BRIDGING THE GAP: KNOWLEDGE OF DIASTASIS RECTI ABDOMINIS IN POSTPARTUM WOMEN

J. Wiley^1,2, L. Santurri², L. Borrero², R. Maher¹

Background: Research on Diastasis recti abdominis (DRA) has primarily focused on diagnostic tools, surgical and conservative treatments. Despite the association of significant physical symptoms and impact on quality of life, evidence is absent regarding knowledge or education provided to women about this condition.

Purpose: This study explored the lived experience of women who either self-identified or were medically diagnosed with DRA. A deeper insight into the experience of women with DRA may serve to enhance the patient-provider interaction during this critical time.

Methods: Qualitative methodology with a basic interpretive approach and purposive sampling was used. Participants shared their experiences through a semi-structured, in-depth interview. Recruitment occurred in a variety of settings including outpatient physical therapy practices, OB/GYN offices, online support groups, and local colleges and universities. In-person or online interviews were completed following verbal consent and audio was recorded. Transcribed audio recordings were used for coding and identification of overarching themes. Rigor and trustworthiness were enhanced using a variety of techniques.

Results: Eight predominant themes emerged from the data: lack of patient knowledge, lack of education offered by providers, impact on self-image, desired education, sources of self-education, benefits of education, problems with available education, and patient recommendations for care. Participants reported that lack of education limited their ability to self-identify associated signs and symptoms leading to negative impacts on body image, fear of future functional limitations, and an inability to seek appropriate treatment. Pursuit of alternative sources resulted in inconsistent information leading to confusion and fear. Participants who received appropriate education reported an associated reduction in anxiety and the impetus to seek help with recovery.

Conclusion(s): Our analysis shows that for women experiencing DRA, the amount and type of education they receive is important. It can lead to self-advocacy, affect self-perception of health status, and provide direction for otherwise unknown treatment options. This study identifies potential gaps in the patient-provider relationship as well as opportunities for improvements in available evidence-based knowledge for patients and providers. Ultimately, empowering patients to seek and gain knowledge about their health can have a profound impact on health outcomes. Future research should expand on the themes identified in this study. The education received and the experiences of women in a broader geographic area could give insight into health disparities and current best practices. Additionally, analysis of the perceptions patients have on empowerment and self-advocacy as it relates to health could help evolve the patient-caregiver relationship.

Implications: The results highlight the need for effective targeted educational programs allowing women to make informed decisions. Allowing clinicians a look through the personal lens of affected women could provide the impetus to develop targeted education.

Funding, acknowledgements: This study was unfunded.

Keywords: diastasis recti abdominis, postpartum, qualitative research

Topic: Pelvic, sexual and reproductive health

Did this work require ethics approval? Yes

Institution: Philadelphia College of Osteopathic Medicine

Committee: Internal Review Board

Ethics number: H20-002X