Common, but not normal
It has been months since the birth and the tummy is still there. It feels “looser”, sometimes swells by the evening, and when you sit up in bed a ridge appears down the middle. You may also have back pain or leakage. And from all sides you hear “just do some sit-ups”.
During pregnancy, the two sides of the rectus abdominis muscle move apart to make room for the baby. This is physiological and happens in almost all women by late pregnancy. In many, the gap narrows by itself over the following months; in others it remains, and we call it diastasis recti. More than the width of the gap, what matters is function: whether the abdominal wall can transfer load and support your trunk.
What may be at the root
- Stretched connective tissue. The linea alba, the tissue joining both sides of the muscle, may have become thin and less taut.
- Pressure management. Holding your breath, pushing your tummy out on effort or unsuitable abdominal exercises increase pressure on the midline.
- The pelvic floor. The abdomen and pelvic floor work as a team; when one does not respond, the other suffers.
- Breathing and posture. A stiff ribcage, flared ribs and a “tummy forward” posture keep the abdominal wall under strain.
- Caesarean scar and visceral mobility. Adhesions can change how the abdominal wall moves.
How we can help
In the consultation we assess the abdominal wall at rest and in movement, your breathing, posture and — with your consent — the pelvic floor, because they go together.
Pelvic physiotherapy works on deep abdominal activation coordinated with breathing and the pelvic floor, and on a gradual progression back to exercise and daily tasks, without fear of moving. Visceral osteopathy can complement this, especially where there is a caesarean scar or abdominal tension. Many women feel their tummy becomes firmer and more functional; where there is an associated hernia, your doctor will assess other options.
What you can do now
- Roll to your side to get up. To get out of bed, turn onto your side first and push up with your arms rather than sitting straight up.
- Breathe out on effort, letting your tummy gently draw in, without holding your breath.
- Put classic sit-ups on hold until you have been assessed — and watch whether your tummy domes along the middle during any exercise.
If this sounds like you, get in touch. Your body did something extraordinary; it deserves support as it recovers.