Diastasis recti

By trimester

Weeks 1–13

1st trimester

In the early postpartum weeks, a wide gap is extremely common and often improves on its own as swelling goes down and the abdominal wall starts to recover. Gentle activation of the deep core muscles, rather than crunches, is the usual starting point.

Weeks 14–27

2nd trimester

By a few months postpartum, once you've had clearance to return to more activity, structured core rehabilitation, often with a pelvic floor physical therapist, becomes more useful if the gap hasn't closed much on its own.

Weeks 28–birth

3rd trimester

In later postpartum recovery, a gap that has persisted for six months or more may need a more individualized plan, and a portion of people continue to notice a separation long-term without it necessarily causing problems.

What does the evidence show for diastasis recti?

• Diastasis recti abdominis affects the large majority of women in the early postpartum period, with one study finding it present in 90% of non-exercising women shortly after birth; roughly 60% still have it after the initial six-week recovery window, and about 39% are still affected at six months. 1
• A gap wider than about 2 centimeters between the two sides of the abdominal muscle at the midline is generally considered the threshold for diastasis recti, though success is typically judged by symptom improvement rather than the exact measurement alone. 2
• Clinical palpation of the gap can be imprecise, since the thickness of subcutaneous fat and how relaxed the abdominal wall is at the moment of checking can both affect what a hand can feel, which is part of why some clinicians prefer ultrasound measurement for a precise number. 3
• Most sources recommend conservative management, meaning lifestyle changes, gradual return to activity, and physiotherapy, as the first approach for a bothersome separation, though research specifically on whether exercise programs close the gap itself has produced mixed and inconclusive results. 4
• A true abdominal wall hernia needs to be ruled out in anyone with diastasis recti symptoms, since an undiagnosed hernia carries its own risk of bowel obstruction or strangulation; a healthcare provider can usually make this distinction on a physical exam, sometimes with imaging if there's any question. 2

When should I call my provider about diastasis recti?

A visible bulge or doming along the midline that comes with real pain, especially pain that doesn't ease with rest, or a firm lump that can't be gently pushed back, can point to a true abdominal wall hernia rather than diastasis recti alone, and a missed hernia carries a real risk of bowel obstruction or strangulation. Sudden, severe abdominal pain, nausea and vomiting, or a bulge that becomes hard and tender are reasons to seek care the same day rather than waiting for a routine postpartum visit. Because a physical exam alone can't always tell diastasis recti and a hernia apart, ask your provider for a hands-on check, and imaging, if the picture isn't clear. None of these lists replace your own judgment: if this symptom worries you, that on its own is enough reason to check in with your healthcare provider.