Hernia During Pregnancy: What Do You Need To Know?

A hernia is a medical condition that develops when a portion of an internal organ pushes through an opening in a muscle and protrudes. Some hernias develop over time, while some are birth defects. The groin and abdomen are the two areas where hernias commonly occur. It’s not necessarily a problem right away if a hernia develops during pregnancy unless it starts to hurt. However, if left untreated, it could progress to a more serious condition and potentially cause life-threatening complications.

It is crucial to let your doctor know if you have a hernia and are attempting to get pregnant or are already pregnant in order to be checked for any issues and treated for any pain. If you have a hernia, you may want to get it repaired before you are pregnant so that you can focus on growing a healthy baby without the worry and stress a hernia can bring.

What causes a hernia to develop during pregnancy?

Hernias are caused by a muscular wall weakening or by a muscle that never fully grows together. People are more likely to be born with this weakness than to acquire it later in life. But some conditions and health issues might also contribute to the tissue weakening, which can result in a hernia. Women are more likely to develop hernias in pregnancy because abdominal muscles tend to stretch, thin, and weaken throughout pregnancy.

The following factors increase your risk of developing a hernia while pregnant, according to the Mayo Clinic:

  • Obesity or being overweight
  • Multiple pregnancies (twins, triplets, and more)
  • Previous abdominal surgery, including hernia repair
  • Older age
  • Family history of hernias
  • Lifting heavy objects
  • Chronic sneeze or cough
  • Chronic constipation or gastrointestinal tract issues

What are the signs and symptoms of a hernia during pregnancy?

Not all pregnant women with hernias experience symptoms. A hernia may go undetected until a doctor performs a routine physical examination or diagnostic imaging as part of your prenatal care.

However, a hernia frequently manifests in women as a lump or bulge that pops up when you lie down or apply pressure to a neighboring area. This protrusion could be visible, or it could just be something you can feel.

Pain from a hernia is usually dull but can be exacerbated by physical activity such as walking fast, sneezing, coughing, lifting heavy objects, exercise, or even laughing very hard.

As your pregnancy advances and your body weight increases, your symptoms may intensify.

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More FAQ’s about Hernia During Pregnancy

What types of hernias are most common during pregnancy?

We all know that a woman’s belly grows larger and larger throughout the course of her pregnancy, causing the abdominal wall to stretch. This can show weaknesses that lead to one of these types of hernias in pregnant women.

Umbilical Hernias
In most cases, umbilical hernias during pregnancy are neither serious nor a cause for panic. Your belly button is the exact location where an umbilical hernia occurs. Instead of intestines, internal abdominal adipose tissue (fat) most frequently protrudes through the front of the abdominal wall. Your “innie” navel becomes an “outie,” in essence. An umbilical hernia in pregnancy can lead to belly button pain. Although they are moderately uncomfortable, they rarely call for medical treatment.

Periumbilical or Epigastric Hernias
Similar to an umbilical hernia, this type of hernia develops near the navel rather than right at the belly button. They frequently occur after pregnancy and are typically brought on by weak abdominal tissues. Periumbilical hernias could cause more pronounced edema and could be rather large. If your doctor believes there is an increased risk of strangulation from the hernia, surgery can be required.

Inguinal Hernias
This is the least common type of hernia in women. Inguinal hernias develop lower in the groin area, where muscles and abdominal wall fibers might strain as a result of uterine pressure. Males typically experience a groin hernia more often than females.

Ventral Abdominal Wall Hernia
The risk of ventral hernia in pregnant women is low. However, compared to women who did not become pregnant after their hernia surgery, women who had hernia repair surgery prior to becoming pregnant had a nearly 56% higher risk of ventral hernia recurrence. To help lower the chance of recurrence, it is important to discuss your plans for having children following your repair with your hernia surgeon.

What options are available to treat a hernia during pregnancy?

According to a study written in the January 2018 issue of the journal Frontiers in Surgery, there is no clear consensus regarding the ideal timing to repair a hernia in a pregnant woman.

You and your doctor might decide to postpone surgery on your hernia until after you give birth if it is only a small hernia and is not causing any uncomfortable symptoms.

However, most medical professionals would advise having your hernia repaired while you are still pregnant if it is giving you any discomfort.

If you develop a strangulated hernia, the hernia becomes trapped, or some other complication arises, emergency surgery will be required.

