Up to two-thirds of women have some abdominal separation after pregnancy. Here's how to check, which exercises make it worse (sit-ups, crunches), and what the evidence says actually helps.
Diastasis recti — also called DRAM (diastasis of the rectus abdominis muscle) or abdominal separation — is when the two halves of the central 'six-pack' muscle separate along the midline. This is caused by the uterus pushing the muscles apart during pregnancy as the linea alba (the connective tissue between them) stretches and thins.
Research estimates it affects anywhere from 27% to 100% of women to some degree by the end of pregnancy — the wide range reflects different measurement criteria, but the consensus is that it is extremely common. It is not a complication. It is a normal consequence of pregnancy.
The characteristic sign: when you try to sit up from lying down, your abdomen 'domes' or 'cones' along the midline — a visible ridge or tent appears. This is the most distinctive indicator that a gap exists and is under load.
The finger-width test: lie on your back with knees bent and feet flat. Slowly lift just your head (not a crunch — just lifting your head). Using your fingertips, feel along the midline from just above your navel to just below it, pressing gently. Note how many fingers you can fit into any gap you find.
Interpreting what you find:
1–2 finger widths: within the normal range for postpartum women. Often resolves without specific intervention.
2–3 finger widths: moderate separation. Worth addressing with targeted exercise and ideally a women's health physiotherapist assessment.
3+ finger widths: significant separation — referral to a women's health physiotherapist is recommended.
Any visible doming during the test: means the linea alba is not adequately supporting load during that movement, regardless of finger width.
The most important single piece of information about diastasis recti recovery is this: standard abdominal exercises make it worse, not better.
Exercises to avoid until the gap has resolved or you have had a physiotherapy assessment:
• Crunches and sit-ups — the most commonly performed core exercise, and the most commonly harmful for diastasis. The forward flexion and intra-abdominal pressure loading directly stresses the midline.
• Leg raises — same mechanism as crunches.
• Planks and push-ups (early postpartum) — until the linea alba has sufficient tension to support this load.
• Heavy lifting with breath-holding — including picking up older children while bracing incorrectly.
This matters because women returning to exercise postpartum are commonly advised to 'do core work' without any awareness of diastasis — and mainstream postnatal exercise classes often include exactly the movements that cause harm. This is not theoretical: inappropriate loading of an unresolved diastasis can widen the gap and delay resolution by months.
The foundation of diastasis recovery is restoring tension in the linea alba before progressing to higher-load movements. This starts with breathing and deep abdominal activation.
The starting exercise: lie on your back, knees bent, feet flat. Breathe in. As you breathe out, gently draw your lower abdomen in towards your spine — like you're pulling your hip bones towards each other. Hold for 3–5 seconds while continuing to breathe. Relax fully. Repeat 8–10 times. This is activating the transversus abdominis (TA), the deep corset muscle that supports the linea alba.
From this foundation, a women's health physiotherapist can guide you through a progressive programme specific to the degree of separation and your functional needs. NICE and NHS guidance recommends physiotherapy referral for any diastasis causing functional difficulty. You can self-refer to NHS pelvic health physiotherapy in many regions — search 'pelvic health physiotherapy [your area].'
Most diastasis that is within 2–3 finger widths resolves or improves significantly with appropriate exercise and time. Most women are not given this information at their 6-week check. You may need to ask specifically.
For some women, a significant diastasis persists after 6–12 months of appropriate physiotherapy, particularly those with a gap above 3 finger widths or significant linea alba laxity. Symptoms may include: lower back pain, pelvic girdle pain, a persistent visible bulge along the midline, difficulty with functional loading (lifting, stairs, carrying).
Surgical repair (abdominoplasty) is available both privately and, in some cases, on the NHS if functional impairment is significant. This is a last resort after physiotherapy has been appropriately pursued. It requires a referral from your GP, usually after documented physiotherapy.
More practically: abdominal support garments (not tight binding, but structured postpartum support belts) can provide symptom relief during recovery. They are not a treatment — they don't close the gap — but they reduce the load on the linea alba during daily activity and can make the recovery period more manageable.