Diastasis Recti in Pregnancy and Postpartum: What It Is, Why It Happen

If you’ve Googled “diastasis recti” at 2 a.m. because your belly feels different, your core feels unreliable, or you noticed coning down the middle when you sit up, you’re in very good company. Diastasis recti is common during pregnancy and can persist postpartum, but it’s also one of those topics that gets flattened into scary before-and-after pictures and “fix your mom pooch” messaging.

Your body deserves better than that.

This guide explains what diastasis recti is, why it happens, and how to support recovery, including digestion, when to seek help, and feeding and baby-holding positions that reduce strain as you heal.

Diastasis recti abdominis (DRA) is a widening of the space between the two sides of the rectus abdominis (“six-pack”) muscles along the midline connective tissue (the linea alba). (1) Clinically, you’ll also hear “inter-rectus distance (IRD),” which is simply the measured space between the muscles. (1)

A key point that gets missed online: diastasis is not just about width. The tension and function of the connective tissue matters too. Two people can have a similar “gap” and very different symptoms and strength. Reviews consistently emphasize that DRA presentation and impact vary, and measurement methods/definitions differ across studies. (1)

Pregnancy asks your abdominal wall to do a lot:

• Mechanical stretch as the uterus grows and the abdominal wall lengthens and adapts. (1)

• Connective tissue changes influenced by pregnancy hormones and changes in tissue properties. (1)

• Postural and load shifts that change how pressure is managed through the abdomen and pelvis. (1)

In other words, many bodies widen at the midline because they are making room and managing pressure. That doesn’t mean you did anything wrong.

Prevalence depends on how and where it’s measured, but it’s clearly common in late pregnancy and not rare postpartum. A longitudinal observational study of first-time pregnant women reported DRA prevalence of 100% in late pregnancy (week 35) and 39% at 6 months postpartum. (2) Reviews similarly note wide-ranging prevalence estimates, influenced by diagnostic criteria and measurement technique. (1)

Also important: not everyone with DRA has pain or dysfunction, and not everyone without a measurable DRA feels great. Symptoms aren’t one-size-fits-all. (1)

Some people first notice diastasis because of how their abdomen looks or feels. Others notice function changes.

Common experiences include:

• Doming/coning or a ridge along the midline when sitting up, coughing, or lifting (a pressure-management cue). (1)

• A feeling of “softness” or reduced tension at the midline. (1)

• Core fatigue with tasks like carrying, standing for long periods, or getting out of bed. (1)

• In some cases, pelvic floor symptoms (leaking, heaviness, prolapse symptoms) may be present at the same time, though research on the relationship is mixed and ongoing. (3, 4)

If you’ve been told “it’s just cosmetic,” but you feel limited in daily life, trust that. Function matters.

You’ll see a lot of finger-width tests online. Palpation can be useful for a quick screen, but ultrasound is often considered the most accurate method for measuring IRD in research and clinical settings. (1, 3)

A 2021 study specifically examined ultrasound-based diagnostic criteria for DRA and explored correlations with pelvic floor dysfunction in early postpartum women, highlighting both the clinical interest and the variability in defining DRA. (3)

Practical takeaway: If you want a clear baseline and targeted plan, a pelvic floor PT or rehab clinician who uses ultrasound or validated assessment methods can be incredibly helpful.

You don’t need to “prevent” every millimeter of widening to be doing things right. The goal is to support function, comfort, and pressure management.

1) Practice pressure-aware movement

If you see doming, breath-hold, or feel a midline “push,” it’s usually a sign to modify. (1) Helpful cues:

• exhale on effort (standing up, lifting, rolling)

• slow down transitions

• avoid repeated high-pressure moves that consistently dome your midline

2) Train your deep core gently (without chasing a flat belly)

Many rehab approaches focus on coordinated function of the diaphragm, abdominal wall, and pelvic floor as a system. (1) Think “coordination” and “capacity,” not crunch marathons.

3) Don’t let fear drive your movement

Evidence suggests pregnant women can train abdominal and pelvic floor muscles in structured programs without necessarily worsening diastasis, depending on the approach and outcomes measured. For example, postpartum-focused exercise research consistently emphasizes safe, progressive training rather than avoidance. (5, 6)

If you’re pregnant and unsure what’s safe, a pelvic floor physical therapist is the best place to get individualized modifications that match your pregnancy and symptoms.

