What should you know about postnatal abdominal separation?

Postnatal abdominal separation, also called diastasis recti, is a widening between the abdominal muscles that may affect core support after pregnancy. It can appear as a ridge or doming along the middle of the abdomen when you sit up or strain. Some people have no discomfort, while others notice back ache, reduced strength or difficulty controlling pressure through the trunk.

Pregnancy stretches the abdominal wall and the connective tissue between the two sides of the rectus muscles. The gap is not judged by appearance alone; a clinician also considers tension, movement and function. A bulge that is painful, firm or confined to one spot may have another cause, such as a hernia, so self-diagnosis is not enough.

A postnatal physiotherapist can assess breathing, posture, abdominal coordination and pelvic-floor function, then build exercises around your stage of recovery. Start gently, breathe out during effort and avoid movements that cause doming, pain or pressure symptoms. Rolling to your side before getting out of bed and supporting your abdomen when coughing may feel more comfortable. Recovery is gradual; progress should be based on control rather than appearance.

Arrange an assessment if the separation is painful, limits lifting or daily activity, or comes with urine leakage, pelvic heaviness or persistent back pain. Seek urgent care for a sudden painful bulge, vomiting, severe abdominal pain, fever or a bulge that becomes hard and cannot be gently reduced. These features may indicate a problem other than uncomplicated muscle separation.

Ask whether your symptoms fit diastasis recti, whether a hernia should be excluded and which exercises are suitable now. Ask when lifting, running or abdominal work can be increased, how to modify movements that cause doming and whether referral to Postnatal Physiotherapy would help.