Facing Diastasis Recti and the Decision for Surgery

Years after my youngest was born, I found myself on an examination table, listening to a doctor explain the separation between my abdominal muscles. He asked me to do some crunches, measuring the widening gap and declaring it severe. When I attempted a sit-up, he pointed out the unusual bulging that formed, almost as if my stomach had become a curious showpiece.

Curious about my fitness habits, I bragged about attending power-lifting classes three times a week and my goal of becoming an instructor. Yet, he reminded me, “You could be incredibly fit, but it wouldn’t change a thing.”

I was aware I had diastasis recti, a condition that arises naturally during the third trimester of pregnancy, causing the abdominal muscles to part ways to accommodate a growing fetus. It’s estimated that around 60% of postpartum women experience this, with some—like myself—facing persistent separation even years later.

Back pain was my main issue, and over time, diastasis can lead to further complications, including incontinence and overall weakness. The doctor suggested surgery, specifically an abdominoplasty, as the sole solution. Unfortunately, insurance deemed it “cosmetic,” so they wouldn’t cover it.

Dr. Frank Agullo, a plastic surgeon, pointed out that despite the significant impacts diastasis recti has on daily life—like lifting my children or even getting a good night’s sleep—insurance companies focus solely on the absence of immediate medical danger. “The fascia is intact; it’s just a cosmetic issue to them,” he explained.

I was left feeling a bit lost. “So, I have to live with this if I can’t afford it?” I asked. He nodded in understanding, which felt more like an acceptance of my predicament than a solution.

Upon leaving, I quickly scheduled a consultation with a plastic surgeon. With two previous pregnancies leaving me with sensitive, loose skin on my abdomen, I’d been contemplating a tummy tuck for years. My wardrobe had shifted to high-waisted soft pants to ease the discomfort, and during hotter months, the slightest pressure against my midsection triggered a rash.

The continual discomfort was hard to ignore, but the thought of surgery was daunting. I worried about the risks, especially since abdominoplasty has a higher mortality rate compared to breast surgeries. The sudden loss of my father when I was 15 made any risk feel unbearably heavy.

After the last birth, though, the persistent back pain led me to reevaluate. Despite intensifying my workouts, hoping to build strength, my core remained weak, leading to a slipped disk while lifting my older child. As I juggled family responsibilities and a full-time job as a speech pathologist, my situation only worsened.

Eventually, the state of my body began to influence my mood. I felt less energetic and playful, which wasn’t fair to my children. “The way my back feels is distracting me from being a good mom,” I confided to the surgeon. He listened patiently as I expressed my fears about anesthesia and the recovery process. The lack of pressure from him gave me time to seriously weigh my options.

Ultimately, I decided to go through with the surgery once I had saved enough money to pay upfront. The decision felt urgent as I was completely worn out from managing my discomfort. The surgery was my only viable option after consulting several specialists.

Dr. Shim Ching, my surgeon, explained the procedure. “We’re essentially building a corset inside your body,” he said, detailing how he would tie the separated muscles back together through a horizontal incision.

At the pre-op appointment, he marked my abdomen and explained we’d have to remove my belly button. I was taken aback but it became somewhat of a light-hearted moment when he showed me various options for a new belly button. I confessed I had no idea what I wanted, and he suggested a soft oval, which I agreed to.

The day of the surgery, I arrived early to prepare. I don’t remember much after getting on the operating table; a mask was placed over my face, and I was out.

Upon waking, a sharp pain in my left shoulder overshadowed everything. The recovery nurse explained it was due to gas used during surgery. As I struggled to put on my sandals, I had a moment of regret, questioning my choice to undergo surgery. However, the nurse’s gentle words encouraged me: “You built three human beings; now it’s time to heal.”

Remarkably, my shoulder pain faded quickly, and thanks to painkillers administered throughout my abdominal region, I only felt mild discomfort. It took about six months to fully straighten up, but I hardly faced complications aside from a significant battle with COVID shortly after surgery.

Reflecting on my past views about plastic surgery, I once perceived it as indulgent. However, I now believe it should be accessible to those with physical impacts from childbirth. The discomfort resulting from diastasis recti is real and should be treated as a medical concern. Insurance can provide pain relief without addressing the root issue.

Five years later, I’m grateful I chose this path. My recovery led to an improvement in my posture and allowed me to engage in everyday activities, like walking, without pain. My back pain has notably subsided, and my core feels strong.

With the discomfort behind me, I can be more present for my kids, actively taking them on trips and easily lifting them when needed. And yes, I’ve come to appreciate my new belly button, which serves as a reminder that sometimes, embracing a perceived taboo can lead to positive change, even if others may judge.