Hernias and Pregnancy: Causes, Symptoms, and Treatment Options

Hernia Info Authors

How pregnancy changes the body—and why hernias can develop

Pregnancy can be an exciting and beautiful time in a woman’s life —but it also brings significant physical changes. As your body adapts to support a growing baby, muscle stretching, thinning, and increased abdominal pressure can make pregnant women more susceptible to developing a hernia.¹

This article explains some causes of hernias during pregnancy, how to recognize symptoms, and when to seek medical care, and what treatment options may be available before or after delivery.

What is a hernia?

A hernia is created when part of an organ or tissue that holds it in place pushes through a weakened area of muscle, such as the abdominal wall.¹ Most hernias are external, with tissue pushing through the abdominal wall creating a visible bulge, while some are internal, remaining inside the abdomen without a visible lump. There are several types of hernias, which can range from completely painless to severely uncomfortable—and some may require emergency treatment.

Why can pregnancy increase your risk of a hernia?²

Because your growing uterus increases abdominal pressure and hormonal changes relax your muscles, it can make it easier for a hernia to develeop during pregnancy. The causes and risk factors can also include:

Increased abdominal pressure: As the baby grows, pressure inside the abdomen rises significantly.
Muscle weakening and stretching: The abdominal muscles thin and stretch to accommodate the growing uterus, creating potential weak spots.
Hormonal Changes: Pregnancy hormones, like relaxin, can soften tissues and ligaments.
Rapid Weight Gain: Excessive weight gain during pregnancy can increase abdominal pressure.
Previous Surgery or Scar Tissue: Previous abdominal surgery can create weak spots in the abdominal wall.
Advanced maternal age (over 35 years)
Frequent heavy lifting
Previous history of hernia(s)
Obesity

What are the most common types of hernias in pregnancy?

Some of the common types of hernias due to pregnancy include:

Umbilical: This is the most common type of hernia during pregnancy. It occurs near your belly button and may cause it to look like an "outie." They are generally non-alarming and do not often require immediate medical attention.³
Inguinal: More often found in men, inguinal hernias happen when your intestines protrude through your lower abdominal wall or inguinal canal (the area that holds your uterus). Being pregnant can weaken the abdominal muscles and cause increased pressure inside your abdomen. You may notice a bulge on either side of your pubic bone where your thigh and groin come together which becomes more obvious when you're upright, especially if you cough or strain.⁴
Femoral: Femoral hernias are rare, making up only 3 percent of all hernias, but they occur about 10 times as often in women as in men.⁵ They occur when fatty tissue or part of the intestine squeezes through an opening in the abdominal wall and into the upper thigh, near the groin. A femoral hernia can happen when the femoral canal stretches, which may occur during pregnancy due to weight gain around the hips and upper legs. You may notice a lump around the crease of the groin and upper thigh, especially when you cough, stand, or strain. If the lump can not be irreducible (pushed back in), it may require emergeny surgery due to the chances of strangulation.⁶
Incisional: About a third of people who have abdominal surgery develop an incisional hernia within three to six months, though they can occur at any time.⁵ Pregnancy is a risk factor for this type of hernia, which occurs at the site of a previous surgical incision (such as a healed C-section scar).² You may notice swelling or bulging around the previous surgical incision with some pain around the protrusion. While generally considered less severe than other hernias, if repair is needed, surgery will be required.⁵

What are the symptoms of a hernia during pregnancy?²

Hernias in pregnant women do not always cause obvious symptoms. For those who do have symptoms, you may feel a lump when you lie down or push on the area. This area may occasionally become sore, particularly if you have been active. If you are unable to push the hernia lump back into your body while lying down, then the hernia may be trapped or incarcerated. If you become nauseated, vomit, and/or the bulge starts to turn red, purple, or dark, then the hernia may be strangulated. In either of these scenarios, you should seek immediate medical attention.

When there are symptoms present, they may include:^2,5

A visible or palpable lump in the abdomen (belly button) or groin.
Pain, discomfort, swelling, and/or tenderness in the affected area (especially after physical activity).
Constipation.

⚠️ When to seek emergency care

Seek immediate medical attention if you experience any of these situations:²

Incarceration: The hernia cannot be pushed back into the body while lying down.
Strangulation: The bulge turns red, purple, or dark, accompanied by nausea or vomiting.
Nausea or vomiting: This can suggest digestive issues, indicating the possibility of a trapped (incarcerated) hernia.

Could it be something other than a hernia?

