How to Handle an Umbilical Hernia in Pregnancy

Nearly all pregnant people get an "outie" navel during pregnancy, thanks to increased pressure pushing outwards from an expanding uterus, but in some situations, that pressure becomes so great that it can actually weaken the abdominal muscles, causing an umbilical hernia.

An umbilical hernia occurs when an area of the abdominal muscles becomes weakened to the point that they allow the intestines to bulge through. Umbilical hernias can occur in newborns, children, and adults. In adults, umbilical hernias are closely associated with pregnancy, which can cause a new umbilical hernia or aggravate a pre-existing one.

With pregnancy especially, the abdominal muscles are already stretched and experiencing a lot of pressure, so it's easy to imagine how an umbilical hernia could happen. However, thanks to the body's design, umbilical hernias are still pretty rare in pregnant people, estimated to occur in less than 1% of pregnancies.

Fortunately, when umbilical hernias do happen during pregnancy, they rarely cause problems or require surgery. Read on for more information on what pregnant people need to know about the causes, symptoms, and treatment of umbilical hernias in pregnancy.

What Causes an Umbilical Hernia in Pregnancy?

In the second and third trimesters, the expanding uterus puts pressure on the abdomen. This pressure pushes the belly button outward, causing many pregnant people to go from having "innies" to "outies." But if the belly button protrudes extensively or is unusually sore and tender, it might indicate that it's not just a baby behind your new navel: It could also be a sign of an umbilical hernia.

A "bulge" around the belly button or a belly button that is very tender to the touch are two signs of an umbilical hernia during pregnancy. Not all pregnant people will even notice symptoms, so the hernia could be hard to spot.

Further complicating matters is the fact that almost all pregnant people will experience some level of abdominal muscle separation during pregnancy to allow for their growing uterus. When that separation is wider than about 2 centimeters, it is considered diastasis recti. Diastatis recti could make you more prone to developing a hernia during or even after pregnancy if the ab separation persists.

Umbilical Hernia Symptoms in Pregnancy

Some pregnant people experience no signs of umbilical hernia. But others have symptoms that include:

• A bulge near the belly button
• Pressure near the belly button
• Dull pain that becomes worse with exertion
• Constipation and nausea, especially with severe hernias

The bulge from an umbilical hernia can range in size from a grape to a grapefruit. It usually goes away when the person lies down and swells up when they sit, cough, or use the bathroom. Some people can see this lump while others can't.

Umbilical hernias may be diagnosed during a prenatal visit or you may need to see a specialist. If you're having any symptoms of an umbilical hernia, talk to a health care provider as a first step.

What to Do For an Umbilical Hernia During Pregnancy

The treatment for an umbilical hernia during pregnancy depends on how severe the hernia is and if it's causing any danger to you or your baby. In some cases, a health care provider may recommend a "wait and see" approach to get you through the rest of your pregnancy.

In others, the doctor may recommend surgery to repair the hernia, which can be performed with minimal risk to the pregnant person or baby, even during pregnancy. If you need surgery but there's no imminent danger, you can also wait until you have delivered to repair the hernia.

Rarely, though, intestines can become trapped in the hernia, which is called incarceration, or potentially strangulated. Incarceration is usually a medical emergency because it can damage your organs (especially the intestines) and cut off their blood supply. If you notice the area around your belly button turning a dark color or experience a sudden increase in pain, vomiting, or fever, seek medical attention.

If this happens to you (and remember, this is pretty rare!), it can be fixed during pregnancy with a surgical procedure. Surgeons can also surgically repair an umbilical hernia during a C-section.

In the meantime, you can take these steps to help prevent your hernia from getting worse:

• Avoid constipation by staying hydrated and eating high-fiber foods. Constipation creates strain during bowel movements, which could make hernias worse. You may also want to talk to a health care provider about a stool softener, as pregnancy itself can cause constipation.
• Don't lift anything heavy; the added pressure might expand your hernia.
• Prevent irritation by wearing loose clothing that doesn't put extra pressure on the hernia.