Here’s the honest truth: diastasis recovery is usually about function over time, not a quick “close the gap” project. And the evidence reflects that nuance.

A randomized controlled trial found that a deep core stability program significantly decreased IRD and improved quality of life in postpartum women compared with traditional exercises alone. (5)

At the same time, systematic reviews have found that conservative interventions may produce small or inconsistent reductions in IRD, and that benefits may be more meaningful in function, strength, and symptoms than in “gap size” alone. (6)(7)

So the best framing is:

• targeted rehab is worth it, especially if you have symptoms

• progress is individualized

• success is not defined only by a measurement

Pressure strategies (like coordinated exhale-with-effort) are not “woo.” They’re a practical way to manage intra-abdominal pressure while the linea alba regains strength and tension. Reviews and postpartum exercise research frequently emphasize this system approach, even as specific protocols vary. (1, 7)

If you’re early postpartum, think foundations:

• log roll to get out of bed (reduce coning)

• exhale on lifts

• short walks, as tolerated

• gentle rehab exercises that don’t dome your midline

If you’re later postpartum and still struggling, you did not “miss your window.” There isn’t a single deadline for recovery.

A lot of postpartum parents notice bloating, constipation, or digestive discomfort and wonder if it’s connected.

Postpartum pelvic floor and anorectal disorders are common and under-discussed, and they include constipation as well as hemorrhoids and other concerns. A 2025 peer-reviewed clinical review highlights that these problems are common and often go untreated for too long. (8)

There’s also emerging research exploring GI symptoms in people with diastasis. One study of patients undergoing surgical diastasis repair reported high baseline rates of bloating and constipation and substantial symptom improvement after repair. (9) That doesn’t prove diastasis is always the cause of bloating, but it validates a real pattern many patients report: when abdominal wall support and pressure mechanics are compromised, digestion can feel harder.

Gentle support that tends to help (without turning food into a battleground):

• Hydration and gradual fiber increases (too much fiber too fast can worsen bloating) (8)

• Short, frequent walks to support motility (8)

• Avoid chronic straining; if you’re straining regularly, it’s a sign to get help (8)

If constipation is persistent, painful, or paired with pelvic heaviness or leakage, pelvic floor therapy can be especially useful.

You’re not just “recovering” in a vacuum. You’re feeding a baby (often for hours a day), and posture adds up.

A 2023 biomechanical study measured spinal curvature and lumbar muscle activity across breastfeeding positions and found differences in muscle activation; notably, supported side-lying showed lower erector spinae activation compared to other postures, suggesting it may help reduce muscle fatigue. (10)

A randomized controlled trial also found that ergonomic breastfeeding training reduced musculoskeletal disorders in mothers, reinforcing that positioning education can meaningfully change comfort outcomes. (11)

Positions many postpartum bodies find diastasis-friendly:

• Side-lying nursing (supported): often reduces abdominal bracing and back fatigue. (10)

• Football/clutch hold: keeps baby’s weight off the front of your abdomen and can feel supportive after a C-section or with midline strain. (10)

• Laid-back/reclined: can reduce pressure through the abdomen and let you relax your ribs and belly.

Small posture tweaks matter too:

• bring baby to you with pillows instead of hunching forward

• keep ribs stacked over pelvis as much as possible

• soften your shoulders and jaw (tension often travels)

If you’re bracing hard through feeds because latch is painful or baby is slipping, it’s worth addressing latch and support, because discomfort drives protective tension.

Carrying a baby is repetitive load carriage, and biomechanics research shows it changes forces and movement patterns. A study on infant carrying methods found that holding or wearing an infant impacts forces and kinematics during gait and common tasks, with implications for caregiver pain and dysfunction. (12)

Practical, core-friendly cues:

• Keep baby close to your center (avoid long, leaned-back carries)

• Switch sides if you hip-carry

• Use a supportive carrier when possible to reduce constant asymmetrical loading (12)

• Exhale on lifts (crib, car seat, floor pickups) to reduce pressure spikes

This isn’t about “perfect posture.” It’s about reducing the repeated moments that make your midline work overtime.

You don’t need to wait until you feel broken. Consider getting evaluated if you have:

• Persistent or worsening doming/coning with everyday movements (1)

• Pain that limits function (back, pelvic, abdominal)

• Pelvic floor symptoms: leaking, heaviness/pressure, bulging sensations, painful sex, or persistent constipation/straining (3, 8)

• Concern for a hernia (a distinct bulge, pain at a focal spot, symptoms that worsen with coughing/straining) (1)

• A feeling that your core “can’t support you” during daily tasks

Early support is often easier than trying to undo months of compensation.

