Diastasis recti: the tummy gap after pregnancy

The two long muscles down the front of the tummy are joined in the middle by a band of connective tissue. As the baby grows, this band stretches and the muscles move apart. Almost every woman has some separation by the end of pregnancy.

After delivery, the gap gradually narrows for most women. In one large study, about six in ten women still had a gap at six weeks after birth, and about one in three at a year. A gap is not dangerous in itself, but it can come with a bulging tummy, back pain or a feeling that the core is weak.

Lie on your back with your knees bent and feet flat. Place your fingertips across the middle of your tummy, just above the belly button. Lift your head and shoulders slightly off the floor, and feel for a gap between the muscle edges. Check again below the belly button.

Note how many fingers fit in the gap and how deep your fingers sink. A gap of two finger widths or more is usually considered diastasis recti. How firm the tissue feels when you lift your head matters as much as the width: a gap that feels firm and tense is often less of a problem than a narrower one that feels soft and deep.

Also watch your tummy when you sit up from lying down. A ridge or tent shape down the middle, called doming or coning, is a sign the area is not yet coping with that load.

Gentle core exercises that start with breathing, the pelvic floor and the deep tummy muscle, then progress gradually to harder exercises as the tummy controls the load without doming.

Getting up from lying by rolling onto your side first, rather than sitting straight up, especially in the early weeks.

Paying attention to how you lift your baby, car seat and buckets, keeping the load close and breathing out as you lift.

Treating constipation, since repeated straining increases pressure on the tummy and pelvic floor.

Older advice said crunches and planks should be avoided forever. Current thinking is more balanced. Early after delivery, exercises that cause doming are best avoided. Later, the aim is to load the tummy muscles gradually while controlling doming, and many women return to crunches, planks and sport without problems.

Belly binding, a long tradition in many Indian families, can give comfort and a feeling of support in the first weeks. It does not replace exercise, and binding very tightly for long periods can increase pressure on the pelvic floor. If you use a binder, keep it comfortable and combine it with gentle exercise.

See a doctor if you have a lump near the belly button that is painful, hard, or cannot be pushed back, especially with vomiting. This can be a hernia that needs urgent attention. Surgery for diastasis recti itself is usually only considered for large gaps that still cause problems after a good rehabilitation programme.