Your Postpartum Body — Weight, Diastasis Recti, and Returning to Exercise

Diastasis recti abdominis (DRA) is the separation of the two sides of the rectus abdominis muscle (your "six-pack" muscle) along the midline connective tissue (linea alba). Some degree of separation is universal during pregnancy — it's how your body makes room for a growing baby. The question is whether it resolves afterward.

Prevalence is high: studies show that approximately 100% of women have some diastasis by the third trimester, about 60% still have it at 6 weeks postpartum, about 45% have it at 6 months, and about 33% have it at 12 months without intervention. Severity ranges from mild (1–2 finger-widths of separation) to significant (3+ finger-widths).

To check for DRA: lie on your back with knees bent. Place your fingers along the midline above your belly button. Lift your head and shoulders slightly off the floor. Feel for a gap between the muscle edges and how deep your fingers sink. A gap of more than 2 finger-widths or significant depth indicates DRA worth addressing.

Why it matters: DRA isn't just cosmetic. A weak linea alba provides less support for your spine and pelvis, which can contribute to lower back pain, pelvic floor dysfunction, poor posture, and a persistent "pregnant-looking" belly despite weight loss.

The good news: DRA responds well to targeted rehabilitation. A pelvic floor physical therapist can assess the width and depth of separation, prescribe specific exercises that reapproximate (bring together) the muscles, teach you which movements to modify or avoid, and monitor progress over weeks and months. Core rehabilitation exercises focus on deep core activation (transverse abdominis, pelvic floor) rather than traditional crunches or sit-ups, which can worsen DRA.

What to avoid initially: traditional crunches, sit-ups, full planks, and any exercise that causes your abdomen to "dome" or bulge along the midline. These increase intra-abdominal pressure against a weakened linea alba.

The "bounce back" culture is toxic and medically unfounded. Here's what the research actually shows about postpartum weight trajectory.

Immediate loss (first 2 weeks): most women lose 10–13 lbs at delivery (baby, placenta, amniotic fluid) and another 5–10 lbs in the first two weeks as the uterus shrinks and excess fluid is shed through sweating and urination. This is not fat loss — it's fluid and tissue.

First 6 months: the most active weight loss phase. Breastfeeding burns approximately 300–500 extra calories per day, which contributes to gradual weight loss for many women (though some women find that breastfeeding increases appetite enough to offset this, or that their bodies hold onto fat reserves to support milk production).

6 to 12 months: weight loss typically slows. At 12 months postpartum, studies show that the average woman retains 1–5 kg (2–11 lbs) above pre-pregnancy weight. This is an average — some women return to or drop below pre-pregnancy weight, while others retain more.

Factors that influence postpartum weight retention: gestational weight gain (women who gained more during pregnancy tend to retain more), pre-pregnancy BMI, breastfeeding duration and exclusivity, sleep quality (sleep deprivation increases hunger hormones and promotes fat storage), diet quality, physical activity level, stress, and genetic and metabolic individual variation.

What actually helps: focusing on nutrition quality rather than calorie counting (especially while breastfeeding), adequate protein to preserve muscle mass, gentle return to exercise (walking first, then progressive activity), sleep optimization (as much as possible with a baby), managing stress, and patience.

What doesn't help: crash dieting (especially while breastfeeding — it can reduce milk supply and deplete nutritional reserves), comparing yourself to celebrities or social media, weighing yourself daily (fluctuations are normal and discouraging), and setting arbitrary deadlines for your body to "go back."

Your body grew and birthed a human. It may not look the same, and that's not a failure.

The old "cleared at 6 weeks" model is being replaced by a more graduated, individualized approach. The Royal College of Obstetricians and Gynaecologists and other leading bodies now recommend a phased return.

Weeks 0–2: gentle walking (start with 5–10 minutes around the house), pelvic floor exercises (gentle Kegels if comfortable), deep breathing and diaphragmatic exercises, and gentle stretching.

Weeks 2–6: gradually increase walking duration and pace, begin gentle core activation exercises (no crunches or planks), continue pelvic floor work, and listen to your body — if bleeding increases after activity, you've done too much.

Weeks 6–12 (after provider clearance and ideally a pelvic floor assessment): return to low-impact aerobic exercise (swimming, cycling, elliptical), begin progressive strength training with light weights, start modified core rehabilitation exercises for DRA, and avoid high-impact activities until pelvic floor is assessed.

3–6 months: gradually return to running, jumping, and higher-impact activities (only if the pelvic floor can support it — a pelvic floor PT assessment before returning to running is strongly recommended by the Returning to Running Postnatal Guidelines), progressive strength training, and sport-specific training.

Signs you're progressing too quickly: increased lochia or return to red bleeding, pelvic heaviness or pressure, urinary leakage during exercise, pain at the incision or tear site, and abdominal doming (visible bulge along the midline during exertion).

Cesarean-specific considerations: avoid core-loading exercises for at least 8 weeks, protect the incision site (no pressure or friction), and start with scar mobilization at 6 weeks to prevent adhesions.

The most important message: the goal of postpartum exercise isn't to "get your body back" — it's to rebuild functional strength, protect your pelvic floor, support mental health, and create a sustainable movement practice for the years ahead.