Pelvic floor physical therapy (PFPT) isn’t just “Kegels.” It’s rehab for the system that supports your pelvis, core, breathing mechanics, and daily movement patterns.

Research continues to explore the relationship between DRA and pelvic floor dysfunction. A 2021 ultrasound-based study specifically examined diagnostic criteria for DRA and reported correlations with pelvic floor dysfunction measures in early postpartum women. (3) Other studies also investigate these associations, though results across the literature are not perfectly consistent. (4)

Even when diastasis isn’t the “cause” of pelvic floor symptoms, the two often coexist because pregnancy and birth affect both systems. Addressing them together tends to be more effective than treating them like separate problems.

It’s hard to talk about diastasis without acknowledging the pressure new moms face to “get their body back.” A systematic review on postpartum body dissatisfaction describes multi-level pressure to return to pre-pregnancy body shape and size, and links to mood and self-esteem impacts. (15)

If diastasis has you spiraling, that is not vanity. That is the collision of a normal postpartum body change with a culture that treats recovery like a deadline.

Your job is not to look unchanged. Your job is to heal.

1. Du Y, et al. Diastasis recti abdominis: A comprehensive review. (2025). https://pmc.ncbi.nlm.nih.gov/articles/PMC12234620/

2. da Mota PGF, et al. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum. (2015). https://pubmed.ncbi.nlm.nih.gov/25282439/

3. Qu E, et al. The ultrasound diagnostic criteria for diastasis recti and its correlation with pelvic floor dysfunction in early postpartum women. (2021). https://pmc.ncbi.nlm.nih.gov/articles/PMC7779936/

4. Li M, et al. Ultrasonographic evaluation of diastasis recti abdominis and its association with pelvic floor dysfunction. (2024). https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1441127/full

5. Thabet AA, Alshehri MA. Efficacy of deep core stability exercise program in postpartum women with diastasis recti abdominis: a randomized controlled trial. (2019). https://pmc.ncbi.nlm.nih.gov/articles/PMC6454249/

6. Benjamin DR, et al. Conservative interventions may have little effect on reducing diastasis of the rectus abdominis in postnatal women: a systematic review and meta-analysis. (2023). https://pubmed.ncbi.nlm.nih.gov/36934466/

7. Weingerl I, et al. The effects of conservative interventions for treating diastasis recti abdominis: a systematic review with meta-analysis. (2022). https://pmc.ncbi.nlm.nih.gov/articles/PMC9707186/

8. Sitaraman L, et al. Postpartum anorectal and pelvic floor disorders: evaluation, treatment, and prevention. (2025). https://pmc.ncbi.nlm.nih.gov/articles/PMC12226706/

9. Bruno A, et al. Improvement of gastrointestinal symptoms after diastasis recti repair. (PubMed record). https://pubmed.ncbi.nlm.nih.gov/41489645/

10. Biviá-Roig G, et al. Biomechanical analysis of breastfeeding positions and their effects on lumbopelvic curvatures and lumbar muscle responses. (2023). https://pubmed.ncbi.nlm.nih.gov/37075644/

11. Afshariani R, et al. The influence of ergonomic breastfeeding training on some health parameters in infants and mothers: a randomized controlled trial. (2019). https://link.springer.com/article/10.1186/s13690-019-0373-x

12. Havens KL, et al. Baby carrying method impacts caregiver posture and loading during gait and item retrieval. (2020). https://pmc.ncbi.nlm.nih.gov/articles/PMC9423689/

13. Beamish NF, et al. Impact of postpartum exercise on pelvic floor disorders and diastasis recti abdominis: systematic review and meta-analysis. (BJSM, 2024/2025). https://pmc.ncbi.nlm.nih.gov/articles/PMC12013572/

14. Hilde G, et al. Postpartum pelvic floor muscle training and urinary incontinence: randomized controlled trial. (2013). https://pubmed.ncbi.nlm.nih.gov/24201679/

15. Lee MF, et al. A systematic review of influences and outcomes of body dissatisfaction during the postpartum period. (2023). https://pubmed.ncbi.nlm.nih.gov/37682058/