Your baby has been in the world for a while, but you still look a little pregnant? The reason could be diastasis recti. In this article, you’ll learn how abdominal muscle separation occurs, how to test whether you have diastasis recti, and how to treat it after childbirth.

What is a rectus diastasis?

Your abdominal wall consists of skin, a layer of fat, connective tissue ( Fascia ), and muscle. The rectus abdominis muscles normally run, as their name suggests, in a straight line from the rib cage to the pelvis. In the case of a rectus diastasis ( diastasis recti or Centerline break ), however, the abdominal muscles separate to the left and right, and the Linea alba, the vertical connective tissue seam on the abdomen, widens from about two to up to ten centimeters. This creates a tangible gap above, at, or below the navel, which can visually resemble a fracture.

How does a diastasis recti occur?

Women are often affected by diastasis recti, especially during pregnancy. As your belly grows, the rectus abdominis muscles stretch significantly, lose tension, and separate. The pregnancy hormone relaxin, which also helps the cervix open during childbirth, promotes this stretching. Diastasis recti usually develops in the second half of pregnancy, and almost all pregnant women are affected shortly before birth. However, it often becomes noticeable only after childbirth, when the abdominal muscles do not return to their original position and a bulge remains in the abdominal wall between the muscle strands. The likelihood of developing diastasis recti increases with a second, third, or fourth pregnancy, especially if the muscles have already been stretched multiple times. Training the straight abdominal muscles from the 20th week of pregnancy can also promote the formation of the gap: from this point on, the muscles gradually give way to the growing baby bump, and targeted training can intensify this process, causing the gap between the rectus abdominis muscles to become even larger.

Even babies can have a rectus diastasis, as many are born with a relatively wide gap between the rectus abdominis muscles. However, treatment isn’t necessary for little ones; the rectus diastasis usually disappears on its own once they start to walk.

How can I recognize a diastasis recti?

You can recognize a rectus diastasis by a visible and palpable bulge in your stomach when you tense your abdomen. Depending on the severity, it can be between two and ten centimeters wide and 12 to 15 centimeters long, and it may extend from the rib cage to the pubic bone. Usually, the bulge around the navel is most pronounced. If you’re unsure whether you have diastasis recti, you can easily do this test yourself:

• Lie on your back and place your knees hip-width apart.

• Place two fingers on your abdominal wall above the navel, with your fingertips pointing toward the pubic bone.

• As you exhale, lift your head and shoulders slightly off the ground and engage your abdominal and pelvic floor muscles.

• At the same time, press your fingers into your abdominal wall and check whether you can feel a gap between the muscle strands and, if so, how long and wide it is.

• Lower your head and shoulders again before repeating the test below the navel.

If the gap above or below the navel is two, three, or more finger widths, it is considered a rectus diastasis. Before taking any further steps, you should have the diagnosis confirmed by your doctor. They can recommend a special training program or refer you to a physiotherapist if needed.

What are the consequences of a diastasis recti?

A severe rectus diastasis can make childbirth more difficult, as you can’t use your abdominal muscles as effectively to support pushing. An upright position, where you engage your back muscles, can help. Aside from that, a rectus diastasis initially causes no physical discomfort or pain. Nevertheless, many moms are bothered by the fact that, due to rectus diastasis, it can still look like they have a baby bump months after birth. Additionally, the abdominal muscle gap can lead to long-term consequences such as pain in the lower back, buttocks, or hips, since rectus diastasis affects the supporting, stabilizing, and carrying functions of the entire abdominal musculature.

Can a diastasis recti be prevented or treated?

It is completely normal for your abdominal muscles to separate during pregnancy, and it can’t be avoided. About 60 percent of women still have a rectus diastasis six weeks after pregnancy, and 32 percent still have it one year after childbirth. However, you can do quite a bit to prevent the gap from becoming too large and to help it close again after birth.

During pregnancy you should put as little strain as possible on your straight abdominal muscles and at the latest from the halfway point of pregnancy, refrain from training this muscle group . Also, make sure you always get up by rolling onto your side, and avoid lifting heavy objects.

Also after the birth you should give your body time to rest at first. Do not train your straight abdominal muscles without guidance as long as you can feel a diastasis recti, so the gap doesn’t widen. Immediately after birth, a belly band can help support your upper body. After about six to eight weeks and a check-up with your gynecologist, you can begin a Postnatal recovery course , which, among other things, trains the inner abdominal muscles and the pelvic floor. If you have a severe diastasis recti that does not close on its own, you can supplement postpartum exercises with targeted training. Start with a
midwife or a physiotherapist. She/he can show you specific exercises to treat diastasis recti and guide and support you through the process. You can also begin postpartum recovery for diastasis recti several years after childbirth. If the diastasis recti does not close despite targeted training or causes pain, surgery on the abdominal muscles may be advisable. However, this is only necessary in very rare cases.

Even if it may feel a little bothersome, diastasis recti is a completely natural side effect of pregnancy. With a little patience and targeted exercises, your core will most likely be as strong as it was before in no time. We wish you all the best on your journey!