Why Your Core Might Feel Different Post-Pregnancy: Understanding Diastasis Recti

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Why Your Core Might Feel Different Post-Pregnancy: Understanding Diastasis Recti | Hernia Info

What every woman should know about diastasis recti

If you’re noticing a bulge or gap in your abdominal muscles during pregnancy or postpartum, it may be diastasis recti. While it can look similar to a hernia, diastasis recti is a separate condition, and learning about its symptoms, causes, and treatment options can help you better understand what's happening and know when it may be time to speak with a healthcare provider.

Why Your Core Might Feel Different Post-Pregnancy: Understanding Diastasis Recti | Hernia Info

Understanding diastasis recti

Diastasis recti happens when the two sides of the "six-pack" muscles separate as the connective tissue between them stretches and widens. As the uterus grows, it places increased pressure on the abdominal wall, which can contribute to the separation. It’s very common during pregnancy, affecting about 60% of women after childbirth. The separation often improves after childbirth, but for some women it persists for months, or even years, afterward.¹

Why Your Core Might Feel Different Post-Pregnancy: Understanding Diastasis Recti | Hernia Info

So, what’s the difference between diastasis recti and a hernia?

Diastasis recti and a hernia can both cause a bulge, but for different reasons. Diastasis recti refers to the separation of the abdominal muscles, while a hernia occurs when tissue or part of an organ pushes through a weakness or opening in the abdominal wall.³ These conditions may happen in the same area. An umbilical hernia could even develop as a complication of diastasis recti.¹

Because both conditions can cause abdominal bulging and similar symptoms, it isn’t always easy to tell them apart. Understanding the other symptoms of diastasis recti may help provide a clearer picture of what's going on.

Why Your Core Might Feel Different Post-Pregnancy: Understanding Diastasis Recti | Hernia Info

Common symptoms of diastasis recti

Diastasis recti can cause a variety of symptoms, including:^1,2

A visible bulge or ridge just above or below your belly button that remains even after losing any weight gained during pregnancy
A soft or jelly-like feeling around your belly button
Core weakness
Lower back pain due to weakened core support
Difficulty lifting or completing everyday activities
Urinary incontinence or constipation

Diastasis recti itself is not usually painful, but the separation may make your core feel weaker and contribute to discomfort during everyday activities.¹

Why Your Core Might Feel Different Post-Pregnancy: Understanding Diastasis Recti | Hernia Info

Common causes of diastasis recti

Diastasis recti most commonly develops during pregnancy. As the baby grows, the uterus expands and stretches the connective tissue between the abdominal muscles, which can cause the muscles to separate.1 Hormonal changes during pregnancy also soften the connective tissue, making it easier to stretch.²

Certain additional factors may increase the likelihood of developing diastasis recti, including:¹

Carrying twins or multiples
Having pregnancies close together
Delivering a larger baby
Being over age 35 during pregnancy
Pushing during vaginal delivery

Diastasis recti can also affect people who have not been pregnant, particularly following significant weight changes or repeated activities that increase pressure within the abdomen.²

Why Your Core Might Feel Different Post-Pregnancy: Understanding Diastasis Recti | Hernia Info

Diagnosing diastasis recti

A healthcare provider can often diagnose diastasis recti during a physical exam. They may ask you to tighten your abdominal muscles while they check for a gap between the muscles or a bulge along the middle of your abdomen.² This bulge often looks less like a distinct lump and more like a ridge or "pooch" running down the center of the abdomen, which may become more noticeable when sitting up, coughing, or straining.^1,2 Generally, a gap larger than 2 centimeters between the muscles is considered diastasis recti.¹

If needed, your healthcare provider may recommend imaging, such as a CT scan, to take a closer look at your abdominal wall and also check for a hernia.²

Why Your Core Might Feel Different Post-Pregnancy: Understanding Diastasis Recti | Hernia Info

When should I see a healthcare provider?

Contact your healthcare provider if you notice a persistent gap or bulge, have pain, or are concerned about changes in your abdomen. A provider can confirm the diagnosis and refer you to a physical therapist or pelvic floor specialist if warranted.¹

Why Your Core Might Feel Different Post-Pregnancy: Understanding Diastasis Recti | Hernia Info

How is diastasis recti treated?

Treatment for diastasis recti typically begins with physical therapy and exercises designed to strengthen the deep abdominal muscles and improve core stability. A physical therapist or pelvic floor specialist can create a structured plan that fits your needs and help you perform each movement safely.^1,2

Movements to avoid include crunches, sit-ups, and other exercises that cause the abdomen to bulge or dome, as this may worsen the separation.^1,2

If symptoms persist despite conservative treatment, your healthcare provider may refer you to a surgeon to determine whether surgery is an appropriate option. Surgery may be considered if the separation is significant or does not improve with physical therapy. If you also have a hernia, both may be addressed during the same surgery.²

Why Your Core Might Feel Different Post-Pregnancy: Understanding Diastasis Recti | Hernia Info

Can it heal on its own?

Unlike a hernia, it is possible for diastasis recti to improve or heal on its own. The separation may become smaller as your body recovers after childbirth. However, the amount of improvement can vary depending on factors such as the severity of the separation.¹ In some cases, symptoms may persist, and certain movements may worsen the separation over time.¹ If you continue to notice a bulge, weakness, or difficulty with everyday movement, speak with your healthcare provider. They can evaluate your symptoms and help determine whether additional treatment may be helpful.

Why Your Core Might Feel Different Post-Pregnancy: Understanding Diastasis Recti | Hernia Info

FAQs

You can do a simple self-check, but you won’t be able to confirm a diagnosis. Lie on your back with your knees bent and feet flat on the floor. Lift your shoulders slightly and use your fingers to feel for a gap between the abdominal muscles. If you notice a gap of 2 or more finger widths, contact your healthcare provider for an evaluation.¹

Yes. Although diastasis recti is most common during and after pregnancy, it can affect anyone. Men may develop diastasis recti due to chronic straining, heavy lifting, constipation, or significant weight changes.¹

Diastasis recti and hernias are different conditions, but they can be related. Both affect the abdominal wall, and an umbilical hernia can develop as a complication of diastasis recti.¹

Diastasis recti itself is not usually painful, but it may be associated with symptoms such as low back pain, weakness, or difficulty performing everyday activities.¹ If you are experiencing pain or other concerning symptoms, speak with your healthcare provider for further evaluation.

Yes. Certain movements that cause the abdominal wall to bulge outward may worsen the separation.¹ Early evaluation and treatment may help prevent symptoms from becoming more bothersome.

Why Your Core Might Feel Different Post-Pregnancy: Understanding Diastasis Recti | Hernia Info

Getting the care you need

Changes to your abdomen during and after pregnancy are common, and learning more about what may be causing them can help you know when to seek care. If your symptoms continue or you are unsure whether you have diastasis recti, a hernia, or both, talk with your healthcare provider. If you think a hernia may be part of the problem, Surgeon Finder can help you connect with a surgeon in your area.

Why Your Core Might Feel Different Post-Pregnancy: Understanding Diastasis Recti | Hernia Info

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References

This site is not intended as a substitute for professional medical care. Only your physician can diagnose and appropriately treat your symptoms. BD does not recommend the use of any particular physician or team of physicians. Please consult your healthcare provider for advice regarding who should be part of your hernia repair team.

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