What is abdominal separation?

Some women find their stomach muscles weaken and separate during and after pregnancy. This is known as abdominal separation, ‘diastasis recti’ or ‘recti divarication’. It is a common condition and often gets better in the first 8 weeks after having your baby.

Abdominal separation occurs when the growing uterus causes the 2 long, parallel muscles of your stomach to separate from each other. These muscles run from your chest to your pelvis, just under the skin, down the middle of your belly.

Abdominal separation is partly due to the pressure of your growing baby, and partly due to the hormonal changes that take place during pregnancy. It usually starts in the second half of pregnancy.

Abdominal separation is more common in women who have had more than 1 child, are aged over 35 or who are having twins or triplets (or more). It can also occur in a small-statured woman who is having a larger-than-average baby.

It is sometimes known as ‘DRAM’ (diastasis of rectus abdominis muscle).

What are the signs and symptoms of abdominal separation?

If you have abdominal separation after the birth of your baby, you may be able to see a gap between the two bands of abdominal muscles. You can see this gap more clearly if you lie flat on your back and lift your head up.

You might also notice a physical canoe-shaped bulge in the middle of your stomach, especially when your abdominal muscles are active.

Some women with abdominal separation also get lower back pain, as the separation prevents the stomach muscles from supporting the back.

How is abdominal separation diagnosed?

Your GP, midwife or physiotherapist can check how big your abdominal separation is by measuring it with their fingers or a measuring tape, or by doing an ultrasound.

Does abdominal separation go away by itself?

Abdominal separation usually goes away after the birth of the baby. That said, up to 1 in 3 women still report problems with abdominal separation 12 months after the birth.

How can abdominal separation be prevented during pregnancy?

Strengthening your core muscles before you get pregnant or in the early stages of pregnancy might help prevent abdominal separation.

It’s best to avoid putting excess strain on your abdominal muscles while pregnant. Avoid sit-ups or planks. Try to avoid constipation and if you have a cough, get it treated.

How is abdominal separation after the birth treated?

It’s important to stop the separation from getting worse. Try these tips:

• Avoid lifting anything heavier than your baby.
• Roll onto your side when getting out of bed or sitting up.
• Choose gentle exercises (rather than intense ones) that strengthen the deeper stomach muscles.
• Skip activities and movements that can make abdominal separation worse, such as sit-ups (crunches), oblique curls and some yoga poses (ask your GP, midwife or physiotherapist for advice).

You can also wear a supportive brace or compression underwear to help support your back and resolve the muscle separation.

There is a good chance that with time and care, the muscles will come back together. If that doesn’t work as well as you’d like, surgery after you’ve had your baby is an option.

Surgery often involves using stitches to repair the abdominal wall and reduce the gap between the muscles. This can improve quality of life and muscle strength, especially when separation is wider than 3cm.

Where to get help

If you notice anything unusual about your stomach muscles or experience any symptoms, see your GP, midwife or physiotherapist. You can find a physiotherapist near you using the healthdirect service finder.

You can also contact Pregnancy, Birth and Baby on 1800 882 436 to speak with a maternal child health nurse.