Hernia During Pregnancy: Types, Causes and Treatments

Suffering from a hernia during pregnancy can not only be very worrying, but it can also cause complications during labor. Typically, hernias will be removed following the delivery, however, in certain cases, immediate treatment is necessary.

In this expert guide, you’ll learn everything you need to know about the causes of hernias in pregnancy and the risks that they could pose. You’ll also discover how you can best safeguard your own and your baby’s health while suffering from this condition.

What Are Hernias?

Hernias are essentially an anomaly in which one of the body’s internal organs starts to push outwards through a tear or hole in the body’s musculature. It’s fairly common to experience hernias in the groin, abdomen or lower torso.

Once they’re formed, hernias don’t disappear but many won’t require repair unless they’re causing problems. Pregnancy means that your growing uterus will exert pressure on the walls of your abdomen and this can result in hernias.

The good news is that your hernia may not affect your pregnancy, but if you allow it to go untreated for an extended period of time, complications could arise.

What Are the Different Types of Pregnancy-Related Hernias?

There are three primary types of hernia associated with pregnancy.

Umbilical Hernias

These are also known as navel hernias. Despite their name, they don’t have anything to do with the fetus, uterus or amniotic sac. Rather, the name is derived from the location of the hernia – in the spot where your umbilical cord was located. Since this part of the body has a natural opening, when your uterus stretches that opening by tear, opening further. Although an umbilical hernia in pregnancy may cause some pain in the area of your belly button, it should only be inconvenient and not excessively uncomfortable.

Inguinal Hernias

Unlike a navel hernia, an inguinal hernia will occur if muscular tissue around the area of the groin becomes ripped or torn. They’re especially common in pregnancy since the growing uterus will push down on your pelvic floor, further weakening your abdominal walls. Inguinal hernias look like a small expansion or bulge in your groin.

Paraumbilical Hernias

This type of hernia will occur either below or above your navel where your own umbilical cord was located. Usually, they’re caused by weak abdominal muscles and are mostly seen in women who are obese. They typically look very large and cause severe swelling so surgical intervention will be necessary since there’s a risk of hernia strangulation if it is allowed to go untreated.

Risk Factors of Hernias During Pregnancy

Although inguinal and femoral hernias are common across the entire population regardless of age or sex, umbilical hernias are more common in pregnancy due to the increased pressure from the growing uterus. While all pregnant women have a greater chance of developing a hernia, some have an even greater probability than others due to certain factors. These include:

• Being obese or overweight
• Having a multiple pregnancy with twins or triplets (or more)
• Previous surgery in the abdominal area
• Previous hernia repair surgery
• Older maternal age
• A family history of suffering from hernias
• Regular lifting of heavy objects
• Chronic constipation
• Chronic coughing or sneezing

Causes of Hernias During Pregnancy

A hernia can occur in individuals of all ages, but they’re especially likely to occur in someone who has been born with weaker muscles, highly active individuals or older people. There are some other factors that are linked with a muscular weakness that leads to hernias:

• Slow increase of pressure on the abdominal walls by the expanding uterus in pregnancy
• Lifting weights that are too heavy
• Increased abdominal fluid
• Gaining too much weight
• Continuous sneezing or coughing
• Too much exertion while passing stools or urinating

Symptoms and Signs of Hernias During Pregnancy

Not all pregnant women who develop a hernia experience symptoms. In fact, some women only discover they have one when their doctor carries out an imaging test or physical exam relating to their pregnancy care.

Others will notice symptoms such as a lump or bulge, which appears when they lie down or when they push down on an area nearby. This bulge may only be able to be felt or, sometimes, it may be seen too.

Hernias can cause a dull pain that becomes sharper whenever you exert yourself. If you bend over, walk quickly, cough, sneeze, laugh or lift a heavy object, you may experience a stabbing sensation. As your pregnancy advances and your weight increases, those symptoms will probably become increasingly intense.

If you notice any of the following signs or symptoms during your pregnancy, you could be suffering from a hernia. They include:

Protrusions or Bulges

Most commonly, the first sign of pregnancy hernias is a protrusion or bulge through the stomach area which is sore and doesn’t go away on its own. Putting on weight during pregnancy puts additional stress on your abdominal walls, which are already weak, increasing the tear size in your muscle.

Tenderness

if you’ve undergone an abdominal surgical procedure, you will have special tenderness in your stomach region, and this could potentially lead to hernias. In obese women, the chance of developing a hernia after surgery is higher since the scar tissues will stretch because of the additional pregnancy weight. Hernias often cause pain around the scar when running, lifting heavy items or coughing.

