Healing Diastasis Recti After Cesarean Birth
If you’re a mom, chances are you’ve heard the term diastasis recti (DR) tossed around. Maybe your OB-GYN mentioned it during a postpartum check-up, or perhaps you noticed that your belly didn’t quite look or feel the same after having your baby. For moms who had a cesarean, dealing with diastasis recti can feel even more overwhelming. Not only has your core been stretched during pregnancy, but it was also surgically cut through during delivery. That’s a double whammy for your abdominal muscles and your recovery process.
In this post, we’ll explore diastasis recti, its effects on cesarean moms, and, most importantly, how you can start healing your core. This isn’t about quick fixes or bouncing back; it’s about rebuilding strength from the inside out so that you can feel confident and strong again.
What is Diastasis Recti?
Diastasis recti occurs when the connective tissue (the linea alba) between the two sides of your rectus abdominis (your "six-pack" muscles) stretches and thins out, causing a separation. During pregnancy, this happens naturally as your belly expands to make room for your growing baby. While some degree of separation is normal during pregnancy, diastasis recti becomes a concern when the gap remains wide postpartum and doesn’t close properly.
Signs and Symptoms of Diastasis Recti
You might have diastasis recti if:
You notice a visible bulge or doming along the midline of your abdomen when you sit up or strain.
Your belly still looks pregnant months after delivery.
You experience lower back pain, pelvic instability, or poor posture.
You feel weakness in your core and struggle with activities that require abdominal strength.
Why Cesarean Moms Have a Unique Challenge
For moms who delivered via cesarean, diastasis recti can pose an even greater challenge. Here’s why:
Core Muscles Were Already Stretched: During pregnancy, your abdominal muscles are stretched to their limit. This stretching weakens the core, making it harder for the muscles to contract and close the gap postpartum.
Surgical Trauma: A cesarean involves cutting through multiple layers of tissue, including your abdominal muscles. This further weakens the core and disrupts the normal healing process, making it harder for the muscles to realign naturally.
Scar Tissue Formation: Scar tissue forms at the incision site after a cesarean. This scar tissue can restrict movement, limit muscle activation, and create imbalances in the core.
Delayed Recovery: Since cesarean recovery involves managing both the surgery and postpartum changes, many moms delay core exercises or avoid them altogether due to fear of hurting themselves.
How to Check for Diastasis Recti
Before starting any healing exercises, checking whether you have diastasis recti and how severe it is is important.
Steps to Check for DR:
Lie on Your Back: Bend your knees, place your feet flat on the floor, and relax your head and shoulders.
Lift Your Head and Shoulders Slightly: Place your fingers just above your belly button and lift your head slightly as if doing a small crunch.
Feel for a Gap: Gently press your fingers into the midline of your abdomen. If you feel a gap between the two sides of your abdominal muscles, that’s diastasis recti.
Measure the Gap: Note how many fingers fit into the gap and where it’s widest (above, at, or below the belly button). A gap of more than two fingers is generally considered DR.
Healing Diastasis Recti: A Step-by-Step Approach for Cesarean Moms
Healing diastasis recti is about retraining your core muscles to work together again. The goal isn’t just closing the gap but improving core function, stability, and strength. Here’s a step-by-step approach tailored for cesarean moms:
1. Reconnect with Your Core Through Breathwork
After a cesarean, your core may feel disconnected. Diaphragmatic breathing helps re-engage your deep core muscles, including the transverse abdominis (the muscle that acts like a corset around your midsection).
How to Do It:
Sit or lie down in a comfortable position.
Place one hand on your chest and the other on your belly.
Inhale deeply through your nose, allowing your belly to expand while keeping your chest still.
Exhale slowly through your mouth, gently drawing your belly button toward your spine.
Repeat for 5-10 minutes daily.
2. Start with Gentle Core Engagement Exercises
Once you’ve mastered diaphragmatic breathing, move on to gentle exercises targeting the deep core without straining the midline.
Exercises to Try:
Heel Slides: Lie on your back with your knees bent. Slowly slide one heel away from your body while maintaining core engagement. Return to the starting position and switch sides.
Marching: Lie on your back and lift one leg at a time to a tabletop position, keeping your core engaged.
Pelvic Tilts: Lie on your back with your knees bent. Gently tilt your pelvis upward, pressing your lower back into the floor.
3. Incorporate Pelvic Floor Exercises
Your pelvic floor works closely with your core. Strengthening it can improve core stability and help with postpartum issues like incontinence.
How to Do It:
Contract your pelvic floor as if you’re stopping the flow of urine.
Hold for a few seconds, then release.
Repeat 10-15 times, gradually increasing the hold time.
4. Address Scar Tissue
Scar tissue from your cesarean can restrict movement and core activation. Gentle scar massage can help break up adhesions and improve mobility.
How to Do It:
Once your incision has fully healed (usually after 6-8 weeks), gently massage the scar using small circular motions.
Gradually increase pressure as tolerated, focusing on tight or restricted areas.
Perform scar massage for 5-10 minutes a day.
5. Progress to Functional Movements
As your core strengthens, start incorporating functional movements that mimic daily activities. This will help you build strength and stability in real-life situations.
Exercises to Try:
Squats: Keep your core engaged and back straight as you lower into a squat.
Dead Bug: Lie on your back with arms and legs in the air. Slowly lower the opposite arm and leg toward the floor while maintaining core engagement.
Bridges: Lie on your back with your knees bent. Lift your hips while squeezing your glutes and keeping your core engaged.
What to Avoid When You Have Diastasis Recti
Certain movements can worsen diastasis recti by increasing intra-abdominal pressure or straining the midline.
Until You Complete Core Rehab Avoid:
Crunches, sit-ups, and oblique twists.
Planks and push-ups (until your core is strong enough).
Heavy lifting without proper core engagement.
Any movement that causes doming or bulging of your abdomen.
When to Seek Professional Help
If you’re unsure about your progress or if your diastasis recti isn’t improving despite consistent effort, consider seeking help from a:
Pelvic floor physical therapist
Postpartum fitness specialist
They can assess your core function, provide personalized exercises, and ensure you’re healing safely.
Final Thoughts
Healing diastasis recti after a cesarean is possible, but it takes time, patience, and the right approach. Remember, your core went through a lot during pregnancy and surgery, so give yourself grace as you rebuild your strength.
By starting with gentle breathwork, core engagement exercises, and scar tissue care, you can gradually restore function and stability to your core. As you progress, focus on consistency and proper form rather than rushing the process.
Ready to start your healing journey? Join my newsletter to download my Free Cesarean Rehab Guide with foundational exercises, scar massage techniques, and lifestyle tips for better core strength today. This guide will help you take control of your recovery and rebuild your strength with confidence.
