Diastasis recti: abdominal separation

What it is

Diastasis recti, often called ab separation or mummy tummy, is a widening of the gap between the two halves of the six-pack muscle. A band of tissue called the linea alba runs down the middle of your belly. In pregnancy, it stretches and thins to make room. That is how it is meant to work.

You may notice coning or doming: a ridge that pops up along the midline when you sit up from lying down or strain. That is the sign most mothers search for.

By the third trimester, nearly all pregnant women have some separation. About 6 in 10 still have it at six weeks postpartum, and about 1 in 3 at a year. It is more common with twins and with a bigger baby. It is not a tear and not a hernia, though a hernia can happen at the same spot.

What's typical

In pregnancy, the gap opens most after week 35. After birth, it narrows most in the first 8 weeks on its own. Many mothers check it with their fingers: lying on their back, knees bent, head lifted an inch, fingers pressed above the belly button. Two finger widths or less, with a firm floor under your fingers, is within normal. More than that, or a soft spot you sink into, is worth a check. How the tissue holds tension matters more than the width. A wide but firm gap often works fine. A narrow soft one may not.

What's known

Pelvic floor physical therapists are the people who assess and treat this, and both ACOG and the American Physical Therapy Association point to them. Programs that train the deep core and breathing have decent evidence for closing the gap and, more important, for function. Crunches and planks early on tend to make doming worse. Belly binding after birth is a tradition in many cultures, from Malaysian bengkung to Latin American fajas, described as support for the core and back while it recovers. Research on binding alone is thin. Surgery exists for severe cases, usually after a year or more of therapy.

What helps

• Roll to your side to get up from lying down, in pregnancy and after. Push up with your arms.
• Exhale on effort. Breathe out as you lift the baby, the car seat, or yourself off the couch.
• Watch for the ridge. If something makes your belly dome, that is feedback to change the move or wait.
• Gentle breathing work: breathe into your ribs, then draw the lower belly in on the exhale. Many therapists start here.
• Book a pelvic floor physical therapy check at six to eight weeks postpartum, or sooner if you feel unsupported.

Who helps

Tools: Birthworker Directory · Postpartum Prep Checklist

Related

• Your pelvic floor after birthPostpartum: Your Body
• Returning to exercisePostpartum: Your Body
• Belly bindingNourishment and Traditions
• Your body after birth: weight, shape, and timelinesPostpartum: Your Body
• Moving your body in pregnancyPregnancy: Your Body
• Cesarean recovery, week by weekPostpartum: Your Body

Sources

• American Physical Therapy Association — Diastasis recti patient guide
• American College of Obstetricians and Gynecologists — Patient FAQ on exercise after pregnancy
• NHS — Your post-pregnancy body: separated stomach muscles

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