All pregnant women experience diastasis recti, a separation in the abdomen that occurs when the tissue between the rectus abdominis muscles—the two sides of your “six pack”—stretches or tears at the central vertical line. After delivery, the condition persists in up to 60% of women.
“The abdominal muscles and surrounding tissue have to stretch to accommodate for the growing fetus over the course of pregnancy,” says Ellen Casey, MD, a sports medicine physician in the Department of Physiatry and the Women’s Sports Medicine Center at HSS.
Diastasis recti is usually painless, though it can cause an abnormal sensation or discomfort, Dr. Casey says. Some women with diastasis recti notice a distension or protrusion of their abdomen when they eat or drink, she says. Women with persistent diastasis are often left to seek answers about how to rebuild their core.
One clear indication of diastasis recti is a doming of the abdominal muscles when you put pressure on your core, says Anna Ribaudo, PT, DPT, OCS, Capp-OB, a clinical lead and board certified orthopedic clinical specialist at HSS who is certified in perinatal care. Instead of the abdomen maintaining a flat, horizontal plane during a crunch exercise, for instance, women with diastasis recti might see their abdominal muscles protrude into a tent-like shape.
If you’re unsure whether you have diastasis recti, a simple self-test can check for an abdominal separation:
Notice how many fingers fit between your separated muscles—that’s the width of your gap—and also whether you feel pressure of the abdominal muscles against your fingers. That pressure is a good sign, Ribaudo says, indicating the muscles maintained some strength. All told, she says, the severity of the diastasis recti depends on the length and width of the gap and the strength of the surrounding abdominal muscles.
Don’t attempt to fix your abdominal separation until after giving birth, Ribaudo says. “If you have it during pregnancy, it’s not going to go away.”
Healing your diastasis recti after childbirth is as much about knowing what not to do as what to do, Ribaudo says. Everyday activities that put pressure on your core, such as bearing down during a bowel movement or holding your breath when you pick up your baby, can exacerbate the abdominal separation. Here's how to heal it.
The Every Mother program primarily employs an abdominal draw-in maneuver; participants are encouraged to pull their belly button toward their back while in a variety of body positions as the instructor cues them to cinch tighter. (The HSS study did not compare the program to any other diastasis recti exercise regimen.)
If you’ve been working steadily to heal your diastasis recti, Ribaudo says, you should see noticeable results within six months. “The other component of diastasis is the contractibility strength of your core and ability to engage it with activities,” she says. “So although there still may be a separation, how the muscles function is more important.”
You should see a healthcare professional with expertise in musculoskeletal conditions related to pregnancy and delivery, such as a physical therapist, if your diastasis recti occurs with other related issues, such as pelvic floor dysfunction, pain during intercourse, or incontinence four months or more after childbirth.