Do I have diastasis recti?

Diastasis recti after birth: what actually happens

Nobody explains this one properly. Here's the part that usually gets left out — how it heals on its own, what makes it worse in the early weeks, and where the line is between "give it time" and "get it checked".

Why the gap opens in the first place

Your two vertical abdominal muscles are joined down the middle by a band of connective tissue called the linea alba. As your baby grows, that band stretches and thins to make room, and the muscles move apart. This isn't damage, and it isn't something you did wrong. It's what the body is supposed to do to carry a baby.

After birth, the stretch starts to reverse. The NHS says the separation "will usually go back to normal by the time your baby is 8 weeks old." That's the marker worth holding on to, because most of the worry happens in those first eight weeks, when the belly still looks pregnant and nobody has told you that's expected.

Week by week, roughly

Weeks 0–2. Everything is still soft and swollen, and your uterus is still shrinking. You cannot judge your abdominal separation now, and checking it repeatedly will only upset you. Rest, walk gently, and breathe.

Weeks 2–6. The fastest natural closing usually happens in this window. Swelling settles, the uterus finishes returning to size, and the tissue begins to tighten. This is also the window where the wrong movements set you back, which is the next section.

Weeks 6–8. This is when a self-check starts to mean something. Many people are down to a gap of one to two fingers, firm rather than squishy underneath. Your six-week appointment is the moment to ask about it out loud, rather than wondering privately.

After 8 weeks. If the gap is still obvious, the NHS advice is to contact your GP, because a persisting separation can go along with back problems. Your GP can refer you to a physiotherapist. This is not an emergency and it is not a failure — it's simply the point where guided exercises work better than waiting.

Months and years later. Some separation can persist long-term. One 2024 study of women at 3 to 30 years after birth found a gap wider than 2 cm in roughly a third of them, and wider than 3 cm in around one in ten. A measurable gap is common, and on its own it isn't the same thing as a problem — how your middle functions matters more than the number.

What to avoid in the first 6 to 8 weeks

The NHS is specific here: avoid sit-ups, planks and high-impact exercise to begin with, and avoid heavy lifting and straining on the toilet. Crunches in particular can widen the separation rather than close it.

Two more that catch people out. First, rolling straight up out of bed — roll onto your side and push up with your arm instead. Second, holding your breath while you lift anything, including your baby or a car seat; breathe out as you lift. Constipation is worth taking seriously too, because straining pushes outwards on exactly the tissue you're trying to let heal.

One sign to watch during any movement: a ridge or dome that pops up down the middle of your belly when you sit up, lift something or get out of the bath. That doming means the load is too much for your middle right now. It isn't dangerous, but it's a signal to stop that movement and come back to it in a few weeks.

What to start with instead

Gentle beats intense here, and it works. The NHS recommends regular pelvic floor and deep stomach muscle exercises, along with good posture, to help reduce the size of the separation.

A sensible order in the early weeks: breathing that lets your ribs move sideways rather than your belly push forwards; pelvic floor exercises; then very small deep-abdominal work, such as drawing your lower belly gently in as you breathe out. Short, slow walks count too. All of it can be done lying down, which is about the right ambition when you're feeding a newborn every two hours.

What you're rebuilding is the ability of your middle to manage pressure — that's why breathing and pelvic floor work come before anything that looks like a "core workout". Sit-ups, planks, running and heavy lifting come much later, usually once you've been cleared and no longer see doming during everyday movements.

Who gets it more often

Some of this is outside your control, which is worth knowing if you've been blaming yourself:

• Twins or multiples — more stretch, and a 2024 study found twin pregnancy an independent risk factor
• Several pregnancies, especially close together — the tissue is stretched repeatedly
• Being over about 35
• A larger baby
• Higher BMI, in some studies

None of these mean it won't improve. They mean it may take longer and may benefit from guided exercises rather than time alone.

When to stop waiting and see someone

Book an appointment if the gap is still obvious at 8 weeks, if you have back or pelvic pain, if you leak urine when you cough, laugh or run, if you feel a dragging heaviness in your pelvis, or if there's a visible bulge at your midline that doesn't flatten when you relax. A lump that stays bulged even at rest should be checked to rule out a hernia.

A pelvic floor physiotherapist is the right professional for this, and one appointment often changes everything — not because the exercises are secret, but because someone watching you do them can tell you what your body is actually doing.

Sources: NHS — Your post-pregnancy body · Prevalence and risk factors of diastasis recti abdominis in the long-term postpartum (Scientific Reports, 2024)