Diastasis Recti in Postpartum Women: Association with Delivery Method and Health-Related Quality of Life

Abstract

Diastasis Recti (DR), defined as the separation of the rectus abdominis muscles along the linea alba, is a common postpartum condition resulting from pregnancy-related musculoskeletal changes. Despite its high prevalence, the association between Mode of Delivery (MOD), DR severity, and postpartum Quality of Life (QoL) remains insufficiently explored. This cross-sectional study aimed to determine the frequency and characteristics of DR among postpartum women, compare its occurrence between normal vaginal delivery and Cesarean section (C-section), and evaluate associated QoL outcomes. A total of 344 primigravida postpartum women aged 20–40 years were recruited from PNS Shifa Hospital and Jinnah Postgraduate Medical Centre, Karachi. Participants were assessed at least six weeks postpartum and diagnosed with DR using the inch-tape method. Demographic and obstetric data were collected through a structured proforma, while health-related QoL was evaluated using the SF-36 questionnaire. Data were analyzed using SPSS version 23. Most participants were aged 26–30 years (46.8%), and 43.0% were overweight. DR was most commonly observed both above and below the umbilicus (68%). A highly significant association was found between MOD and DR location, with C-section participants demonstrating more extensive separation (p < 0.001). Body mass index showed a near-significant association with MOD (p = 0.054). Women who underwent C-sections reported significantly poorer QoL, including greater physical and emotional limitations, higher pain levels, and worse perceived health compared to the previous year. These findings suggest that C-section may be associated with more severe DR and reduced postpartum QoL, highlighting the importance of early screening and targeted physiotherapy interventions.