The real mommy makeover.

In today's New York TImes style section, there's an article about mommy makeovers. You know, where they combine all your needs into one! gimmicky! opportunistic! simple! procedure! Tummy tucks, boob lifts, lipo. Even va-j-j beautification surgery. We're all clamoring for these now, I guess.

I don't really care if moms want to get their boobs lifted or tummies tucked. If you are unhappy and have tried other means to reshape your body, knock yourself out. But what goes unsaid in this light article (What did I expect? It's in the "Style" section, after all.) is that there are a few important aspects of post-partum bodies that very few people talk about. And maybe some of these women would feel more confident and sexy if they had some help truly addressing what pregnancy and childbirth do to the way your body functions as well as how it looks.

How about this for a mommy makeover? How about requiring all OB/GYNs to check moms at the 6 week post-partum visit for diastasis recti and pelvic floor strength? And if problems exist in either area, referring to a physical therapist who specializes in post partum women's health? Is that really so difficult?

Depending on who you ask, diastasis recti, which is the separation of your rectus abdominus along the vertical center line of your belly, happens in 50-85% of all pregnant women. And yet, very, very few moms I know have ever heard of it, let alone been checked for it. Why OBs don't routinely check for it is beyond me. If left untreated, the abdominals may never go back together, leaving your belly protruding, your posture unsupported and your spine unprotected. Just going to the gym and doing mindless crunches not only doesn't help, it makes it worse.

Don't know if you have it? Try this test: Lie down on your back with your knees bent, feet flat on the floor. Place one hand on your belly, fingertips together and pointing down toward your feet. Lift your head off of the mat without trying to do anything in particular with your abs (ie. if you know Pilates, don't try to engage your transversus, just lift your head). With your head off the floor, press your fingertips into your belly to see if they fall into a trough-like space between the two halves of your abdominals. If you can get three or more fingers into the trough, you have a disastasis that needs immediate attention. You should take special care when lifting heavy things (as in DON'T DO IT) and you should start on a program of corrective exercises. I won't go into them here but if you don't have the ability to hire a great Pilates instructor or see a physical therapist, there are some good ones on the web. Like here.

Here's where I say that you should see your doctor and I'm not a doctor so don't take my advice as a medical opinion and blah blah blah.

And let's just say that, postpartum, you are peeing yourself, or sex is painful. These are both common symptoms of pelvic floor dysfunction and will mostly likely be helped by seeing a doctor and physical therapist who specialize in treatment of the pelvic floor. For some women, just doing some kegels is enough to get you shipshape again. For others, you may need biofeedback or internal physical therapy (yep, that means just what you think it does). Either way, do not assume that since you had a baby you will just have to live with painful sex or a Costco sized box of pantiliners for the rest of your life.

Now if anyone has any advice about the boob issue, I'm all ears.