Diastasis Recti and Constipation | Two Common Postpartum Body Challenges

Kim and her partner holding their baby

Guest Blog By Kim Vopni, The Vagina Coach

There are two things that I will never forget about the early hours after giving birth to my first son – Diastasis Recti and Constipation.

I remember how disconnected my upper body felt from my lower body when I got up to go to the bathroom for the first time after my baby entered the world.  I felt like I had to hold myself together.  What was a fairly tight compact part of my body, was now a vacant space with very little tone.  The muscles in my abdominal wall had stretched well beyond their normal, optimal length and the rectus muscles (think 6 pack) had also moved away from their midline position – a condition known as diastasis recti.  

Two images of abdominal muscles, one showing diastasis recti

As I sat down to pee, I had a sudden panic attack knowing that at some point I was also going to have to poop!  

The thought of that first bowel movement after giving birth is almost scarier than the birth itself! This fear coupled with other influences I will elaborate on below, can contribute to postpartum constipation.  

Diastasis Recti and constipation are very common and with the right information, can be very well managed and don’t have to be a big deal in the early postpartum period or beyond.  Let’s look first at constipation.

Pushing on the toilet

POSTPARTUM CONSTIPATION

Once the baby is born, we as parents start to diligently record every feed and every poop our baby makes.  What no one really thinks about is that the new mom would benefit from having someone do the same for her.  Nutrition is a key element of postpartum healing and can play a huge role in healing and nourishing the body as well as managing bowel movements therefore reducing the likelihood of constipation.

Labour typically slows down the digestive system, especially if you had an epidural and it can take a few days to get back on track.  Other things that can influence the digestive system in the early weeks postpartum are pain medications, iron supplementation and fear of pooping!  A lot happens in the pelvis and to the vagina, perineum and anus – things like tearing, stitches, tenderness and hemorrhoids.  The thought of anything else passing through can be a bit stressful to say the least.  Stress activates the ‘fight of flight’ response which reduces blood flow to the digestive system and can contribute to constipation.

From a Chinese medicine perspective the first system that needs to be addressed in postpartum healing is the digestive system.  The digestive system is responsible for transforming food into blood and energy and if digestion is off, then the body will not benefit from the food consumed and therefore not build the blood and energy needed for healing.  

Digestive System Diagram

MOTHER ROASTING

It is also believed in Chinese Medicine that the body has ‘opened’ during pregnancy and birth and is therefore susceptible to ‘wind’ or ‘cold’.  New mothers have a 30 day period of “sitting in” where the mother does not go out and is instead served warm soups, stews, and broths that are easy to digest.

Korea has a 100 day period where the mother and child do not leave the home. In Japan, the mother and baby stay at the mother’s parent’s home for some pampering and one-on-one time with the baby. India and African nations include traditions of 10-40 day isolations where additional support is provided including massage, childcare and food preparation. 

Other practices from places like Malaysia include belly binding and hot stones on the abdomen to help cleanse it, close it and heal it. 

These practices not only allow the body time to recover from the trauma of giving birth but provide a period of mental rest that I firmly believe creates a solid foundation for mom and baby from day one.

BELLY BINDING

The belief of the need to ‘close’ the body is justified.  Diastasis Recti has been shown to happen to 100% of women in the third trimester and the gap between the muscles doesn’t always return to its pre-pregnancy state, nor does the connective tissue naturally regain its supportive tensioning role in the core. The muscles in the pelvic floor have also stretched and in some cases have been cut or torn which can contribute to challenges with core control and continence.

Belly wrapping or belly binding aims to provide temporary compression and support to the pelvis and abdominal wall in the early weeks postpartum when the muscles are temporarily hindered in their ability to contribute to core control.   