The following methods may be available to treat or manage your hernia during pregnancy if there is no immediate danger:

Hernia Repair During Pregnancy
If you are experiencing symptoms or if your hernia is significant enough to run the risk of developing complications, your doctor may recommend surgically correcting it while you are still pregnant.

There are no specific guidelines as to which time in pregnancy is best to undergo elective repair to treat a hernia. Some medical professionals advise it in the first or second trimester, while others feel that the second trimester is the best for surgery. Laparoscopy is a minimally invasive treatment option.

Abdominal hernia recurrence during pregnancy is substantial if it is treated using only sutures and no steel mesh to support the area of weakened muscle.

However, utilizing mesh during the procedure can reduce your abdominal wall’s flexibility and cause pain, both throughout your current pregnancy and any subsequent pregnancies.

Laparoscopic ventral hernia repair is believed to be safe before and during pregnancy, without any significant impact on the pregnancy or delivery.

Hernia surgery during pregnancy is regarded as a safe procedure.

Hernia Repair During a C-Section
You might be able to have your hernia fixed concurrently with a Caesarean section (C-section) if your hernia is not extremely severe.

When an umbilical hernia repair takes place during a c-section, it doesn’t take any longer than a normal c-section. However, repairing an inguinal hernia during a c-section can make the surgery take quite a bit longer than it would normally.

Similar to elective hernia treatment during pregnancy, doing a hernia repair during a C-section with a simple surgical suture seems to carry a higher chance of hernia recurrence than utilizing surgical mesh.

Hernia Repair After Childbirth
If you have a mild hernia, you and your doctor may opt against having it fixed during a C-section for a number of reasons, including the possibility that you will become pregnant again.

Hernia repair may be performed separately as soon as five to eight weeks after giving birth, or it may be postponed for a year or more to give your body more time to recuperate from pregnancy.

Do hernias pose a danger to the baby?

Your baby is cozied up inside your uterus, so a small hole in your abdominal wall won’t directly harm her throughout pregnancy or labor. Even if you’re hurting, remember that your baby can’t feel it, and a minor hernia will not hinder fetal development.

However, if the hernia is making it difficult for the mother to eat, she should speak with her doctor about ways to ensure the right nutrition because the baby needs a lot of nutrients to grow.

Can you develop a hernia during childbirth?

A normal, healthy vaginal delivery is usually possible for most women with hernias. Your doctor will probably advise you to labor normally, even if you have a small hernia.

However, in some circumstances, such as if you’ve already undergone a cesarean section or have a hernia that is extremely large or low in your abdomen, your doctor could advise having a C-section to deliver your baby.

Rarely, a hernia can develop during or right after labor as opposed to throughout the course of pregnancy. This is due to the fact that pushing a baby out requires a lot of abdominal pressure, which can occasionally result in a hernia. If this happens, your doctor will evaluate the severity of the hernia and determine what treatment strategy would be most appropriate.

When should I be concerned about a hernia during pregnancy?

Make an appointment with your OB/GYN or visit your Emergency Room if you experience severe pain or any of the following changes in your body to ensure that your hernia hasn’t become strangulated (the blood supply to the trapped tissue is cut off) or obstructed your intestines:

  • Increase in the amount of hernia-related pain that does not go away with rest.
  • A painful hernia bulge that is protruding and unable to be pushed back in.
  • Vomiting and nausea concurrent with a sore, red, and tender-to-the-touch hernia bulge.

The Iskandar Complex Hernia Center offers complex hernia surgery and advanced abdominal procedures to treat hernias in pregnant women with unparalleled empathy and expertise, so you can enjoy your pregnancy and a dramatically improved quality of life. Dr. Iskandar has a listen-first approach to patient care and offers minimally invasive hernia repair procedures that provide optimal recovery for a healthy pregnancy. Dr. Iskandar is one of the leading experts on the treatment and prevention of complex hernias in the United States, and other surgeons often refer their more complicated cases to him. To schedule an appointment with Dr. Iskandar, visit the Iskandar Complex Hernia Center website or call their Dallas-Fort Worth area office today.

Posted on January 25, 2023

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Dr. Iskandar, MD, FACS is a board-certified general surgeon with fellowship training in minimally invasive surgery and bariatric surgery. He is an accredited Surgeons of Excellence in Hernia Surgery by the SRC. The Iskandar Complex Hernia Center is one of only two North Texas Hernia Centers deemed Centers of Excellence. As a globally respected complex hernia expert, he specializes in complex hernia repair and abdominal reconstruction. He is also an Associate Professor of Surgery at Texas A&M School of Medicine.