Abdominal separation occurs during pregnancy when the linea alba (a long ligament which runs from your pubic bone to your sternum) splits to allow a growing baby to fit inside the abdominal cavity. Diagnosis of abdominal separation is made when the gap between the abdominal is over 2cm (about 3 fingers wide).

Who is at risk?

We don’t really know why some women develop a larger separation than others. Interestingly the evidence that we do have doesn’t indicate the size of the separation has anything to do with the size of the baby, the size of the mother abdomen, height or age[1]. One study reports 33% of women have a separation by the time they are 21 weeks pregnant, 60% at 6 weeks after the birth, 45% 6 months after the birth and 33% at one year after the birth1.

 Abdominal separation will get better naturally, won’t it?

Abdominal separation decreases naturally straight after birth up until your baby is about 2 months old[2]. After this time if the abdominals are still separated they require specific exercises to bring back together. So it is important to address abdominal separation as soon as you can.

The abdominals are very important for trunk control and when they are separated your ability to activate and coordinate your abdominals can be compromised. It is important to to have good mechanics around your abdominals to lift, hold and run after your new baby. The last thing you need as a new mother is to have back and pelvic pain. Improving your abdominal strength and co-ordination is also important for returning to your pre-baby flat tummy.

How do I know if I have an abdominal separation?

A physiotherapist who treats post-partum women can assess the depth and width of your abdominal separation. You can try and measure the width of the separation by yourself by lying on back with your knees bent. Place your hand just above your belly button. Lift your head and shoulders off the ground and feel for a soft gap between the abdominals. The number of fingers you can fit between the gap will give you an indication of the size of the separation.

What should I do if I do have an abdominal separation?

It is important to start doing specific abdominal exercises to bring the muscles back together. The same abdominal exercise program does not work for everyone. In some cases certain abdominal exercises can worsen your gap. It is important to not see any doming of your tummy when performing exercises. There is evidence to support abdominal crunches as a way of bring the abdominals back together[3]. You can try this exercise by yourself

  1. Lie flat on your back with your knees bent
  2. Activate your pelvic floor muscles (the sensation when you are trying to stop a wee or pass wind)
  3. Lift your head and shoulders up off the bed as you activate your pelvic floor
  4. Hold this crunch position for 3 seconds and repeat 10-20 reps per day

NOTE: If you see your abdominals doming – stop this exercise and consult a physiotherapist!

Emily Standen – Physiotherapist