Manage abdominal separation after pregnancy

An anatomical drawing showing rectus abdominis, transversus abdominis and oblique muscles at the front of the abdomen

During pregnancy your body releases the hormones to soften your ligaments and abdominal muscles to allow for your growing baby. There is always a small gap between abdominal muscles, but this becomes larger during pregnancy.

An abdominal separation is the widening of the normal 1-2 finger gap between the two sides of the rectus abdominis muscle at the front of the abdomen. It is also known as rectus abdominis diastasis, or RAD.

The majority of women will have an abdominal separation during the third trimester and the early postnatal period.

The following information explains more about abdominal separation, how to check for and measure it after pregnancy, and tips to help you manage and recover.

The following exercises are designed to strengthen and tone the muscles that have been stretched by pregnancy and childbirth.

You can start these exercises in the first few days after giving birth. If you had a caesarean, wait until 6 days before starting. These exercises can be seen on the FSH intranet on your bedside TV.

 Woman lying on her back with her knees bent

 

      Pelvic tilts
  1. Rest on your back, with your knees bent and slightly apart.
  2. Breathe out as you squeeze and lift your pelvic floor and tuck in your lower stomach.
  3. Breathe out as you tilt (rock) your pubic bone toward your face, then slowly relax.
  4. Repeat 5 to 10 times.

A woman lies on her back with her arms by her sides and her knees bent. One knee is dropped to the side.

 

  

Bent knee drops

  1. Breathe out and gently tuck in your lower stomach muscles.
  2. Slowly roll one knee slightly to the side.
  3. Keeping your stomach firm and pelvis still, bring your knees back to the centre.
  4. Repeat 5 times, breathing regularly.
  5. Rest for 10 seconds, change sides and repeat.

 

Woman lying on her back with a straight leg on her heel on the bed

 

  

Heel slides

  1. Tuck in you lower stomach muscles.
  2. Do not hold your breath.
  3. Start with both legs straight
  4. Keeping stomach tucked in and back flat Slowly slide heel along the bed so your hip and knee are bent.
  5. Then bring your heel back to starting position (legs straight).

Woman lying on her side with her knees open and heels together

 

 Clams
  1. Lie on your side with your hips and shoulders in line.
  2. Tuck in your stomach and draw in your pelvic floor.
  3. Without moving your hips, push your heels together and lift your top knee slightly.
  4. Slowly relax your knee down.
  5. Continue breathing throughout.

Woman lying on her back with her hips lifted in the air

 

   Bridging
  1. Relax your breathing.
  2. Tighten buttocks and draw in your pelvic floor.
  3. Gently lift your bottom until shoulders, hips and knees are in line.
  4. Come down gradually so your spine peels back onto the bed from the top of your spine to the bottom of your spine.
 

Woman on her hands and knees with her right arm pointing forward

 

    Arm/leg lift
  1. Resting on all fours, tuck in your lower stomach muscles and pelvic floor muscles.
  2. Keeping your body still, gently lift one arm and then lower it down, relaxing your pelvic floor. Keep your body still, only moving your arm or leg. 
  3. Repeat each arm and leg 10 times.

A woman stands leaning over with her hands on a bench 

Woman on her hands and knees with her right arm pointing forward

 

    Neutral spine
  1. Standing leaning forward with your head on a bench, or on all fours, position your spine in a neutral position (flat spine).
  2. Draw in your pelvic floor.
  3. Tuck in your lower stomach.
  4. Hold this position for 3 breaths.

 

 A woman moves to a standing position from a bed with her hands placed on her thighs.

 

    Roll onto your side 
  1. Rest on your back with your knees bent.
  2. Breathe out and tuck in your lower stomach muscles.
  3. Keep holding your muscles in as you roll onto your side.
  4. Push up using your elbow and hand.
  5. Use your legs to grip the bed.

A woman moves to a standing position from a bed with her hands on her thighs.

  

Standing up

  1. Feet should be shoulder width apart.
  2. Tuck in your lower tummy and draw in your pelvic floor.
  3. Lean forward and bring your nose over toes.
  4. Roll your body weight forward.
  5. Let your momentum carry you up into a standing position.

Reverse this routine to get back into bed.

A woman lies on her back with the fingers of one hand at her belly button and rests her other on the thigh of the same leg.If you have had a caesarean birth, please wait 1 week before measuring.

  1. Lay on your back, with your knees bent and slightly apart, and relax your head onto the bed.
  2. Place the fingers of one hand at your belly button and rest the other on the thigh of the same leg
  3. Move the hand resting on your thigh up your leg as you bring your head off the bed (see photo).
  4. Let the fingers at your belly button feel how far apart the muscles have separated at your abdomen. You should feel two ridges of muscle under your fingers when your abdominal muscles contract.

If the gap is more than 5 fingers width, please contact the physiotherapist on 6152 9486 or email fsfhgphysiotherapygenderhealth@health.wa.gov.au

Early exercise for abdominal separation

Advanced exercises for abdominal separation

Do not perform these without clearance from a medical professional or your physiotherapist. Monitor for symptoms of pelvic floor issues.

More information

Find out more about physiotherapy after pregnancy, caring for you after birth, or return to the Maternity page.

 

Last Updated: 07/03/2024