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Expecting? Pregnancy risks your doctor doesn't always warn you about

There’s never a better time to focus on good health than when you’re pregnant. From what to expect when you’re expecting to what to eat and how to exercise, there’s an extensive pool of advice available these days. Yet there are still some pregnancy issues that often go unmentioned.
Below are two pregnancy concerns that aren’t as widely talked about, but very important for every expectant mother to know.

Diastasis Recti

Diastasis recti (DR) is your pre-pregnancy “six-pack” being spread apart. About half of pregnant women will get DR. This happens when you’re pregnant to make room for the baby, but problems can occur post-pregnancy if this separation doesn’t naturally correct itself.

Lucky Bennett, a naturopathic doctor at The Women’s Club in DMV area explains that DR is common during pregnancy because at this time, “the brain can lose the connection to these muscles almost entirely.”

If you’ve recently given birth, or even if it’s been several years and you’re wondering if you might have this condition, there are some common symptoms to look out for, including:

• A bumpy ridge that goes down the center of your abdomen

• Mid or lower back pain

• Urinary incontinence

• A “pregnancy pooch” that just won’t go away

Your doctor or a personal trainer can confirm if you have DR. But, you can also find out on your own by trying out this simple at-home test:

Step 1: Lay on your back, knees bent, with your feet flat on the floor and one hand supporting your head.

Step 2: Place your index and middle finger from your opposite hand just above your belly button, then raise your head and neck up while pressing your fingers into the separation between your ab muscles.

Step 3: While pressing down, see if you can horizontally fit more than two fingers into the opening. If you can, you might have DR, especially if you can press down to your first knuckles.

Now, what if you do have DR?

“The good news is that this problem can be reversed with the right movement and exercises,” Bennett says. It’s all about getting back control of these muscles and regaining a strong posture.

Keep in mind, however, that there are many common abdominal exercises that are actually unsafe if you have this condition, and can make it worse. For example, your abs will be rendered too weak to be hanging down in a plank.

So, after getting the all-clear to resume exercise from your doctor, start with basic core strengthening exercises like single leg lifts or wall sits. You’ll want to focus on exercises that pull the muscles in, not push them out. If hiring a personal trainer isn’t an option for you, there are plenty of books and online videos on the topic to show you the right exercises to help you heal.

Pregnancy & Lactation Associated Osteoporosis (PLO)

The second lesser-known, but very important pregnancy issue to be aware of is Pregnancy & Lactation Associated Osteoporosis (PLO). PLO is a rare form of osteoporosis with fractures triggered by pregnancy or breastfeeding or both. It was first discovered by doctors back in the ‘40s.

Since healthy women of childbearing age are too young for doctor-ordered screening bone (DXA) scans, which measure bone and mineral density, they usually have no idea how their bone health is, or that pregnancy could compromise it. In some cases, osteoporosis may pre-date the pregnancy, or they may have an underlying health condition that has unknowingly compromised their bones, and then the fractures are triggered by reproductive events.

A typical story about how a new mom finds out that she has osteoporosis goes like this: Shortly after giving birth, and usually after having breastfed a few months, she is crippled with extreme back pain out of the blue — maybe after simply lifting her child in the baby carrier or doing a household chore. She probably thought it was just a strain from having weakened back muscles from pregnancy, and figured there was little she could do but live with the pain for a while. But then, she eventually discovers that it doesn’t ever go away, thus finally prompting a check-up.

Unfortunately, once getting checked, a correct diagnosis can take months or even years. And most mothers have to insist on an X-ray or an MRI. It’s only then when getting a scan, do those with PLO discover that they have sustained (sometimes multiple) vertebral fractures, and have the DXA scores of a much older woman.

Luckily, in some cases, those with PLO have bounced back to their normal bone health after they stop breastfeeding, but others have to take osteoporosis medications.

Even though this condition is extremely rare, it’s seriousness has recently come to the attention of some of the nation’s top doctors, including Adi Cohen an endocrinologist at Columbia University Irving Medical Center.

Cohen has been studying osteoporosis in younger women since 2005 and became aware of PLO as part of these studies. She is now leading the first large-scale FDA-funded study of PLO with the help of an orphan (rare) disease grant program.

Cohen and her team are currently taking bone samples, bone images, blood samples and saliva from a comprehensive group of PLO sufferers. “We are looking at things like genetic factors, hormonal factors and bone structure to try and figure out the best treatments and prevention strategies for this disease in the near future,” Cohen says.

The hope is that doctors nationwide will soon better inform expectant mothers of this possible risk, know how to readily identify it, and then prescribe proper and immediate treatment.

Hopefully, when it comes to DR and PLO, you won’t have to worry about either of these issues. But, it doesn’t hurt to be armed with as much knowledge as possible, especially when doing something as important as bringing a new life into the world. Of course, if you feel like you have any health issues from pregnancy, always see your doctor or a health professional.

Melanie Switzer-Reilly is a Washington, D.C.-based television producer and print journalist.

About Melanie Switzer-Reilly

Baltimore's Child Staff

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