The changes the abdominal wall goes through in pregnancy and birth leave far more than cosmetic issues for women to deal with. Women should learn about these changes and how to manage them. By doing so, they will have the opportunity to make the best choices for their body in their pregnancy fitness and in their postpartum recovery.There are three groups of abdominal muscles—the transversus abdominis muscles make up the deepest layer, then the oblique muscles (internal and external), and finally the rectus abdominis muscles, which are the outermost abdominals (see figure 4.1). They all attach via an aponeurosis, a broad sheet of dense connective tissue, to the linea alba, which is the connective tissue that holds the two rectus muscles in place. All the abdominal muscles face increasing stretch and strain in both pregnancy and birth, but it is the rectus abdominis muscles moving away from the midline as the belly grows that many consider to be the most visible and lasting change.