Q&A with Lara Williams, MD March 14 2013, 0 Comments

Lara Williams, MD is a board-certified OB/GYN who currently practices with Everywoman's Health in Portland, Oregon. She graduated from Rice University in Houston, Texas and did her residency in OB/GYN at University of New Mexico in Albuquerque, New Mexico. During that time, she injured her hands. Through Pilates, Aston Patterning and Cranio-Sacral therapy, she was able to completely heal her injuries. She started training as a Pilates instructor through Core Dynamic Pilates and was PMA certified in 2006. She is now studying to be an instructor in both Gyrotonic and Gyrokinesis exercise systems. She conducts Pilates workshops in Pelvic Floor Rehabilitation and continues to use Pilates.


Every Woman's Health

"The immediate post-partum period is the culmination of fatigue, sleep deprivation, hormonal changes, muscle and nerve stretch/injury, redistribution of weight, laxiaty of the ligaments, poor nutrition (mainly from being too tired to eat), the art of breastfeeding and complete devotion to a newborn's hourly needs. During that period, finding support for all of those facets of recovery and growth can be challenging and even more difficult because of the added requirement of finding childcare. This is a critical period for a woman to regain strength and balance in both physical and emotional realms and more needs to be done in the way we offer support."
—Dr Lara Williams, on Birth Recovery

Q+A with Dr. Lara Williams


Diastasis recti is defined as a separation of the rectus abdominis muscles (the muscles in the center of the abdomen) into right and left sides. Normally they are joined the middle of the abdomen at the linea alba. During pregnancy, as the uterus continues to grow, the rectus muscles must stretch to accommodate the enlarged uterus. In some cases (a large baby, excess amniotic fluid, twins or other multiples, or just because), the muscles will separate to either side of the abdomen and leave a space between them. This can be felt on exam by your physician or midwife. Sometimes patients will notice a soft bulge in the middle of their abdomen when they try to sit up.


Yes. When the abdominal muscles don’t work in concert with each other then the muscles in your back have to compensate. For example, when you go to lift something like your beautiful child and their car seat and the diaper bag and the toy bag for the other child and your purse which has everything you could possibly need for any emergency, your back muscles have to strain to compensate for your poorly functioning abdominal muscles. Since the back muscles are not made to perform the functions of the abdominal muscles, this can lead to back strain and pain.


A hernia is a defect or weakening in the fascia (the strong layer that separates the inside organs from the stomach muscles). Sometimes this defect allows an organ (such as the intestines) that was previously contained by the fascia to protrude through this layer. A medical examination and either ultrasound or CT scan is needed to distinguish between a hernia and a diastasis recti . An example of a hernia would be an umbilical hernia, where part of the small intestine pushes through a weakening or defect in the fascia in the belly button. It will feel like a soft ball and sometimes can be very painful. This is a common place to get a hernia after a pregnancy or some surgeries.


First, you need to be seen by your medical professional to make sure that this is a diastasis recti and not a ventral (central) or umbilical (around belly button) hernia. There are physical therapists and other fitness experts who specialize in diastasis recti. Surgery may be needed in advanced cases, but most diastasis recti resolve with appropriate exercises. It is important to learn what exercises are good to help resolve your diastasis since some abdominal exercises can actually make it worse.