Can You Get Diastasis Recti After a C-Section?

Had a C-section and still have ab separation? A physiotherapist explains how diastasis recti and C-section recovery overlap, and where to start.

Many people are surprised to learn this. "I had a C-section, so why do I still have a gap?" or "I thought the surgeon fixed my muscles." Let's clear it up.

What is diastasis recti, and why does it happen?

Diastasis recti abdominis (DRA) is a widening of the linea alba, the connective tissue running down the middle of your abdomen between the two sides of the rectus abdominis. As your baby grows, that tissue stretches to make room. That's a normal adaptation to pregnancy, not an injury.

It's also very common afterwards. In a Norwegian study that followed 300 first-time mothers, roughly 60% had some separation at 6 weeks postpartum, about 45% at 6 months and about a third at 12 months (Sperstad et al., British Journal of Sports Medicine, 2016). Most of those were in the mild range.

Does having a C-section cause diastasis recti?

Not directly. The separation develops during pregnancy, before the birth happens. Research comparing C-section and vaginal birth has found mixed results: some studies report slightly more DRA after caesarean, others find no meaningful difference. The honest summary is that pregnancy is the main driver, and birth method is at most a minor factor.

Does the surgeon stitch the abs back together during a C-section?

Usually not. In a typical caesarean, the surgeon cuts through the skin and fascia, then separates the rectus muscles along the midline to reach the uterus. The muscles themselves usually aren't cut. Surgeons close the fascia, but closing the incision isn't the same as repairing a pregnancy-related diastasis. So it's completely possible to have both a healing C-section scar and a gap.

How is diastasis recovery different after a C-section?

The goals are the same. What changes is the starting point:

• More layers are healing. Skin, fat, fascia and the tissue around the uterus all need time. Early on, the focus is protecting the incision and getting comfortable moving.
• Sensation can be reduced. Numbness or a "shelf" around the scar is common (see C-section scar numbness and shelf), and it can make the lower abdomen harder to feel and activate.
• Bracing and guarding. It's natural to hold your belly protectively after surgery. Over time that can turn into shallow breathing and a deep core that doesn't switch on and off easily.
• Lifting starts sooner than you'd like. You're recovering from major surgery while lifting a baby, a car seat and laundry.

None of this means healing is worse. It just means patience matters more in the first weeks.

How can I tell if I have diastasis recti after a C-section?

A gentle self-check (lying on your back, knees bent, lifting your head slightly and feeling along the midline) can give you a rough idea. Our step-by-step guide is here: how to check for diastasis recti at home. Wait until your incision has healed and you feel comfortable, and avoid pressing on or near the scar.

The width of the gap is only part of the picture. How the tissue feels under tension, whether you see "doming" or "coning" when you move, and whether you have symptoms like back pain or leaking all matter. A pelvic-health physiotherapist can assess this properly.

Where should I start rebuilding my core after a C-section?

These are general first steps many people find helpful. Follow your surgical team's guidance on timelines, and stop anything that causes pain, pulling at the scar or doming.

1. Breathe 360°. Let your ribs widen sideways and back as you inhale, and soften as you exhale. This re-coordinates your diaphragm, deep core and pelvic floor. More in diaphragmatic breathing postpartum.
2. Find your transverse abdominis. On an exhale, gently draw your lower belly in toward your spine, as if zipping up snug jeans, without holding your breath. Release fully on the inhale.
3. Exhale on effort. Breathe out as you stand up, lift the baby or get out of bed. That helps manage the pressure inside your abdomen.
4. Log-roll out of bed. Roll onto your side and push up with your arms instead of sitting straight up. It's kinder to both your incision and your midline.
5. Scar care once healed. When cleared by your provider, gentle scar desensitisation and mobility can help sensation return (see the scar post above).
6. Progress gradually. Heel slides, bent-knee fallouts and glute bridges, then side-lying and kneeling work, then more load. Coordination comes before intensity.
7. Hold off on high-pressure moves at first. Full crunches, sit-ups and long planks are best added later, once you can control them without doming. See postpartum core exercises to avoid (at first).

When should I get help?

Please see a healthcare provider promptly for redness, warmth, discharge or opening of the incision, fever, or worsening pain. A pelvic-health physiotherapist in your area is worth seeing if you notice a bulge or doming that isn't improving, a soft spot you can push your fingers deep into, back pain, leaking, pelvic heaviness, or you simply feel stuck. And if you're months or years out, it isn't too late. Read is it too late to fix diastasis recti?

Bottom line

A C-section doesn't protect you from diastasis recti, and it doesn't automatically repair it either. Ab separation comes from pregnancy itself, and rebuilding after a caesarean follows the same principles, with a gentler start while your incision heals. Cleared isn't the same as recovered, and you don't have to figure the rebuild out alone.

Frequently asked questions

References: Sperstad JB, Tennfjord MK, Hilde G, Ellström-Engh M, Bø K. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. Br J Sports Med. 2016;50(17):1092–1096.

This article is general education from a physiotherapist's perspective. It is not individualized physiotherapy advice, does not create a therapist-patient relationship, and is not a substitute for care from a licensed healthcare provider in your area. Harleen Kalra is a physiotherapist registered in British Columbia, Canada. For personalized assessment and treatment, please see a licensed pelvic-health provider where you live.