Difficulty Moving

if you suffer from a femoral hernia in your thigh area, you may become less mobile, particularly as you approach the third trimester. This type of hernia will look like a small bulge close to your groin and it can seriously impact your movement depending on its size. This hernia is considered to be the most dangerous type during pregnancy since it may block your femoral artery. In turn, this could slow or even stop the supply of blood to your intestinal organs and cause gangrene.

When lying down, pushing the hernia back into your body should be possible. If you can’t do this, try applying ice packs to the affected area as this can help.

Incarcerated and Strangulated Hernias

If you still can’t push the hernia back after trying this, this could be a sign that you have an incarcerated (trapped) hernia, which will require medical treatment quickly as it could become strangulated.

Strangulated hernia symptoms include:

• Vomiting and nausea
• A sudden pain which gets worse
• The bulge of the hernia may turn purple, red or dark in color
• You may struggle to pass gas or stools

If you are experiencing any of the above symptoms, you should immediately contact a doctor as you may require urgent treatment.

Complications of Hernias During Pregnancy

Several complications are linked with hernias and especially during pregnancy. In its early stages, a hernia may be barely noticeable, however, as you progress in your pregnancy it will start to grow larger slowly and any additional strain in the affected area could make it even larger.

Soreness and pain are common symptoms of hernias. Usually, that pain will be constant; however, it may occasionally occur in phases. Should the pain be unbearable, it’s important to speak to your doctor.

A hernia during pregnancy may alter your heartbeat’s rhythm, resulting in palpitations and racing. This could be dangerous so treatment is required. Also, the area around the hernia won’t receive any blood circulation, so your skin tone could change, becoming paler. If this happens, it is a critical situation, and emergency surgery may be necessary.

How Can My Hernia Be Treated in Pregnancy?

The first course of action in treating a hernia during pregnancy is to use support bands as these can stop your hernia from growing.

It’s also important to stop lifting any heavy items and to get plenty of rest.

In some cases, a mild hernia that appears during your pregnancy may require no treatment. Swelling around the belly button could be just fat which has been pushed in between your muscles and after delivery it may go away on its own.

The only way of fixing a more serious hernia, though, is to have surgery. This should usually be avoided until after your baby is born. Typically, you will be advised to wait for around 3 months at least after the birth so you have sufficient time to recuperate after the delivery.

The surgical procedure which is usually used for removing hernias is a laparoscopy during which small incisions are made and a camera introduced into the area so invasive surgery won’t be necessary. Generally, a hernia will be repaired with a mesh-like material that is stitched in place to strengthen the muscles in the area.

Following hernia surgery, you shouldn’t lift any items weighing more than 10lbs for a period of 6 weeks. Hernia repairs may reopen, or you could develop another hernia in the future as your muscles will remain weak afterwards, so taking care of yourself after your procedure is imperative.

Preventing Hernias From Developing

It isn’t easy to prevent a hernia from developing since it may occur for many reasons at any time. Fortunately, though, being pregnant won’t actually worsen your hernia. Taking care to support the hernia region well, particularly when sneezing, coughing or laughing, will reduce any soreness or pain. You may even be able to achieve this by applying your hand over your hernia whenever carrying out these activities.

There are some things you can also do to try to prevent hernias from developing during pregnancy:

• Wear loose clothing with good circulation, particularly around the legs and pelvis
• Wear clothing that gives gentle support to your growing abdomen
• Pull yourself up when lying or sitting by using support
• Don’t pick up anything heavy, including older children
• Try not to climb a lot of stairs
• Put up your feet whenever possible
• Do low-impact exercises like yoga, stretching and walking

Final Thoughts

Rest assured that in the majority of cases, a hernia isn’t dangerous in pregnancy. It is vital, though, to get it repaired after giving birth, particularly if you’re planning another baby.

If your hernia is quite small and no symptoms, your doctor will almost certainly choose to wait until after your baby is delivered before giving you treatment. If you’re having a C-section, it’s possible to fix a hernia at the same time.

In rare circumstances, though, hernia surgery during pregnancy may be recommended. If you are experiencing excess pain, or your hernia is causing damage to your other organs or intestines, immediate surgery may be necessary but since this can be a risky procedure which increases the chance of miscarriage or premature delivery, it’s likely that all steps will be taken to avoid this first.

If surgery is recommended, it will probably take place during your second trimester since your growing baby makes the repair procedure difficult once you reach your third trimester.

Hernias are fairly common and don’t have an ongoing impact. There’s also no need to worry as you approach your due date or during labor. All good midwives and obstetricians can handle pregnant women with hernias professionally and safely, so make sure that your healthcare team are aware of your condition so that they can be well-prepared for your delivery. It is very rare to need a C-section purely due to having a hernia, so if you want a vaginal birth, that shouldn’t be a problem for you.

Of course, you should always consult your doctor if you’re unsure, to make sure that this is the right course of action for your needs.