Rectus abdominis after a C-section: what to know

A caesarean birth involves an incision through the lower abdomen and uterus; the abdominal muscles are usually moved aside rather than cut across. Swelling, scar sensitivity, reduced trunk strength, and protective muscle tension can nevertheless make the abdomen feel different. Pregnancy itself stretches the abdominal wall, and some people notice a midline gap called diastasis recti.

A bulge, pulling sensation, difficulty rolling in bed, or discomfort with coughing can reflect healing and reduced coordination. A persistent or painful bulge may have another cause, so it should be examined rather than self-diagnosed.

Follow maternity guidance, protect the incision, and increase walking and daily movement in small steps. Avoid lifting or strenuous abdominal work until cleared. Exhale during effort, support the wound when coughing, and stop exercises that cause pain, pressure, or doming along the midline.

Postnatal physiotherapy can assess breathing, abdominal coordination, scar mobility, pelvic floor function, and diastasis. A tailored programme may begin with gentle activation and progress as healing allows.

Contact your maternity team promptly for increasing wound redness, warmth, swelling, discharge, fever, opening of the incision, severe abdominal pain, heavy bleeding, shortness of breath, or a painful new bulge. Sudden chest pain, fainting, or one-sided leg swelling needs emergency attention.

Is my abdominal gap or bulge consistent with healing, diastasis, or a hernia? When can I progress lifting and exercise? Would postnatal physiotherapy help, and how should I care for the scar?