Healing Your Core After Baby: The Science of Diastasis Recti and Pelvic Floor Recovery

'My core just isn't the same since having a baby.' This is one of the most common things I hear from postpartum women — and for good reason. Pregnancy fundamentally changes the anatomy and function of your core, and the rehab process requires patience, knowledge, and the right approach.

In this post, we'll unpack the science of postpartum core recovery, explain what diastasis recti and pelvic floor dysfunction actually are, and give you a clear framework for restoring function safely.

What Happens to Your Core During Pregnancy?

Your core is not just your 'abs' — it's an integrated pressure system made up of the diaphragm (top), transversus abdominis (front and sides), multifidus (back), and pelvic floor (bottom). During pregnancy, this system is progressively loaded and altered:

• The uterus grows upward and outward, stretching the linea alba (the connective tissue running down the middle of the abdomen)

• The pelvic floor bears increasing load from the growing baby

• Hormones like relaxin loosen connective tissue and ligaments

• Abdominal muscles are stretched and displaced laterally

By the third trimester, the linea alba is wider in virtually all pregnant women — this is a normal adaptation. The question is how well it recovers postpartum.

Understanding Diastasis Recti (DRAM)

Diastasis recti abdominis (DRAM) is defined as a separation of the rectus abdominis (the 'six-pack' muscle) at the linea alba. It affects the majority of women by the third trimester.

Crucially, the presence of a gap is less important than whether that gap can generate tension. A wider gap with good tension may function better than a smaller gap with none. This is why a hands-on assessment with a women's health physiotherapist is essential — not just a self-test.

Signs of DRAM: a visible ridge or 'dome' down the midline when sitting up, lower back pain, difficulty with load transfer, and a feeling of abdominal weakness or instability.

The Pelvic Floor: More Than Just Kegels

The pelvic floor is a group of muscles and connective tissue forming the base of the pelvis. Its functions include supporting the pelvic organs, controlling bladder and bowel, enabling sexual function, and working as part of your core's pressure management system.

Postpartum pelvic floor dysfunction can present as:

• Stress urinary incontinence (leaking with coughing, sneezing, or jumping)

• Pelvic organ prolapse (heaviness, bulging, or dragging sensation)

• Pelvic pain or pain with intercourse

• Urgency or frequency of urination

  
  

Contrary to popular belief, a hypertonic (too-tight) pelvic floor is just as problematic as a weak one — and Kegel exercises alone are not always the right solution. This is why individualised assessment matters.

A Phased Approach to Core Rehabilitation

Phase 1: Reconnection (Weeks 0–6)

Before loading the core, you need to re-establish the connection between your breath, diaphragm, and pelvic floor. Key exercises include:

• 360-degree breathing: inhale to expand the ribcage in all directions; exhale and gently draw up and in through the pelvic floor

• Diaphragmatic breathing in supine, seated, and standing positions

• Gentle pelvic floor contractions and releases (not just squeezing — the release is equally important)

Phase 2: Stability and Load (Weeks 6–16)

Once neuromuscular control is re-established, introduce:

• Dead bugs, bird dogs, and heel slides

• Modified planks (on knees) with breath synchronisation

• Glute bridges with pelvic floor engagement

• Gradual loading of the transversus abdominis

Phase 3: Functional and Dynamic Loading (4+ Months)

This phase reintroduces higher-load exercises including:

• Full planks and push-ups

• Squats, deadlifts, and carrying variations

• Progressive return to impact (if applicable) — guided by a physiotherapist

Red Flags to Watch For

Stop and seek professional assessment if you experience:

• Leaking urine during any exercise

• Pelvic heaviness or pressure after exercise

• Lower back or pelvic pain during or after exercise

• Visible doming or coning down the midline during movement

  
  

The Most Important Advice I Can Give You

Every postpartum body is different. The internet's generic core exercise programs are not designed for your specific anatomy, birth history, or presentation. A women's health physiotherapist assessment is the most valuable investment you can make in your postpartum recovery.

Core recovery is a process — not a program you complete in 6 weeks. Give your body the time it needs, and build from a foundation of function, not aesthetics.