Diastasis Rectus Abdominis: Time to Reconsider Our Approach. A Scoping Review

Background: Pregnancy-related diastasis rectus abdominis (DRA) is common and characterized by widening of the interrecti distance (IRD). Despite increasing research interest, uncertainty remains regarding diagnostic criteria, clinical relevance, and optimal management. This lack of consensus may contribute to inconsistent practice and over-pathologization of normal pregnancy-related adaptations. This review aimed to summarize evidence on assessment, diagnosis, clinical significance, prevention, and conservative management of DRA while highlighting biopsychosocial considerations and the influence of health messaging on women’s experiences. Methods: An exploratory scoping review was conducted using MEDLINE, Embase, PubMed, and PEDro databases. Peer-reviewed observational studies, randomized controlled trials, and review articles published in English were included. Evidence was synthesized descriptively within a biopsychosocial framework. Results: Evidence suggests that IRD widening during pregnancy represents a normal physiological adaptation, with substantial spontaneous recovery occurring postpartum. However, no consensus exists regarding diagnostic cutoff values, measurement methods, or anatomical locations for defining DRA. The clinical relevance of increased IRD remains debated, particularly for small to moderate separations. Evidence supporting exercise-based interventions to reduce IRD is inconsistent, although abdominal and pelvic floor exercise appears safe and may improve function and patient-reported outcomes. Emerging research highlights the importance of biopsychosocial factors, including body image, fear of movement, and the influence of social media and clinical messaging. Conclusions: Reframing DRA as a physiological adaptation during pregnancy may reduce unnecessary concern and support confident engagement in movement and exercise. Future research should prioritize consensus on diagnostic criteria, development and use of clinically meaningful outcomes, and understanding of persistent DRA to guide evidence-based, person-centered care.