The changes in your pregnant body are mind boggling.
But then, so is growing an entirely new human being.
For instance, the delightful pro-gestation hormone, progesterone, has a lot to answer for. Its effects include loosening all of your smooth muscle to accommodate all your extra blood in expanded blood vessels (otherwise your blood pressure would go through the roof). What’s not so nice is its indiscriminate nature, which means not only your blood vessels relax but also your oesophagus (giving you heartburn) and your rectum (hello, haemorrhoids!).
Nice.
Another change that can preoccupy your pregnant brain is your tummy. It’s pretty obvious to say that your tummy is getting bigger, but it’s worth remembering that what is happening is this:
the muscles and connective tissues of your abdominal wall are stretching.
Stretched, lengthened muscles aren’t terribly strong. A pregnant woman’s body is stable (in the same way that an inflated balloon is stable), but that’s a bit different from being strong.
That’s why it is difficult, and almost pointless, to use ‘traditional core exercises’ on a pregnant tummy. Crunches, knee raises, sit-ups, mountain climbers – they’re not going to do much.
A better idea is to think about breathing well: spending a few minutes allowing your tummy to relax as best you can while you inhale, and then and exhaling to engage your tummy muscles to a comfortable level (often this feels like squeezing baby in towards your back or up towards your heart). If you’re exercising, adding moderate load to compound exercises like squats (like goblet squats) and hinging (like top-down deadlifts) will let the tummy muscles perform more work.
What about doming or coning?
Your rectus abdominus – the six-pack muscle – is being stretched to the right and left, as well as north-south. The two long strips of this muscle are joined in the middle by a sheath of connective tissue called the linea alba. This stretches too – hurray! Because if it didn’t stretch, you’d be in trouble. Baby would grow into your spleen, or else your muscles would split open (which does not happen).
The linea alba gets thinner while it’s stretched. This can lead to what’s called doming or coning. Just below your ribs, it looks like a firm, narrow dome rising up from your tummy. You might notice it if you are
- on all fours
- coughing, laughing or sneezing
- in a plank or an elevated plank position
- lifting your head up off the pillow
- or doing pull-ups (which I have only seen on Instagram!)
When it happened to me, I thought it was hilarious. Come here, husband, and behold the freakish Alien-style popping of my tummy! How we laughed.
I don’t recommend exploiting it for laughs too often.
Doming means that the pressure in your tummy – your intra-abdominal pressure – is more than your linea alba is comfortable holding while you’re in that position.
Is it bad for you? No.
Will it harm baby? Again, no.
Should you spend a lot of time with your intra-abdominal pressure exceeding your strength? Probably not.
There’s not research on it, but in general we like our lineas alba and abdominal walls to recover well after labour and delivery, so let’s not stretch it any more than necessary. You can avoid unnecessary stretching by controlling intra-abdominal pressure when you can. It’s good for the whole of your core and pelvic floor, not just reducing doming. Do this by:
- Exhaling on exertion. If you’re getting up from sitting down, breathe out. If you’re doing elevated press-ups (one of my Pregnancy Power-UP class favourites) breathe out as you press up, breathe in on the ‘down’ portion of the move. If you’re picking up something a bit heavy or very heavy, breathe out as you lift.
- Avoiding movements that look like sit-ups or crunches. If you’re lying down, get used to rolling on to your side to get up, or get out of bed. This is a really useful postnatal strategy too, so get used to it.
Postnatally the stretched linea alba will recover in most women to be as functionally strong, if not stronger, that pre-pregnancy. Like all recovery, it can take:
- good nutrition
- good breathing practice
- sensible activities of daily life
- rest
- avoiding exercises that overload the repairing area
- massage
For some women, a few appointments with a specialist massage therapist or a women’s health physio can be useful, as can having reasonable expectations of how long it takes to recovery from pregnancy, labour and birth (clue: it can be up to two years).
TLDR: Don’t worry if you see your tummy coning or doming in the third trimester. Your body is doing exactly what it’s designed to do. Practice rolling on to your side to get out of bed, and breathing out as you lift heavy things.