Managing an Umbilical Hernia While Pregnant

An umbilical hernia occurs when abdominal tissue or intestines push through a weakened area in the abdominal wall near the belly button. While umbilical hernias are not uncommon, the risk is increased during pregnancy due to the pressure exerted on the abdominal muscles by the growing uterus.

Managing an umbilical hernia during pregnancy requires a careful balance between monitoring symptoms, using supportive measures, and avoiding activities that worsen the condition. In most cases, hernias do not pose a serious risk, but severe cases may require medical attention.

Several factors contribute to the development or worsening of an umbilical hernia during pregnancy, including:

• Increased intra-abdominal pressure – As the uterus expands, it puts pressure on the abdominal wall, which may cause a hernia or worsen an existing one.

• Weakened abdominal muscles – Previous pregnancies, obesity, or diastasis recti (separation of abdominal muscles) can weaken the muscles around the umbilicus.

• Pre-existing hernia – A small, asymptomatic umbilical hernia may become more prominent or painful during pregnancy.

• Multiple pregnancies – Carrying twins or more increases abdominal pressure, raising the likelihood of hernia formation.

The symptoms of an umbilical hernia can vary in severity and may include:

• A bulge or lump near the belly button, which may become more noticeable when standing, coughing, or straining.

• Mild to moderate pain or discomfort, especially with physical activity or pressure on the abdomen.

• A sensation of fullness, pulling, or aching around the navel.

• In rare cases, severe pain, redness, or swelling, which could indicate a complication like strangulation (when the herniated tissue loses its blood supply).

A healthcare provider can diagnose an umbilical hernia through:

• Physical examination – The doctor may feel for a bulge around the umbilical area that becomes more prominent when the patient stands or coughs.

• Ultrasound or MRI – In cases where complications are suspected, imaging may be used to assess the severity of the hernia and whether any organs are involved.

Most umbilical hernias do not require surgery during pregnancy unless complications arise. Management focuses on symptom relief and preventing further strain on the abdominal muscles.

A maternity support belt or abdominal binder can help:

• Reduce discomfort by supporting the abdominal wall.

• Provide gentle compression to prevent the hernia from protruding excessively.

• Improve posture and relieve lower back pain, which is common during pregnancy.

It is important to use a support belt that is comfortable and does not apply excessive pressure. Consult a healthcare provider before using one.

Lifting heavy objects or engaging in activities that increase abdominal pressure can worsen the hernia. Pregnant individuals should:

• Avoid lifting heavy weights, including toddlers or grocery bags.

• Use proper body mechanics, such as bending at the knees instead of the waist.

• Avoid constipation, which can cause straining during bowel movements.

Constipation can exacerbate an umbilical hernia by increasing intra-abdominal pressure. To prevent constipation:

• Eat a fiber-rich diet, including fruits, vegetables, and whole grains.

• Stay hydrated by drinking plenty of water.

• Engage in light physical activity, such as walking, to promote digestion.

• Use pregnancy-safe stool softeners or fiber supplements if necessary (after consulting a doctor).

While strenuous abdominal exercises should be avoided, certain gentle movements may help support the abdominal muscles. Safe options include:

• Pelvic tilts – Strengthen the lower core without excessive strain.

• Cat-cow stretches – Promote flexibility and reduce abdominal discomfort.

• Modified prenatal yoga – Helps maintain core strength while avoiding pressure on the hernia.

A physiotherapist specializing in prenatal care can recommend specific exercises tailored to individual needs.

Sleeping on the side, especially with a pregnancy pillow, can reduce pressure on the abdominal area and minimize discomfort from the hernia.

Most umbilical hernias during pregnancy do not require surgical intervention unless complications arise. Surgery may be considered in the following situations:

• Incarceration – When the hernia becomes trapped and cannot be pushed back in, leading to pain and potential complications.

• Strangulation – If the blood supply to the herniated tissue is cut off, causing severe pain, redness, and potential tissue death. This is a medical emergency requiring immediate surgery.

• Severe, persistent pain – If the hernia causes ongoing pain that interferes with daily activities, surgical repair may be considered postpartum.

If surgery is needed, two main options are available:

1. Open hernia repair – The surgeon makes an incision near the umbilicus and repairs the hernia with sutures or mesh.

2. Laparoscopic surgery – A minimally invasive approach using small incisions and a camera to repair the hernia.

Most doctors recommend postponing elective hernia surgery until after delivery unless it becomes a medical emergency.

In many cases, an umbilical hernia may improve or become less symptomatic after childbirth. However, some individuals may still require surgery if:

• The hernia remains large or painful.

• The abdominal muscles do not fully recover postpartum.

• A future pregnancy is planned, and the hernia is at risk of worsening.

Elective hernia repair is typically performed after full postpartum recovery, often a few months after delivery.

Managing an umbilical hernia during pregnancy involves symptom relief, avoiding strain on the abdominal muscles, and monitoring for complications. In most cases, a support belt, lifestyle modifications, and careful movement can help alleviate discomfort. However, if severe pain or signs of complications occur, prompt medical evaluation is essential. Pregnant individuals should work closely with their healthcare provider to ensure a safe and healthy pregnancy while managing an umbilical hernia.