you're reminding me so much of things that we tell our clients when they're pregnant.
Like, so, you know, we had a client go in at exactly nine months because she had hyperemesis and she was like, I am not staying pregnant longer than my due date.
I cannot throw up anymore.
And so we went in and she looked like five months pregnant.
She was super tiny, but she was a ballet dancer and she was like five, nine.
And so she had this super long torso and she had a nine and a half pound baby.
And no one would have guessed that she was having that big of a baby.
And I asked somebody in my current hypnobirthing class series, who is, has like the tiniest torso.
And so she is all a belly and it's like so far out.
And it made me think, when you're talking about your own body and kind of how it adapts to a baby being in there, if you have a long torso, do you think you're less likely to have as much separation as somebody who has a small torso and can't fit as much room for that baby?
Yeah, for sure.
That's what I found, at least with my patients.
It's the ones where there's not a lot of space between your ribs and your hips and baby just grows out like a basketball.
Those people are more at risk to have more separation.
And you guys, it's really crazy.
You can actually see it in some people.
So there is a girl that lives in a town that I used to live in.
And so I'm still friends with her on social media and she's heavy into exercise, heavy into nutrition.
And she won a cruise while she was pregnant through this company that she works with.
And she's on this cruise, she's in a bikini and she's pregnant.
And I am not kidding.
You could see her six pack abs over her pregnant belly.
It was wild.
But I'm thinking, gosh, I bet there is a lot of recovery that has to be done there.
You could see that separation from the center of her belly.
So, you know, it's not always that obvious.
And you're saying you can feel it inside.
But I just think that that's so neat that on some people, you can literally see it.
Yeah, when it gets wide enough, especially when we're talking like a three finger separation, if you engage the muscles, it tends to be pretty obvious that it's there.
Even if you're pregnant, you will often see what we'll call coning in that area.
It's so interesting because I honestly thought that everyone had ab separation in pregnancy.
I thought that was just like a normal part of pregnancy.
So it's interesting to hear that that's not necessarily the case and that there are things maybe you can do to prevent that from happening.
Yeah, and I'll say most people do have a little bit of separation during pregnancy.
So I just want people to know that that is considered normal to have some separation to accommodate for a baby, but it's those wider separations and those muscle imbalances and dysfunctions that come along with separation that is abnormal during pregnancy.
Definitely.
There are also other reasons for getting diastasis.
Prenatal is the most common one that we talk about and know about, but anyone can get diastasis.
We see it often in people who are doing heavy, heavy lifting.
So men who are more into heavier, maybe bodybuilding or a CrossFit style of lifting, if they have muscle imbalances and they are lifting heavily without protecting their core or without loading their core appropriately, that stress on their abs can cause separation.
And in men, you'll find that they will appear to have a little bit more of a beer belly, I'll say, than you think that they should have because they work out all the time.
And that's just that little bit of bulging in the front and it can be-
The organs?
Yeah.
I mean, is that what that is?
Yeah, I mean, the pressure of inside trying to get out because there's no stabilization or pressure pushing back in creates that little bit of a pooch right there.
You just made me think of something else because there's, again, social media, like, holy cow, it's everywhere.
But there's another girl that I follow on the social media that's very into bodybuilding and she has just an incredible body.
But she wears one of those like weight belts.
And I figured there was a reason, but I guess that helps like stabilize your core a little bit and makes it a little bit easier for your body to stay together when you're doing that.
So is that something that people should be doing?
Is like if they're heavy lifting, wearing one of those kind of belts?
Yeah, belts are really, really well known in the heavy lifting world.
They also stabilize your back.
So it just stabilizes your whole core, which to me called into question, do we really need to be lifting that heavy?
But some people, you know, that's what they're passionate about, trying to lift the heaviest thing that they can possibly lift.
And that's okay.
We just want to do it in the safest way possible so we can try to avoid some of these things.
I don't feel like I need to lift the heaviest things.
Sam, do you feel like you need to lift really?
No.
I mean, there's been a thought in my mind, like, hey, do you think I could, like, I don't know, pick up my car?
But then I think, no, I'm not.
If your favorite kid was under it, maybe.
If my favorite kid, but the other kid.
Just kidding, children.
Mommy loves you both.
So who typically checks for this?
You check for it?
I check for it?
Yeah, so I'll start by saying, I wish that more people were checking for this, especially for those new moms out there in their journey.
It would be, in my perfect world, it would be your OB or your midwife that checks you very early on in pregnancy.
That is not always the case.
In fact, I haven't really found a lot of OBs do any sort of checking for diastasis.
Midwives are much more likely to check you and just see if you have it.
The earlier you can identify some separation, the quicker you can work towards stabilizing it so it doesn't get worse.
But for those people that haven't found that their healthcare providers are checking it, you can also do a self check.
So we'll talk a little bit about that at some point today, I think.
I also, in my office, which is a chiropractor's office, I always check for separation.
I know some fitness trainers, they always check for separation.
So you'll find some sporadic people out there that will check you.
But I would say just learn how to check it yourself and start early on and just monitor your separation during your pregnancies and during your postpartum healing journey.
So if a midwife or an OB maybe checked early in pregnancy, because you said early in pregnancy, what would they use that information for to refer out for physical therapy even when you're pregnant?
