Do I Have Abdominal Separation?
By Lauren Zanelli, Women’s Health Physiotherapist
Understanding Diastasis Recti in Pregnancy and Postpartum
What Is Abdominal Separation?
Abdominal separation, or diastasis of the rectus abdominis muscle (DRAM), is known as the separation of the rectus abdominis muscles, or the "six-pack" muscles, along the midline of the abdomen. It is a normal physiological process that involves the stretching of connective tissue between the abdominal muscles, known as the Linear Alba. This natural adaptation during pregnancy, allows space for your baby to grow. Whilst some degree of separation is normal during pregnancy, significant or persistent separation postpartum may require intervention.
How Common Is It?
ALL women experience some degree of abdominal separation by the end of pregnancy. Approximately 60% of women have a DRAM at six weeks postpartum. This number decreases to around 32.6% at 12 months postpartum. While many recover spontaneously within the first few months postpartum, some may experience a wider or deeper separation that impacts function or comfort (Frawley et al., 2010). Individualised assessment and management is important, only IF your tummy separation BOTHERS YOU. With the right support and guidance, most women can rebuild core strength, improve symptoms, and return to the activities they love with confidence.
Signs You Might Have Abdominal Separation
Common signs and symptoms include:
A visible bulge or "doming" along the midline of the abdomen, especially when sitting up or straining.
A gap between the abdominal muscles that can be felt when lying on your back and lifting your head slightly.
Lower back pain or pelvic discomfort.
Core weakness
Associated symptoms like urinary or faecal incontinence or pelvic organ prolapse.
When Should You Seek Help?
While some degree of abdominal separation is NORMAL DURING AND AFTER, it's advisable to consult a healthcare professional if:
The separation remains significant beyond 8–12 weeks postpartum AND if it bothers you. Such as…
You're experiencing pain or discomfort.
You notice associated pelvic floor symptoms.
Early intervention can lead to more effective recovery.
What can you do?
Evidence-based approaches to managing DRAM include:
Physiotherapy: Targeted exercises to strengthen the abdominal muscles as well as the pelvic floor muscles and improve core stability. Did you know this normally INCLUDES sit ups?
Breathing and Postural Techniques: Learning effective breathing patterns and posture to support the abdominal muscles.
Avoiding High-Pressure Activities: Avoiding exercises that increase intra-abdominal pressure, such as repetitive heavy lifting from the ground, or straining, especially in the early postnatal period.
References:
Royal Women’s Hospital. Postnatal Recovery & Abdominal Separation
Gluppe, S. L., Engh, M. E., & Bø, K. (2018). Effect of a postpartum training program on the prevalence of diastasis recti abdominis in postpartum primiparous women: a randomized controlled trial. Physiotherapy, 98(4), 260–268.
Hallam, T. (2021). Clinical education materials & teaching on pelvic floor function and dysfunction.