Belly Wrapping

The muscles and connective tissue in the abdominal wall and pelvis are key with regards to stability and control in our inner core but so are the bones and joints. In the pelvis, the shape of the bones provides what is called ‘form closure’ while the muscles, ligaments and connective tissue contribute to what is called ‘force closure’. During pregnancy biomechanical changes occur in the body which can reduce the effectiveness of both form and force closure such as;

  • Altered posture and load bearing;
  • Altered muscle length in the pelvic floor and abdomen (both longer and shorter) which results in reduced ability for muscle force production;
  • The role of relaxin and progesterone contribute to joint laxity and when the ligaments are lax it affects the force closure.
  • The abdominal muscles are stretched to allow space for the enlarging uterus, which can lead to loss of muscle tone and strength in the abdominal region and a compromised ability to produce tension in the thoracolumbar fascia, resulting in reduced force closure in the pelvis;
  • Diastasis recti is a distortion in the abdominal wall and can impair the function of the muscles including their role in posture and pelvic stability;
  • The transversus abdominis, multifidus, diaphragm and the pelvic floor are all anticipatory muscles of the core and are required for force closure in the pelvis – all are affected by posture and alignment changes in pregnancy
  • Intra-abdominal pressure – altered mechanics and alignment mean management of intra-abdominal pressure will change

INTRA-ABDOMINAL PRESSURE

We can’t talk about postpartum recovery and wrapping without talking about intra-abdominal pressure.

Intra-abdominal pressure is defined as the pressure within the abdominal cavity.  It is part of our core stability system.  We need some, but not too much and we need an ability to manage the varying pressures throughout the day. When we take a breath in, the diaphragm descends and there is a compression action on the abdominal contents which acts to stabilize the pelvis and spine.  We can have too much pressure such as a Valsalva maneuverer which is an inhale, then breath hold while bearing down.  This often results in a distended abdomen and can place pressure on the pelvic organs as well.  

The reverse can also be seen in a technique called hypopressives which decreases intra-abdominal pressure and results in a hollowing or concavity of the abdomen.  A reliance on one may result in a compromised ability to manage changes in intra-abdominal pressure such as during lifting or exercise.  

Crunches were given a bad rap because they cause an increase in intra-abdominal pressure but a study found that activities like standing up from a chair or downward dog pose in yoga actually created equal or greater increases in intra-abdominal pressure which suggests that managing intra-abdominal pressure is more about HOW a person performs a movement or exercise rather than the exercise itself.

Wrapping is often considered to be a practice that increases intra-abdominal pressure and it can when done incorrectly.  Wrapping is ideally done to temporarily contribute to force closure in the pelvis with some gentle hugging of the abdominal wall.  Many mistakenly wrap only the waist and wrap very tightly in hopes that it will help heal the gap between the abdominals (diastasis recti).  Instead it increases intra-abdominal pressure, it interferes with digestion and it restricts optimal breathing patterns which can prevent healing of the abdominal wall and pelvic floor and can also contribute to constipation.

My recommendations for postpartum recovery include principles that support rest and belly wrapping in the early weeks postpartum, core retraining with pelvic floor initiated movements, a balance between hyper and hypopressive exercise and nutrition that is based on the traditional practices of mother roasting to support optimal digestion.

’Tis the Season for Seasonal Affective Disorder (SAD)

As the Christmas lights go up in the tree, the snowfall becomes increasingly more frequent, you get the lovely bulky snow tires on your ride for safety, and the holiday frenzies begin in preparation for Thanksgiving, Christmas and the New Year. 

We are used to these cycles, we look forward to them, we count down to them. But just like we know that Santa Claus is comin’ to town on the 25th of December, and baby Jesus’ birthday is celebrated… we know all too well the cyclical pattern that occurs in the moods of those living more in the Northern Hemisphere, that affects every single cell of their body, mind and soul. 

The darkness descends when the sunlight goes down earlier in the evening. 

The trees feel it too, except the mighty luscious evergreens that never lose their light. The rest all look listless, overburdened, weighed down and frozen like icicles, but yet still shining and  shimmering like diamonds under their frost-bitten coat. 

The crisp cool winds add some speed to your step. And the fifty shades of grey you can see in the sky, hug the horizon and envelop the world like a great big present.  

Even though there is a lot of glad tidings, gratefulness and cheer at this time of the year, simultaneously many of us feel an internal heaviness or gloom, spreading like a dark deep shadow over our soul, a sensation of sadness. Everything can feel gloomier at this time of the year, especially if you suffer or have been diagnosed with seasonal affective disorder (SAD) and it can only get worse as the winter drags on. 

