Prevalence of Pelvic Pain and Urinary Incontinence in Association With Diastasis Recti After C-Section

Background: Diastasis recti abdominis (DRA) is defined as a midline separation of the rectus abdominis muscles along the linea alba, commonly occurring during pregnancy and the postpartum period. It has been reported in 66–100% of women during the third trimester and persists in approximately 53% after childbirth. The condition is associated with altered core stability, pelvic floor dysfunction, and compromised quality of life. Identifying its relationship with pelvic pain and urinary incontinence in postpartum women is essential to guide rehabilitation and preventive strategies. Objective: To determine the association of pelvic pain and urinary incontinence with diastasis recti abdominis among postpartum women following cesarean section. Methods: A descriptive cross-sectional study was conducted on 100 postpartum women aged 20–35 years at Government General Hospital Faisalabad and District Head Quarters Hospital Faisalabad over four months. Participants were selected through simple random sampling, and written informed consent was obtained. Women with normal vaginal delivery, umbilical hernia, recurrent abdominal surgeries, post-menopausal status, or active pregnancy were excluded. Screening for DRA was performed using the finger-width method. The Pelvic Floor Distress Inventory Short Form-20 (PFDI-20) assessed pelvic pain, while the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) evaluated urinary incontinence. Data were analyzed using SPSS version 20, and chi-square test was applied to assess associations. Results: The mean age of participants was 28.24 ± 4.16 years (range 20–36). The PFDI-20 showed that 28% of women experienced heaviness in the lower abdomen, 22% pressure in the lower abdomen, and 23% reported pain or discomfort in the pelvic region. Urinary incontinence was present in 36% of participants, with 27% classified as moderate and 9% as severe based on ICIQ-UI scores. Pelvic floor distress was mild in 72%, moderate in 9%, and severe in 19%. Chi-square analysis revealed a significant association between urinary incontinence and DRA (p ≤ 0.05), whereas no significant association was found between pelvic pain and DRA (p ≥ 0.05). Conclusion: The study demonstrated a strong association between diastasis recti abdominis and urinary incontinence in postpartum women following cesarean delivery, while no significant link with pelvic pain was observed. These findings underscore the importance of early screening, preventive education, and postpartum rehabilitation to minimize pelvic floor complications and enhance quality of life.