As a pelvic floor physical therapist who has seen hundreds of women post partum, I get the same question ALL.THE.TIME: When is my stomach going to look normal again? Before seeing Kate Middleton come out of the hospital with a big round belly the day she gave birth, I really didn’t know what post partum bodies looked like. Many women are frustrated with the appearance of their midsection months and even years after giving birth. We know our bodies have to change because they fricken grew a baby (or babies!). We know we should appreciate how COOL that is. But we are human. I believe we can both hold space for both amazement with our bodies AND discomfort surrounding how different they might feel. Besides the fact that it takes many weeks for your uterus to return to it’s normal size, diastasis recti AND that a lot of factors contribute to keeping extra weight on our bodies post partum, here are a few reasons you might not have considered that are contributing to this:
Flexibility of connective tissue due to hormonal changes:
When we are pregnant, our body sends out hormones that increase flexibility of our fascia, ligaments and tendons. This is a pretty good thing, as our body needs to make room to both grow and potentially birth a baby. But these hormones don’t just snap back to normal after delivery. They are thought to stay in the system in some capacity until 6 months after you stop breastfeeding (or give birth if you don’t breastfeed). One area likely affected by this is the connective tissue that lays on top of all your abdominal organs in. That tissue has already gotten stretched out by your baby and it doesn’t “go right back” to it’s normal tension. It’s like your organs used to be held in your belly by tough denim and now they are being held in by stretchy spandex!
Breastfeeding:
If you breastfeed, that liquid gold must be sourced from somewhere! Many people have heard that breastfeeding causes weight to “just fall off”. In many cases, that is simply not the case. Some of the things that might explain this phenomenon is increased stress leading to hormonal changes that keep the body holding onto weight, the body not getting enough calories to make milk (and therefore holding onto excess fat as reserves) and even due to side effects of hormones that HELP us make milk (like Prolactin).
Constipation:
I have seen SO many women whose belly fullness is a direct result of constipation. Constipation can be a HUGE issue post partum. When breastfeeding, our digestive systems tend to get backed up because so much water is being re-absorbed to make milk. This leads to hard, dry, stools and more back up! Increasing water intake can be a HUGE help with this, as can supplements recommended by your medical providers.
Impaired function of core muscles:
Accommodating babies in our bellies gave our core muscles the biggest stretch of their lives for many months. When muscles get into a more lengthened state, they literally CANNOT contract as well. They also haven’t be used in some capacity for a significant length of time. Similar to the explanation of fascia that holds your organs in being stretched out, core muscles that aren’t functioning can’t maintain the same canister that your organs are used to being held in.
Your posture:
When you are pregnant, your ribcage elevates and bends backwards, your pelvis tends to tip forward and people tend to push their hips forward. This is in response to a growing midsection that puts you off balance. After giving birth, I see SO many people post partum (even many years post partum!) who are still standing this way! Standing in this way causes our “guts” to stick out in front of us, rather than being held inside our pelvis. Research shows us that the linea alba (connective tissue between the “six pack” muscles particularly hates being stretched in this fashion, leading to more diastasis recti as well. Try to even out the weight over your entire foot (rather than just in your heels) and bring your ribcage over your pelvis to better align yourself.
We hope this provides some validation to the feelings you are having. If this is your second (or more) baby, these changes tend to be more significant than after your first, especially if you got pregnant less than 6 months after stopping breastfeeding your last. You are doing a great job and remember how powerful your body truly is!