“My core has never been the same since having babies.” You, like me, may have heard this sentiment from mothers and grandmothers. You, like me, may have also experienced this for yourself. Between my second and third pregnancies, I remember recognizing an obvious change in my ability to hold my body in a healthy upright posture. Though common, this experience thankfully does not have to be a permanent reality. It is merely a symptom of diastasis recti (DR), or ab separation, which almost every woman will experience during pregnancy.
What is diastasis recti?
Diastasis recti, or diastasis recti abdominis, is a condition where your rectus abdominis muscles, aka your “six-pack abs,” are separated [1]. This is caused by a weak and/or overstretched linea alba (‘linea alba’ literally means ‘white line’ and in this context, the phrase refers to the tissue running up and down between your left and right abs). The result is that your abs stay separated rather than recovering and pulling back together after being stretched or strained.
If you have an abdominal gap, aka ab separation, over 2 centimeters or 2-3 finger widths, you have diastasis recti. You may even be able to see it if you do abdominal exercises and notice a bulging, coning, or doming in the center of your abdomen. Diastasis recti is extremely common in pregnancy as your growing baby and expanding uterus strain your abdominal muscles. An estimated 60% of women will notice that ab separation continues in the early postpartum period and beyond.
Signs of diastasis recti
Diastasis recti itself is not painful. That said, weakened abdominal muscles can lead to conditions that cause discomfort or pain. If you experience any of the following symptoms postpartum, you should discuss diastasis recti with a healthcare professional.
- Urinary incontinence
- Difficulty maintaining a good posture
- Rapports sexuels douloureux
- Visible coning, bulge, or dome in your ab muscles
- Feelings of a weak and/or separated core
How do you get diagnosed with diastasis recti?
If you suspect that you have DR, the process of being diagnosed is simple. You can even perform a self-assessment to check for potential DR.
How to perform a DR self-assessment
Begin by lying on your back, using a pillow, or putting one hand behind your head to lift your head and shoulders slightly off the ground. Bend your knees, keeping your feet flat on the floor. Place your fingers above your belly button with your palms down and the tips of your fingers facing your toes. Look at your abdomen as you use your fingers to gently feel for a gap between your abs. Test how many fingers fit between your left and right abs.
If you can fit two or more finger widths between your abs, reach out to a physical therapist with specialized training in pelvic floor therapy. (Note that in some states you can refer yourself, whereas in others your OB/GYN or primary care doctor will have to refer you.) A feeling of pressure in the space between your abs can indicate less severe DR. Please note that this self-assessment should not be performed pendant pregnancy, because ab separation is to be expected during this time.
Can you prevent diastasis recti?
It is important to note that pregnancy and the growth of the baby strains the abdomen, so some abdominal separation is normal. If you are over the age of 35, have had multiple pregnancies, or are or have been pregnant with multiples, you are at an increased risk for DR. However, you can begin preventing problematic DR development during the prenatal period.
Selon le GlowBodyPT, a YouTube channel dedicated to pre and postnatal health and healing DR, one of the best ways to prevent DR in the prenatal and early postnatal period is to avoid exercises that put pressure on or overstrain your abdominals. Instead, focus on full-body workouts that promote even strengthening of your muscles. Exercises to avoid or limit include: jackknife, v-up, pull-ups, lat pull-downs, sit-ups, and crunches, to name a few. If you notice a point or coning in your stomach or rib flaring while working out or doing day-to-day activities, you should stop that activity to avoid overstraining and worsening your DR.
Deep breathing exercises and posture work are other important pieces of DR prevention. During the day, take time to stop and adjust your posture. Hold your back straight, put your shoulders back, and take deep breaths, expanding your ribs. This will help you to gently maintain strong core function. In grossesse and postpartum, it is also important to not strain your abs when getting out of bed. Use pillows to support a comfortable side-lying posture and assist you in rolling over to rise from bed without causing coning or doming in your abdomen.
How do you treat and heal diastasis recti?
A pelvic floor PT will perform a full assessment to assess the extent of your DR and then make recommendations specific to your individual needs [2]. Working with a professional trained in pelvic floor therapy will ensure you effectively strengthen your entire core and pelvic floor and address any other related muscle weakness, such as hip instability [3]. A pelvic floor PT will also help you avoid overworking one part of your plancher pelvien by just doing Kegels, which can potentially make your DR worse.
You can begin healing your DR even avant you get a formal diagnosis. Several postpartum exercise plans target healthy core function and DR treatment. We have listed a number of them in our fourth-trimester guidebook series. I have personally enjoyed Lauren Fitter’s YouTube channel for workouts focused on healing DR. The most important thing to remember when healing your DR is to perform exercises that are slow, controlled, and focus on the full body while engaging the deep core, like deep breathing. Until you’ve been cleared to do so, avoid common core exercises like crunches and sit-ups because they will overstrain your abdominals and worsen your DR. Some helpful exercises to begin at home are cat-cow, bird-dog, and hip circles and pelvic tilts on a stability ball.
Le bilan
Some ab separation is normal and to be expected during the prenatal period. However, for many women, this ab separation remains during the postpartum period and beyond. DR doesn’t necessarily heal on its own. Diastasis recti manifests as core weakness, which can lead to problems like urinary incontinence and painful intercourse. Fortunately, ab separation does not have to be a long-term issue. It can easily be diagnosed and treated through appropriate exercise routines and with the help of a pelvic floor physical therapist.
Références :
[1] Hall H, Sanjaghsaz H. Diastasis Recti Rehabilitation. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK573063/ [2] Laframboise FC, Schlaff RA, Baruth M. Postpartum Exercise Intervention Targeting Diastasis Recti Abdominis. Int J Exerc Sci. 2021 Apr 1;14(3):400-409. doi: 10.70252/GARZ3559. PMID: 34055160; PMCID: PMC8136546.
[3] Michalska A, Rokita W, Wolder D, Pogorzelska J, Kaczmarczyk K. Diastasis recti abdominis – a review of treatment methods. Ginekol Pol. 2018;89(2):97-101. doi: 10.5603/GP.a2018.0016. PMID: 29512814.