Yes.
So a typical journey would be you check and you have, if you think you have it or someone tells you you have it, then you go somewhere that will teach you how to stabilize it so it doesn't get worse.
And the most common referral is gonna be like a pelvic floor PT or someone who specializes specifically in core and pelvic floor.
You'll also run into a few chiropractors that are very passionate about the prenatal period and the postnatal period.
At BirthCo, we also integrate rehab activities into every session when you come in, along with the rest of your body work.
And if you have not gone to our social media and watched the hilarious video of me trying that, is it called NuEx?
The NuEx machine, you gotta go watch it because it was wild.
And I also did not know I was being recorded.
I knew my friend was taking pictures.
I did not know she was recording me.
So that's genuine.
I'm not acting.
It was wild.
And I, before that, asked to have myself checked by you because I wanted to know.
And it was interesting because I have it right above my belly button, I think, and then it closes and then it opens again, which was interesting.
So can you tell people how do they do it themselves?
Yeah, yeah.
So the easiest way to check yourself, and you can do this while you're pregnant or you can do it postpartum, is to lay flat on your back.
You want to bend your knees up so your feet are flat on the ground.
And then you want to do a little bit of a crunch up with your neck.
Look at your knees and then take your fingers and press them between your abs or where you think the separation would be, starting at your belly button.
Then you want to walk up to your rib line, back down to your belly button, and then down to your pubic bone.
While you're walking your fingers up and down, you're just putting a little bit of pressure in.
And then I like to rock my fingers side to side.
Especially if it's a wider separation, you might not feel both sides of your abs.
If you stick two fingers in there, you might need to stick two fingers in rock side to side, or stick three in and rock side to side.
And if you're still not sure, then you might want to go get checked by someone who does it professionally, because it can be tricky.
It is harder to check when you're pregnant.
It is harder to check if you are heavier set and there's more tissue that you're feeling through.
It can be harder to check if your torso is longer and you have a hard time kind of reaching down or you don't have the range of motion to turn your fingers that direction and reach down.
So it can be tricky.
I have a lot of people who check themselves and then they're like, can you just double check for me?
Because I'm just not 100% sure what I'm feeling.
So it's okay if you check yourself and you're just not sure to go ask someone else who does it all the time to check you.
You can also look for coning.
And coning is the shape that your stomach takes whenever you do have diastasis and you're engaging the core.
So if you're in that same position and you do a little bit of a crunch up and you see this cone, and if you're not sure what I'm talking about, Google coning with diastasis.
It's a very obvious looking thing.
If you see coning, then you have some separation.
And the wider the coning is, the wider the separation is.
So you can kind of see visually if you've got three finger widths of separation, imagine that that cone is gonna be an inch to an inch and a half of roundness when you engage.
You can also, if you are someone who works out a lot, look at your stomach whenever you're lifting a weight or you're exerting pressure.
I would recommend doing a workout in like a sports bra in front of a mirror and do some of the things that you would normally do and watch what happens to your stomach.
Because if you see some coning as you're doing pressing dumbbells over your head or as you're doing a plank exercise or something like that, if you see that coning, then your core is not engaged correctly and you have some separation.
I've tried to check myself a couple of times and I was checked for diastasis right after I had my daughter, my midwife, checked for it and said that I had maybe like a finger of separation, but that she wasn't concerned about it.
I've never checked really since until recently when we started talking about this.
And then I was like poking around like, I have absolutely no idea what I'm feeling.
It just, I don't know, I don't work out.
I don't have a whole lot of abs going on anyways.
But I need to come in and have you poke around on my tummy and see what you can find because I don't know what I'm feeling for.
I am so grossed out by all of this.
I mean, if you're watching this YouTube, it's on our podcast, you might want to just go check out the YouTube because I have some facial expressions in there because I was really struggling with your explanation of how to check.
Just let me make fat wimp.
And I can't even give myself self-rest exams.
I'm like, that feels gross.
I can't do it.
I have tried to do it.
And even you're explaining like the rocking back and forth, I'm like, just go.
Just like, bow, down, cheek, work my bones.
It's so gross.
Anyways, I'm the big wimp and that's the moral of the story.
That's how she sees babies.
And I'm gonna throw out there that it's okay if you don't feel comfortable feeling around your own body, especially for something like this, because it can be kind of abnormal or weird or gross.
You know, it's kind of like sometimes people struggle with touching their C-section scar because they just feel like it's like, just a little bit weird.
And it's okay if you feel like that.
There are lots of professionals out there that can help you out.
But don't ask Ciarra because she will not.
No, I'm not gonna.
Well, I think next week we're gonna start getting into what to do if you find you do have a diastasis from that check.
And we'll get into kind of some more of the nitty gritty of it, but I'm really excited.
Me too.
And I had to stop myself from asking additional questions because I have so many more questions, but I can't ask them because we're saving it for another week.
That's fine.
It's gonna be good.
It's gonna be awesome.
Thanks for tuning in everybody.
Make sure you are liking and subscribing and following and all of the other podcasting lingo so that you can catch us next week.
We'll talk to you soon, Dr. Melot.
Bye.
Bye.
Thank you for joining us on Birth, Baby.
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