Let’s face it, the warmth of sunshine, the comfortable heat that caresses your body is like a constant hug that you feel during the spring, summer and fall months. Lifting your mood, lightening your step and warming your soul and all those around you that you love. 

Whereas the snowballing of winter, although beautiful, feels cold, numbing and disconnecting to the inner love you have for yourself. 

This is especially difficult for people that are super in touch with their environment and sensitive to changes around them. I’ve noticed that SAD affects mostly those people who are very artistic and expressive. Perhaps they are an artist like Pablo Picasso, or perhaps they dress in a very creative way like Elton John, perhaps they are a thinker or a scientist like Einstein, or a great clothing, hand bag and shoe designer like Kate Spade (who took her life last winter). This time of the year, almost like the hibernation of the bear, can move us deep into a darkness that overwhelms and pushes us into despair. 

Mainly because we notice things slowing down… You feel less energy, you want to stay indoors, even your poops slow down. You may not go as often. To learn about what your poo says about you, download my 50 Shades of Poo and start the journey. 

Your metabolism isn’t optimal, you feel like you gain 10 lbs every winter. Well hey, what do you expect? You’re not outside, not as active, plus you’re hibernating, just like the bear. 

This is all a natural cycle of quiet, rest and preparation for the blossoming springtime. 

The only problem is that it can freeze some of us in its wake. We begin to feel hopeless, unhappy, dark, almost like we have lost our inner sunlight and now the darkness has set in. 

What’s super important at this time of the year is to notice how you are feeling and be open to those light bulb moments, realizing that you possess everything you need to change how you feel, so you can feel better. 

Like Oprah and her favorite things, I’ve found a few of my favorite things that you can do to help your SAD transform to GLAD…. Here are my favorite things to keep the sunshine in your step this season.

FEED ME SUNSHINE!!!!!!

Necessities include adequate levels of vitamin D (the sunshine vitamin), proper exposure to light, and most importantly, minding what you say to your mind! When there is absence of the sun it’s an important time to connect with your soul and come to some amazing realizations about yourself that everything you need is found within and that you are your own best inner sunshine. 

To help you come to this realization faster, more promptly, say this to yourself:

“I am the sunshine that grows my dreams, I walk in faith with grace and light, no matter the darkness that surrounds me. I am my own sunshine! “

Write yourself love letters saying this. You can put it in your calendar, send yourself texts, say this to yourself out loud while you look into the mirror. Physically send it by mail. Yes, by mail! Say a prayer before bed and include this command.  

Over time, this will sink into your subconscious, and even though you don’t initially feel like you are much of a ray of sunshine, over time you WILL begin to believe it and when you do, you will feel better and be sunny, just like a ray of sunshine. 

You truly are all the sunshine you need, it is all within you and moves through you! For real, you just need to learn how to turn it on, just like a lightbulb, and this is the recipe. It’s super easy, but you need to have faith and do the action in order for this to sink in and your sun light to start beaming, warming you, hugging you and brightening up the 50 shades of grey we see in the sky at this time of the year. 

Practice Your Health Practice – SLEEP 

Sleep is the most important health practice. This keep your rhythms in sunshine mode. Sleep sets the tone, it heals us, keeps our body clean, and resets everything, especially your sunshine!!! 

Here’s what I do to make my sleep solid! 

I have a kick a** routine that includes my Queen of the Thrones™ castor oil pack, because it helps me sleep better but also benefits me through the day to poop better, cleanse better, bloat less and stress less so I look and feel better! 

The castor oil pack also stimulates the production of oxytocin, the love and connection molecule that calms our stress and literally feels like great big hug! So when you’re missing the hug of the heat from the sun… there is always a way to make it happen! 

Wearing a sleep mask to bed naturally increases your melatonin. Because of the change in daylight in the northern hemisphere, it can have an effect on our natural melatonin production. 

An eye mask helps you to naturally increase melatonin before you go to bed. When the sun goes down at 5 o’clock, you start to produce melatonin, but by the time you actually go to bed at night, your stores are depleted. Wear the mask to stimulate production and my Queen of the Thrones™ Beauty Sleep Eye Kit will also help to improve eyelash and eyebrow growth, and naturally boost the gentle area around the eyes, reducing the visible signs of aging like darkness under the eyes.  

