Diastasis recti is a common condition during pregnancy where stretching of the abdomen leads to a separation of the muscles. While some abdominal separation is a normal physiological change to make room for a growing baby, proactive steps can reduce the likelihood and severity of the condition. Focusing on proper movement, specific core strengthening, and protective habits supports the abdominal wall throughout gestation.
Defining Diastasis Recti and Risk Factors
Diastasis recti abdominis (DRA) is the widening of the gap between the two sides of the rectus abdominis muscle, or “six-pack” muscles. This separation occurs along the linea alba, a band of connective tissue running down the center of the abdomen that softens and stretches during pregnancy. The condition is a natural adaptation; studies indicate that nearly 100% of women experience some degree of DRA by the third trimester.
The primary cause is increased mechanical tension on the abdominal wall from the expanding uterus, combined with hormonal changes that soften connective tissues like the linea alba. Increased intra-abdominal pressure, often from a large or multiple babies, can exacerbate the separation. Other risk factors include advanced maternal age (over 35), multiple pregnancies, and poor core strength prior to conception. A separation is classified as DRA if the gap between the muscles is wider than two centimeters, or roughly two finger-widths.
Key Strategies for Risk Reduction During Pregnancy
Proactive measures focus on maintaining the integrity of the linea alba by training the deep core muscles and optimizing posture. The goal is to encourage the transverse abdominis (TVA), the deepest layer of abdominal muscle, to provide a stabilizing inner corset for the spine and abdomen. Exercises that safely engage the TVA, such as heel slides, pelvic tilts, and modified bird-dog variations, are effective because they stabilize the core without creating excessive outward pressure.
Proper breathing techniques are foundational for deep core engagement. This involves practicing diaphragmatic breathing, allowing the ribcage to expand fully on the inhale, and then gently drawing the abdominals inward and upward on the exhale. This movement helps create tension across the linea alba, minimizing the width of the separation. Maintaining an upright posture throughout the day is also important, as slouching or excessive arching of the lower back places undue strain on the anterior abdominal wall.
The total weight gained during pregnancy is another factor that can be managed to reduce risk. Maintaining a healthy weight gain through a balanced diet and consistent, safe exercise reduces the overall mechanical load on the abdominal fascia. Consulting with a physical therapist specializing in prenatal fitness or pelvic floor health can provide a personalized program of exercises and guidance.
Movements and Habits to Avoid
Certain movements generate high levels of intra-abdominal pressure that push outward on the stretched linea alba, potentially worsening the separation. Traditional abdominal exercises such as crunches, sit-ups, and full planks should be avoided, especially after the first trimester. These movements force the rectus abdominis to contract sharply, which can result in visible coning or doming of the abdomen along the midline, a clear sign of excessive pressure.
Modified movements are necessary for everyday activities like getting out of bed or standing up from a lying position. Always use the “log roll” technique, which involves rolling onto the side first, then using the arms to push the body up while keeping the torso rigid. This technique prevents the abdominal muscles from performing a full sit-up movement.
Heavy lifting and straining should also be minimized, including lifting heavy groceries or older children. When lifting objects, it is important to exhale and engage the deep core muscles simultaneously, rather than holding the breath and bearing down. High-impact activities like running or jumping may need to be modified or paused, as they create repetitive downward forces that the compromised core unit may not manage effectively.
Postpartum Assessment and Professional Guidance
After giving birth, you can perform a simple self-check to assess for any residual separation. Lie on your back with your knees bent and feet flat, then place your fingers horizontally across the midline of your abdomen near the belly button. Gently lift your head and shoulders just enough to engage the abdominal muscles, then feel for the width and depth of any gap between the muscle edges. It is recommended to check at, above, and below the navel.
The most significant spontaneous healing of the linea alba occurs in the first eight weeks postpartum. Gentle, early core recovery should focus solely on transverse abdominis breathing and pelvic floor activation, avoiding any movement that causes coning or straining. This helps stabilize the core without excessive force.
If the separation is two finger-widths or more, or if symptoms like lower back pain, pelvic pain, or difficulty with daily tasks persist, professional intervention is recommended. A pelvic floor physical therapist (PFPT) can provide an accurate diagnosis and create a customized rehabilitation plan. They guide you through exercises that rebuild core strength progressively, ensuring tension is restored across the midline for long-term function and stability.