When your body is trying to make room for two or more growing babies it can often leave us with lifelong problems. Pregnancy changes our bodies forever and can affect our health and happiness. As a family nurse practitioner and twin mom, I have seen these complaints often in my patients and with my own body. Three common abdominal problems after pregnancy are umbilical hernias, diastasis rectus and pelvic floor issues. Although these problems are not exclusive to twin pregnancies it does occur at a higher rate for us blessed with twins!!

Umbilical Hernia

An umbilical hernia is a bulge near the belly button or navel. Intestines or other tissues can come through an opening in a weak spot of the stomach muscles. An umbilical hernia is caused by the pressure near the belly button often from pregnancy. Very small hernias may not cause problems but larger ones sometimes will need to be surgically repaired. Most woman wait until they are done having all of their babies before it is repaired, as each pregnancy can worsen the hernia.  In some cases, it may have to be repaired sooner and can become emergent. Increasing pain, redness around the area and difficulty going to the bathroom are all symptoms that need to be seen urgently. 

Diastasis Rectus

Diastasis rectus occurs when the abdominal wall muscles separate to accommodate the growing babies. This seems to be more common in twin pregnancies due to the degree and speed the uterus needs to expand. When lying flat on your back with your knees bent you will notice a gap between the abdomen muscles in the middle of your stomach and a “pooch” when standing up. Avoiding heavy lifting and protecting your abdominal muscles with tricks like rolling onto your side before sitting up in bedwhile pregnant can help.Some specific core strengthening exercises before and after pregnancy can help lessen the gap. Surgical intervention for this problem is considered cosmetic so many will women will live with it the rest of their lives.

Pelvic Floor Problems

Pelvic floor problems such as urine leakage, constipation and pelvic floor pain are also common issues after pregnancies. Having 2 babies sitting on your pelvic floor for months can take its toll. These muscles get stretched out and are no longer as effective in their important role of supporting pelvic organs and urine control. Incontinence can hugely affect your life, limiting your activities and having you constantly concerned about where the bathrooms are and having an accident. 


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Although as mothers of multiples we are at a higher risk for these issues there is help! Many physical therapists will specialize in treating many of these conditions. Pelvic floor PT can help with urine leakage and pelvic floor pain. There are surgeons who specialize in urology-gynecology procedures or surgeries for incontinence if PT is not helping. PT can also help you with the correct core strengthening exercises to help minimize the gap from diastasis rectus and keep you from engaging in things that will make it worse. Many women are now seeking this specialized women’s health PT during pregnancy to try to prevent these issues. So, seek out resources in your area that can help you learn how to minimize the effects these issues have on your well-being. Running, jumping, staying active are important as we raise these little ones, so make sure you are getting the care and treatments needed to be your best. Carrying a twin pregnancy is full of challenges and not for the faint of heart but the end result is always worth it despite the sacrifices. So,take care of yourself and enjoy, it’s a fun ride!

About the author

Cristy Hamilton is TLC’s Denver Associate and mother of fraternal twin boys named Liam and Tyler. She grew up in Colorado most of her life. Cristy enjoys working part time in a fulfilling career as a family nurse practitioner in a clinic setting. She received both her bachelors and masters degrees in nursing from the University of Colorado and holds a board certification by the AANP. Cristy has always had a calling to help people. After joining her local twins club and surviving the first year of twins, she started working with the new twin moms and loves helping them find their way through this amazing experience. You can reach Cristy at cristy@twinloveconcierge.com for more information on our Denver services.