What Causes an Umbilical Hernia:

Dr. Gerard M. DiLea, obstetrician-gynecologist and author of The Anxious Parents’ Guide to Pregnancy, explains (BabyZone) that to some extent, everyone has an umbilical hernia! As a fetus develops, there’s a hole in the main supporting layer of the abdomen, allowing the blood vessels of the umbilical cord to go in and out. This small opening sometimes remains after birth. For some people the opening can become larger due to increased abdominal pressure (like a chronic cough or, in our case, pregnancy.) Part of the small intestine passes through this hole causing a hernia.

Symptoms of an Umbilical Hernia

Tenderness around your belly button, especially during coughing or after straining (lifting and carrying around your toddler, for example), may indicate that you have an umbilical hernia.  Sometimes you can feel or see a protrusion right near the belly button that you can actually push back in.

Will I Need Surgery?

In most cases, an umbilical hernia does not need surgery. But sometimes a complication called incarceration develops, where organ tissues or intestines are trapped, cutting off their blood supply. The hernia will be painful. When this happens, a hernia surgery is required to repair the damage. If you suspect that your hernia is causing strangulation, you should see your doctor immediately, because if not corrected, an incarcerated hernia is very dangerous. Look out for symptoms such as swelling, pain, or discoloration.

The surgery is usually done as an outpatient procedure, under general anesthesia, and is a low-risk operation.

feature photo from health.com

A hernia is simply a hole in the muscular layer of the abdominal wall, which causes intestinal or fatty tissue within the abdomen to stick out. This can cause pain and, occasionally, intestinal obstruction.

Hernias can occur as a result of any increase in abdominal pressure. While straining and lifting are most commonly associated with hernias, the pressure in your abdomen will undoubtedly increase from a growing fetus.

Hernias do not go away. Once a hernia has formed, it will remain until it has been repaired. However, not all hernias need to be repaired, particularly hernias that are not causing any symptoms. This is particularly true during pregnancy.

Most hernias diagnosed during pregnancy can be treated without surgery and if surgery is necessary in most cases it can be delayed until several months after the baby is born. In many cases, the hernia becomes less painful later in pregnancy due to the uterus blocking the hole in the muscles.

Surgeons should consider the risks of surgery in considering repair. During the first trimester, the likelihood of a miscarriage is increased with an elective operation. During the third trimester, the likelihood of pre-term labor is increased. Elective surgery should only be considered during the second trimester (months 4-6). However, the growing baby and uterus will place increased stretch and strain on the repair and could result in an early recurrence of the hernia. In general, when hernias return, they are larger than they were originally.

In general, hernias are repaired with a soft and pliable material called mesh. Mesh is sewn around the hernia to reinforce the defect in the musculature. While mesh is very strong and is designed to prevent hernias from returning, it will not stretch. If a mesh is placed during pregnancy, it may tear away from the muscles as a result of the growing uterus, resulting in a return of the hernia. This can cause significant discomfort during the remainder of pregnancy.

Minimally invasive surgical techniques can be used to repair most hernias. Three tiny incisions are made, and a small camera is placed inside of the abdomen. Patients undergoing a minimally invasive, or laparoscopic, hernia repair will have less postoperative discomfort and a quicker return to normal activities while avoiding the larger incision associated with a traditional open operation. The long-term outcomes following hernia repair are comparable between traditional open surgery and minimally invasive surgery.

Even with a hernia, a Cesarean section is not usually necessary. Almost all women can safely deliver a baby vaginally. Your obstetrician or midwife can help you throughout the delivery process to ensure that the hernia does not become a problem during delivery.

The development of a hernia during pregnancy is not uncommon. The joy of future motherhood need not be interrupted by the development of this new bulge. By working closely with your obstetrician and hernia surgeon, most hernias will not endanger your well being or your baby’s.