Objective:

To investigate the impact of delivery mode on diastasis recti abdominis (DRA), pelvic floor muscle strength, sleep quality, and overall quality of life at 6–8 weeks postpartum.

Approach:

• Study Design: A cross-sectional study involving 196 primiparous postpartum women, with 100 vaginal deliveries and 96 caesarean sections.
• Assessment Methods: DRA severity was assessed by measuring inter-recti distance using clinical palpation and high-frequency ultrasound. Pelvic floor muscle strength was evaluated using a perineometer. Sleep quality and quality of life were assessed using the Pittsburgh Sleep Qual…

Key Findings:

• Women who underwent caesarean section exhibited a higher prevalence of DRA (p = 0.019) and wider inter-recti distance at the umbilicus and supra-umbilical levels compared to the vaginal delivery group with differences reaching statistical significance (all p < 0.010).
• The vaginal delivery group demonstrated significantly weaker fast-twitch pelvic floor muscle fibres (p = 0.036).
• Furthermore, the caesarean section group reported significantly lower scores in the physical (p = 0.017) and psychological (p = 0.003) domains of quality of life.
• Multiple linear regression identified poor sleep quality and caesarean section, rather than the severity of DRA, as strong independent factors of reduced quality of life.

Interpretation:

Delivery mode is associated with distinct postpartum recovery trajectories, with caesarean section linked to more severe DRA and poorer early postpartum quality of life, while vaginal delivery is associated with weaker fast-twitch pelvic floor muscles.

Limitations:

• The study is limited to a specific population of primiparous women aged 20–45 years, which may affect the generalizability of the findings.
• The cross-sectional design limits the ability to establish causality between delivery mode and postpartum outcomes.

Conclusion:

The findings suggest the need for delivery-mode-tailored, multidisciplinary postpartum rehabilitation with sleep support as an integral component of care.