The Silent Abdominal Separation
Diastasis recti is a common and often overlooked change during pregnancy. Most women will experience some degree of abdominal separation by the third trimester, and around 45% may still have a separation at six months postpartum.
Several factors may increase the likelihood or severity, including:
being over 35
carrying multiple babies
having pregnancies close together
reduced core strength
individual anatomical differences.
The separation occurs along the linea alba, the connective tissue running from the sternum to the pubic bone. As the abdomen expands to accommodate the growing baby, this tissue naturally stretches and becomes more compliant.
In the early postnatal period, some recovery occurs, often reducing to around two finger widths by eight weeks postpartum. However, this process can plateau, highlighting the importance of focusing on restoring strength and function rather than expecting complete closure.
Importantly, this is a normal physiological adaptation to pregnancy and not something that should be viewed as abnormal.
Diastasis Recti During Pregnancy and Postpartum
Diastasis recti is a very common and natural occurrence during pregnancy. As the uterus expands, the connective tissue between the two sides of the rectus abdominis, known as the linea alba, stretches to accommodate your growing baby.
While this process is normal, it is helpful to remain aware of how your abdominal wall responds to movement and exercise. One key sign to look out for is doming or coning along the midline of the abdomen. This may be visible through clothing or when transitioning between positions.
If doming is present during a particular exercise or daily activity, it is advisable to modify or avoid that movement. Being mindful of how you get up from the floor or out of bed is also important. Rolling onto your side before sitting up can reduce unnecessary pressure on the abdominal wall.
Symptoms and Functional Impact
For some women, diastasis recti may contribute to pelvic or lower back discomfort. The abdominal wall plays a key role in providing stability to the pelvis, alongside the pelvic floor and surrounding musculature.
When the linea alba becomes more compliant and less able to generate tension, this can reduce the effectiveness of the abdominal muscles in supporting the pelvis. Strengthening the gluteal muscles and maintaining good overall strength during pregnancy may help reduce the severity of lower back pain.
The Importance of Breathing and Core Function
Breathing mechanics are fundamental to core function. Practising 360-degree breathing can help engage the deep core muscles, including the diaphragm, transverse abdominis and pelvic floor, while also helping to manage intra-abdominal pressure.
This technique can also act as an effective tool for relaxation and stress management.
360 breathing can be performed in a variety of positions, such as on all fours, seated or lying down. Choose the position that feels most comfortable for you. Aim to practise this daily for around 5-8 controlled slow, deep breaths.
Basic guidance:
Place one hand on your tummy and one hand over your ribs.
Allow your abdomen to relax and expand your ribcage in all directions as you inhale gently
As you exhale, gently draw in the abdomen as your pelvic floor will naturally lift and recoil creating a subtle narrowing of the waist
Keep the spine neutral and avoid ‘belly-only’ or ‘chest’ breathing.
Assessing Diastasis Recti
It is important to understand that recovery is not solely determined by the width of the separation. The quality of tension within the linea alba is equally, if not more, important.
Good tension means the connective tissue can effectively transfer force across the abdominal wall. Reduced tension may feel soft or “squishy,” with little resistance when pressure is applied.
A pelvic health physiotherapist can provide an accurate assessment of both separation and tension, and guide appropriate rehabilitation. Even one or two sessions can be highly beneficial. For this reason, a postnatal assessment is strongly recommended.
Supporting Recovery
If you have been diagnosed with diastasis recti, the focus should be on restoring function rather than simply closing the gap.
Key strategies include:
Maintaining good posture
Practising appropriate breathing techniques
Performing progressive core and pelvic floor exercises
Until you can effectively manage intra-abdominal pressure, certain exercises may need to be temporarily avoided. These can include movements such as sit-ups, double leg lifts and full plank positions.
Recovery Timeline
In the early postnatal period, some degree of natural recovery may occur without intervention. However, research shows that many women still present with a separation at eight weeks postpartum, and some continue to experience it beyond one year.
This highlights the importance of structured rehabilitation and professional guidance where needed.
Can Diastasis Recti Be Prevented
There is no definitive way to prevent diastasis recti. However, maintaining regular exercise during pregnancy may help reduce its severity.
By the later stages of pregnancy, most women will experience some degree of separation. Genetics, tissue properties and individual biomechanics are all thought to play a role.
Exercise Considerations During Pregnancy
As pregnancy progresses, it is important to adapt your training to suit the changing demands on your body.
Heavy, front-loaded abdominal exercises may place excessive strain on the abdominal wall, particularly from the second trimester onwards. Exercises such as full planks can often be modified, for example by performing them on the knees.
Reducing load and intensity in later pregnancy is both appropriate and beneficial. The abdominal muscles are less able to generate force in the third trimester, and your body is already under significant physiological demand.
Training should always feel supportive, not depleting.
What Does Healing Mean
Healing is often misunderstood as the complete closure of the gap between the abdominal muscles. In reality, the primary goal is the restoration of function.
A wider gap with good tension can function more effectively than a narrow gap with poor tension.
Restoring the ability of the abdominal wall to generate and transfer force is essential for posture, movement, and overall support of the body. Without this, some women may experience ongoing weakness, discomfort or reduced performance.
Postnatal Appearance and “Mummy Tummy”
A more pronounced diastasis recti can cause the abdomen to protrude, sometimes described as a “mummy tummy.” This is not simply a matter of body fat or bloating.
It is often due to reduced support from the abdominal wall, allowing the internal contents to shift forward.
Postnatal rehabilitation should focus on rebuilding strength and coordination within the core system. While some women may recover naturally with a gradual return to activity, others may benefit from a more structured and individualised approach.
Final Thoughts
During pregnancy, the goal is to minimise excessive strain on the abdominal wall. Postnatally, the focus shifts to restoring strength, tension and function.
Recovery timelines will vary depending on factors such as genetics, age, number of pregnancies and individual tissue response.
With the right approach, it is entirely possible to regain a strong, functional core and reduce the risk of long-term issues such as back pain or pelvic floor dysfunction.
