Why do abdominal muscles sometimes separate during pregnancy?

Answers from Roger W. Harms, M.D.

During pregnancy, the growing uterus stretches the muscles in the abdomen. This can cause the two large parallel bands of muscles that meet in the middle of the abdomen to separate — a condition called diastasis recti or diastasis recti abdominis. Diastasis recti might cause a bulge in the middle of the abdomen where the two muscles separate. The condition might be noticeable only when the abdominal muscles are tense, such as during coughing.

Diastasis recti develops in late pregnancy, but is usually most noticeable right after delivery. The muscle separation often lessens in the months that follow. However, some degree of separation might remain up to a year after childbirth and beyond. Diastasis recti can weaken the abdominal muscles, causing lower back pain and making it difficult to lift objects or do other routine daily activities.

You might be more likely to develop diastasis recti as a result of pregnancy if you:

  • Are older than 35
  • Have a multiple pregnancy
  • Deliver a baby who has a high birth weight
  • Have repeated pregnancies

During pregnancy, aggressive abdominal exercises after the first trimester also might contribute to the development of diastasis recti.

If you think you have diastasis recti, consult your health care provider. After childbirth, certain exercises can help you regain abdominal strength. A physical therapist can help determine which exercises would be right for you.

If abdominal muscle weakness associated with diastasis recti is interfering with your daily activities, surgery might be recommended to repair the muscle separation. If you're bothered by the bulge in your abdomen, you might also consider surgery for cosmetic reasons.

Oct. 30, 2014