Now whenever we are weighed down by a health concern, or simply don’t feel good, don’t forget to get checked out by your doctor just in case!

Make sure to get checked out for anemia (low iron), vitamin D levels, B12 and folate (especially if you’re a vegetarian), food sensitivities and your hormones. These can all affect how you are feeling. 

So there you have it, it’s your time to shine, don’t you think? Living your life in hibernation mode is over, you are meant to shine your big bright light in our world and be sunny like the sunshine to all those that you come in contact with. Because you matter, your gifts matter to the world and all you need to learn is how to nurture your inner light. 

Shine baby, shine, like a super nova…. 

No one can do it like you and no one can do it better! xoxo 

Love, left sided hugs and all the sunshine—- Dr. Marisol xoxo 

This blog was inspired by my patients that suffer from seasonal affective disorder and one of my fave instagrammers, @thebirdspapaya, sharing her beautiful creative artistic daughter’s struggles with seasonal affective disorder, and Oprah… because she loves her favorite things… and these are mine for seasonal affective disorder. 

Why Is My Poop Green?

Picture this: the Grinch lands in your toilet bowl, totally ruining your Christmas festivities! It causes a *gasp* and a “wtf”?!  Not everything that is red and green this time of year is a good thing!

So what gives? These monstrosities in the toilet bowl that you inspect shouldn’t be smiling back at you like the green goblin, an eerily foreboding sign of the dangers that are lurking in your Christmas menu. You think to yourself, what have I eaten? Green food coloring wasn’t on the menu? Could it be the green smoothie I had the other morning? Is it my intake of greens causing my poo to be green? 

 It can be scary seeing green monsters in the throne, but the reality is it happens every day, all around the world and especially around the 24th of December! The thing is, the color you see in the toilet bowl is a sign of what is going on with the #1 thing that your body produces, your poo! It got a bad wrap being called #2, but it really deserves the throne!

Read more to get in tune with the signs your body is delivering from the divine! Right in time for the new decade, where you can make a massive positive change in your life.

Is Green Poo Normal?

 Green poo isn’t normal, FYI, it’s actually a sign that something may be wrong in the manufacturing plant, A.K.A. your digestive tract.

There may be 50 Shades of Poo (if you haven’t downloaded your copy, do so now here!)… but in general, if you’re healthy and well balanced, your poo should always be brown. Anything along the spectrum of the color of dirt is acceptable.

Outside of this realm, and we don’t have happy campers.

How the Digestive Factory Works to Color Your Poo

Poo gets its color from bile, which is a combination of substances that are to be eliminated out of the body. A part of it is bilirubin (produced from the breakdown of red blood cells). Bilirubin gives it its brown color, in general. 

Problems with color are typically caused by problems with the gall bladder, swelling, stones blocking the opening of the duct into the intestine, and sometimes ominous masses in the intestine. 

What Does it Mean When Your Poop is Green?

 There is another mechanism of action that is especially important when it comes to those green poops. That is stomach acid

Stomach acid wilts green vegetables. Think of it like this, if you leave a salad sitting on the counter and it is emerged in vinegar (that is the same physiological pH as our stomach acid) you will see it wilt and turn brown. This could be a chemical transformation of chlorophyll, or simply just the acidic pH transforming the components of the green vegetable. 

Either way, green poops after drinking a green smoothie is a sign of low stomach acid. Sometimes it also indicates a lack of protein in the smoothie, because protein is the signal for stomach acid to be produced. 

Low stomach acid can also be caused by many factors; too much stress, low protein in your diet (thus not simulating stomach acid), lack of important nutrients such as vitamin B12 and zinc, or autoimmune reactions that affect the stomach acid-producing cells,  to simply name a few.

What To Do About It

To find out how to test and what to do about it, please download my 50 Shades of Poo. It’s the blueprint for the color of your poo, teaching you how to become body conscious about what is going on as well as diagnostics, inspection techniques and how to fix. 

There really is an entire science behind your poo. In your poo, you have the power to understand and be conscious of what is going on inside your body. It’s like having your own personal doctor on dial. It’s time for you to get dialed in my friends. Download 50 Shades of Poo now.