Abdominal Separation (Diastasis Recti)

Reviewed by Traci C. Johnson, MD on November 27, 2022

Diastasis recti” means your belly sticks out because the space between your left and right belly muscles has widened. You might call it a “pooch.”

It's very common among pregnant women. About two-thirds of pregnant women have it.

Newborn babies also can have this belly spread, and it should go away on its own. Men can get it, possibly from yo-yo dieting, from doing sit-ups or weightlifting the wrong way, or from other causes.

Having more than one child makes this condition more likely, especially if they’re close in age. You’re also more likely to get it if you’re over 35 when pregnant, or if you’re having a heavy baby or twins, triplets, or more.

Pregnancy puts so much pressure on the belly that sometimes the muscles in front can’t keep their shape. "Diastasis" means separation. "Recti" refers to your ab muscles called the "rectus abdominis."

When the ab muscles move aside like this, the uterus, bowels, and other organs have only a thin band of connective tissue in front to hold them in place. Without the needed muscle support, a vaginal delivery could be more difficult.

The condition also can cause lower back pain, constipation, and urine leaking. It can even make it harder to breathe and to move normally. It's rare, but in extreme cases, the tissue may tear, and organs may poke out of the opening -- that’s called a hernia.

The muscle opening often shrinks after giving birth, but in some studies of women with diastasis recti, the muscle wasn't back to normal even a year later.

Don't strain. It can make matters worse. Constipation and lifting heavy things, including your kids, strain that connective tissue. Standing up and sitting down also count as heavy lifting in this case, because you’re lifting your body weight.

You push down when giving birth, but if done wrong, this action puts big pressure on the weak belly tissue.

Do be careful with exercise. Some routine fitness moves, including crunches, sit-ups, pushups, press-ups, and front planks, make abdominal separation worse. So can swimming, some yoga poses (like downward dog), and doing anything on your hands and knees. Some trainers may suggest those exercises for women with abdominal separation, not knowing what could happen.

Do heal your belly. Physical therapists don’t have one standard guideline on what moves will bring the belly muscles back into line. Some research found success with the Tupler technique. It involves certain exercises done while wearing a belly splint, which protects and holds the ab muscles together.

When the connective tissue has healed, some Pilates or other exercises may help you strengthen and rely more on your transverse (deep core) belly muscles instead of the outer ones. Not all Pilates or strengthening moves are good during pregnancy, though, so make sure you're working with a trainer who knows what "diastasis recti" means.

The best time to begin core strengthening is before you get pregnant, if you don’t already have an abdominal separation.

Before starting any exercises during or after pregnancy, be sure to ask your doctor what's OK for you to do and what's off-limits for now.

If your abdominal separation is not too big, you may decide to live with it. But you should bring those muscles back together before you have another pregnancy.

Your doctor can measure how far apart your muscles are using finger widths, a measuring tape or instrument, or ultrasound. Then they can see whether it's getting better or worse.

Many women can close their belly gap by learning gentle movements to use while the abs are supported. Ask your doctor for advice. They may refer you to a physical therapist.

If that rehab won’t work for you, maybe surgery will. An operation to correct diastasis may be called "abdominoplasty" or "a tummy tuck." The surgeon folds and sews together the weak central ridge.

It might be possible to get laparoscopy, which is surgery done with only small cuts instead of one large one. Scarring, infection, and other side effects are possible with any operation.

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