How to Handle an Umbilical Hernia in Pregnancy

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

Fortunately, when umbilical hernias do happen, 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 Is an Umbilical Hernia?

An umbilical hernia happens when an area of the abdominal muscles becomes weakened to the point that they allow the intestines or other bodily tissue or organs 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. They are estimated to occur in just under 1% of pregnancies.

Causes of an Umbilical Hernia in Pregnancy

In the second and third trimesters, the expanding uterus puts a lot of extra pressure on the abdomen. This pressure pushes the navel outward, causing many pregnant people to go from having "innies" to "outies." But if the pregnant 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.

Almost all pregnant people will experience some level of abdominal muscle separation during pregnancy to allow for their growing uterus, but not everyone will develop umbilical hernia. When that abdominal separation is wider than about 2 centimeters, it is called diastasis recti. Diastatis recti could make you more prone to developing a hernia during or even after pregnancy if the abdominal separation persists.

Symptoms of an Umbilical Hernia

Some pregnant people with umbilical hernia experience no signs. Others have symptoms that include the following:

• Bulge near the belly button
• Pressure near the belly button
• Belly button is tender to the touch
  
• Dull pain that becomes worse with exertion
• Nausea and constipation, 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 in Pregnancy

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 many cases, a medical provider may recommend a "wait and see" approach to get you through the rest of your pregnancy. If that's the case for you, you can take these steps to help prevent your hernia from getting worse in the meantime:

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

In other cases, the doctor may recommend surgery to repair the hernia, which can be performed with minimal risk to the pregnant person or baby. If you need surgery for an umbilical hernia but there's no imminent danger, you can also wait until you have delivered to repair the hernia. Surgeons can also surgically repair an umbilical hernia during a C-section.

Rarely, though, intestines or other abdominal tissue or organs can become trapped in the hernia, a condition known as incarceration. An incarcerated hernia is usually a medical emergency because it can damage your organs (especially the intestines) and cut off the 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.