Some postpartum body changes resolve with time; others are permanent. Being honest about this helps set realistic expectations and reduces the suffering that comes from waiting for something that isn't coming back.

Changes that typically resolve: most of the excess weight (though 1–5 kg retention at one year is average), postpartum hair loss (full regrowth by 12–18 months), skin hyperpigmentation (melasma and linea nigra fade but may not disappear completely), breast engorgement and initial postpartum breast changes, most of the joint laxity from relaxin, and much of the diastasis recti (with proper rehabilitation).

Changes that may be permanent: wider hips and ribcage (skeletal changes from relaxin and the physical demands of pregnancy), different breast shape and size (even after breastfeeding ends, breast tissue changes are often lasting), stretch marks (they fade to silvery-white but don't disappear), abdominal skin laxity (especially with significant stretching — skin elasticity has limits), foot size increase (half to full size larger is common and permanent), and some degree of pelvic floor change (even with rehabilitation, the pelvic floor has been through a significant event).

Changes that depend on intervention: diastasis recti (responds well to rehabilitation but may persist without it), pelvic floor dysfunction (highly treatable with PT but won't resolve on its own in many cases), weight retention (responsive to nutrition and exercise but individual results vary), and scar appearance (massage and treatment can improve scars significantly).

The body image conversation: postpartum body changes happen in a culture that celebrates "bounce-back" bodies and profits from maternal insecurity. The research on postpartum body image shows that the strongest predictor of body satisfaction isn't actual body composition — it's self-compassion and the ability to appreciate what your body has accomplished.

Your body is different because it did something extraordinary. That's not a problem to fix.

Breastfeeding creates a distinct hormonal environment that affects body composition, exercise, and recovery in ways that are important to understand.

Hormonal effects: breastfeeding maintains elevated prolactin levels, which suppress estrogen. This means vaginal dryness (relevant for comfort during exercise and daily life), continued joint laxity (relaxin remains higher during breastfeeding), lower bone density (calcium is mobilized from bones for milk production — this reverses after weaning), and suppressed menstrual cycling (which affects energy and recovery patterns).

Caloric demands: exclusive breastfeeding burns approximately 300–500 extra calories per day. This doesn't automatically cause weight loss — many women find their appetite increases proportionally. The recommendation is to eat to hunger rather than restricting calories, ensure adequate protein (at least 1.0 g/kg/day), and stay well-hydrated (aim for at least 3 liters of fluid daily).

Exercise and milk supply: moderate exercise does not reduce milk supply or affect milk quality. This is one of the most persistent myths in postpartum fitness, and it's been debunked by multiple studies. Vigorous exercise temporarily increases lactic acid in breast milk, but babies don't typically reject it. The practical considerations are more logistical: feed or pump before exercise for comfort, wear a supportive sports bra, and stay hydrated.

Bone density: breastfeeding draws calcium from maternal bones, temporarily reducing bone density by 3–5%. This is recoverable — bone density typically returns to pre-pregnancy levels within 6–12 months of weaning. However, it does mean that weight-bearing exercise during breastfeeding is particularly important for stimulating bone maintenance.

Weaning and body changes: when breastfeeding ends, the hormonal shift can cause breast size changes, mood fluctuations (the drop in prolactin and rise in estrogen can be significant), and changes in weight trajectory (some women lose weight after weaning as hormones normalize; others gain weight as the caloric demand disappears).

The bottom line: breastfeeding and exercise are fully compatible. The adjustments needed are practical (hydration, timing, support) rather than fundamental.

Postpartum body image challenges are nearly universal — research shows that 70–80% of new mothers report dissatisfaction with their postpartum body. This isn't vanity; it's a response to significant, rapid physical changes in a culture that assigns women's worth to their appearance.

What's normal: feeling strange in your own body, grieving your pre-pregnancy body, avoiding mirrors or photos, feeling pressure to "bounce back," comparing yourself unfavorably to other mothers, and not wanting your partner to see you. These feelings are common and usually improve over time.

What's concerning: if body dissatisfaction is leading to disordered eating (severe restriction, bingeing, purging), exercise compulsion (exercising through pain or prioritizing workouts over recovery), avoidance of social situations, significant depression or anxiety, or affecting your ability to bond with your baby — seek professional support.

Evidence-based strategies: practice self-compassion (research shows self-compassion is a stronger predictor of body satisfaction than actual body composition). Concretely, speak to yourself as you would to a friend. Curate your media — unfollow accounts that make you feel inadequate and follow those that normalize real postpartum bodies. Focus on function over appearance — celebrate what your body can do rather than how it looks. Move your body in ways that feel good, not punitive. Wear clothes that fit your current body rather than squeezing into pre-pregnancy clothes.

Involve your partner: if you have a partner, communicate your feelings. Many partners don't realize the depth of body image struggle and can provide meaningful reassurance and support when they understand.

Seek professional help if needed: a therapist specializing in perinatal mental health can address body image issues within the broader context of the postpartum transition. If body image concerns existed before pregnancy, they often intensify postpartum and deserve specialized attention.

The cultural shift: the "bounce back" narrative is slowly being replaced by a more honest conversation about postpartum bodies. You can be part of this shift by speaking honestly about your experience and rejecting the pressure to perform recovery.