For many women, the months following childbirth bring gradual physical recovery. Hormones stabilize, muscles regain strength, and the body slowly adjusts after pregnancy. Yet some mothers notice that their abdomen still appears rounded or “pregnant” long after delivery—even when they are otherwise healthy and active.

One common reason for this persistent abdominal change is a condition known as diastasis recti, which occurs when the abdominal muscles separate along the midline during pregnancy.

Although diastasis recti is extremely common, it is often misunderstood. Learning how this condition develops, how it affects the body, and when it may benefit from evaluation can help women better understand their postpartum recovery.

What Is Diastasis Recti?

The abdominal wall contains two vertical muscles called the rectus abdominis muscles. These muscles run from the rib cage to the pelvis and are commonly referred to as the “six-pack” muscles.

Between these muscles is a connective tissue structure called the linea alba, which helps hold the muscles together and maintain core stability.

During pregnancy, as the uterus expands, the abdominal wall stretches to accommodate the growing baby. This natural stretching can cause the linea alba to widen, allowing the two sides of the rectus muscles to separate.

This separation is known as diastasis recti.

According to the Cleveland Clinic, up to 60% of women develop some degree of diastasis recti during pregnancy or the postpartum period.

For many women, the muscles gradually move closer together after childbirth. In other cases, the separation may persist.

Why Diastasis Recti Happens

Several factors contribute to the development of abdominal muscle separation during pregnancy.

The primary cause is the mechanical stretching of the abdominal wall as the uterus grows. Hormonal changes also play an important role.

During pregnancy, the body produces hormones such as relaxin and progesterone, which soften connective tissues and ligaments. These hormonal changes help the body adapt to childbirth but also make the abdominal tissues more flexible.

Additional factors that may increase the likelihood of diastasis recti include:

• multiple pregnancies
• carrying a larger baby or multiples
• maternal age
• rapid or significant abdominal stretching
• weakened core muscles prior to pregnancy

Because each pregnancy is unique, the degree of muscle separation varies widely among individuals.

Signs and Symptoms of Diastasis Recti

Many women are unaware they have abdominal muscle separation until months after pregnancy.

The most noticeable sign is a persistent abdominal bulge that does not flatten with weight loss or exercise.

Other signs may include:

• a soft or rounded appearance in the center of the abdomen
• visible “doming” of the abdomen when sitting up or engaging the core
• a gap felt between the abdominal muscles
• core weakness
• lower back discomfort
• difficulty regaining abdominal tone

Some women also notice that traditional abdominal exercises such as sit-ups or crunches make the bulge more visible.

How Diastasis Recti Is Diagnosed

Diastasis recti can often be identified through a simple physical examination.

A physician or physical therapist may ask the patient to lie on their back and gently lift their head while the examiner palpates the midline of the abdomen. This maneuver allows the practitioner to feel the width and depth of the muscle separation.

In some cases, imaging studies such as ultrasound or CT scanning may be used to measure the separation more precisely.

The width of the separation can vary from mild to significant. According to the American College of Obstetricians and Gynecologists (ACOG), separations greater than two centimeters are typically considered clinically significant.

Can Diastasis Recti Improve Naturally?

In many cases, abdominal muscle separation improves during the months following childbirth.

The body gradually restores tension in the connective tissues, and core strength can improve through rehabilitation exercises.

Specialized postpartum physical therapy programs often focus on:

• deep core activation
• pelvic floor strengthening
• breathing mechanics
• safe core stabilization exercises

Research published in the Journal of Women’s Health Physical Therapy shows that structured rehabilitation can improve abdominal function and stability for many postpartum women.

However, recovery outcomes vary depending on the degree of separation and tissue elasticity.

When Diastasis Recti Persists

For some women, the abdominal muscles do not fully return to their original position despite exercise and physical therapy.

This occurs when the connective tissue in the linea alba remains stretched or weakened.

Persistent diastasis recti may lead to:

• ongoing abdominal bulging
• reduced core strength
• difficulty with certain physical activities
• lower back strain due to decreased core stability

These changes can affect posture, physical performance, and overall comfort.

Lifestyle Strategies That May Help

For women with mild to moderate diastasis recti, several conservative strategies may support recovery.

These may include:

Targeted core rehabilitation

Working with a physical therapist who specializes in postpartum recovery can help retrain the deep core muscles.

Gradual strength training

Controlled strengthening of the core, hips, and back muscles can improve stability and support the abdominal wall.

Posture and breathing techniques

Proper posture and diaphragmatic breathing can reduce strain on the abdominal tissues during daily activities.

Avoiding excessive abdominal pressure

Certain exercises that increase intra-abdominal pressure may worsen the separation and should be approached cautiously.

Because every case is different, guidance from a healthcare professional can help ensure exercises are performed safely.

When to Consider an Expert Evaluation

While many women experience improvement with rehabilitation, others may continue to notice significant abdominal changes months or years after pregnancy.

An expert evaluation may be helpful when:

• the abdominal bulge persists beyond one year postpartum
• core weakness interferes with physical activity
• the abdominal gap remains wide despite therapy
• the separation causes discomfort or functional limitations

During an evaluation, a physician can assess the abdominal wall, determine the degree of separation, and discuss the full range of options available for addressing persistent structural changes.

Understanding Postpartum Abdominal Recovery

Pregnancy permanently changes many aspects of the body. For most women, recovery progresses naturally over time as muscles strengthen and tissues regain stability.

However, persistent abdominal muscle separation can sometimes prevent the abdomen from returning to its previous contour or strength.

Recognizing the signs of diastasis recti—and understanding the options available when it persists—can help women make informed decisions about their health and recovery after childbirth.

Women seeking additional information about postpartum recovery may also find it helpful to review our Postpartum Body Changes Checklist, which explains several other common physical changes that occur after pregnancy.

Sources

American College of Obstetricians and Gynecologists (ACOG) – Postpartum Care Guidelines
Cleveland Clinic – Diastasis Recti Overview
Mayo Clinic – Postpartum Recovery and Physical Changes
Journal of Women’s Health Physical Therapy – Postpartum Core Rehabilitation
Harvard Health Publishing – Core Muscle Function and Stability

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