There are two conditions that are commonly mistaken for hernias during pregnancy:

Ovarian cysts or gynecologic conditions: Women are statistically less likely than men to develop hernias, and when they do, the hernia is often small and internal. This leads to frequent misdiagnosis as ovarian cysts or other gynecological conditions. If you're experiencing ongoing abdominal or groin pain and other causes have been ruled out, ask your doctor specifically about hernias.⁷
Diastasis recti: Diastasis recti is a separation of the rectus abdominis ("six-pack") muscles caused by the stretching of pregnancy. It typically develops in the third trimester and creates a midline bulge that can look like a hernia. Most cases resolve within eight weeks postpartum, though some require targeted exercises or surgery.⁸

If you're unsure whether you're experiencing a hernia or something else, consult your OB or a hernia specialist for a proper diagnosis. Learn more about conditions that can be mistaken for a hernia.

When to treat a hernia during pregnancy

There is no single "right" time—treatment timing depends on the hernia's size, symptoms, and input from your surgical and obstetric team. Doctors may typically recommend conservative management that involves rest, or a watch-and-wait approach for smaller hernias with no symptoms. Ususally, doctors opt to postpone surgery until after delivery and after a full recovery, which can last between three to six months, unless it is an emergency situation. For cases that do require surgery during pregnancy, it is suggested to have it during the second trimester.¹

Most women with hernias can have normal vaginal deliveries. On rare occasions, a hernia can appear during or immediately after labor. This is due to the abdominal pressure required during labor as women push a baby out. If it happens, the physician will assess the proper course of action based on the severity of the hernia.³

Below are proposed pathways for treating hernias in women of child bearing age:⁹

Surgical timing	Recommended for
Emergency situations	Can happen before and during pregnancy for strangulated or incarcerated hernias
Before pregnancy	Small, asymptomatic hernias: No repair for now; repair after childbirth or after last pregnancy Large, symptomatic hernias: Laparoscopic mesh repair, and then waiting for one to two years before a subsequent pregnancy
During pregnancy	Small, asymptomatic hernias: Laparoscopic mesh repair after delivery or after the last pregnancy Large, symptomatic hernias: Laparoscopic mesh repair in the second trimester

What are my hernia repair options?

Surgery is the only way to repair a hernia. Fixing it requires closing and strengthening the weakened muscle so the organ can no longer push through.¹ Depending on the size and location of your hernia, there are options to do a hernia repair with or without mesh. If your doctor recommends using mesh for your situation, there are several options available. Your doctor can explain which options or alternatives may be appropriate based on your specific situation. These options can include:

Absorbable mesh: Made from natural materials that absorb over time, leaving no permanent material behind. Because your own tissue replaces the mesh, it may better support your body's natural changes during pregnancy.¹⁰
Permanent mesh: Made from synthetic materials designed to support the repair long-term. Since it stays in the body permanently, it may not adjust to body changes such as weight gain, weight loss, and pregnancy as well as natural tissue.¹¹
Without mesh: In some cases, a surgeon may repair the hernia using the patient's own tissue without an implant. This approach may be considered for smaller hernias, certain patient profiles, or when mesh is not appropriate. Hernia recurrence rates are shown to be higher with non-mesh repairs than with mesh.¹²

To decide what’s best for you, discuss the benefits and risks of both non-surgical and surgical treatment hernia repair options with your doctor.

Hernias and pregnancy: frequently asked questions

In most cases, small, asymptomatic hernias do not directly affect fetal development. However, a strangulated hernia is a surgical emergency that requires immediate treatment to protect both mother and baby.¹³

No. Hernias do not self-resolve. While symptoms may fluctuate, the structural defect often requires medical management or surgical repair.¹⁴

While having a hernia, light activity is often acceptable, but heavy lifting, straining, and high-impact exercise may worsen symptoms. It is important to talk to your doctor to determine safe activity levels for your specific situation, especially while being pregnant.¹⁵

Thankfully, most umbilical hernias in infants are small, painless, and resolve on their own. Still, it’s important that you observe the symptoms. Make note if there is a soft bulge near the belly button and if that bulge becomes more noticeable when the baby cries or strains. Next, call your pediatrician so they can perform an exam to assess any potential complications. Learn more about umbilical hernias in infants.¹³

Hernias during or after pregnancy can happen, but understanding the signs and knowing when to seek care can make a meaningful difference. If you have questions about symptoms, diagnosis, or treatment options, talk to your doctor to help you determine the next steps for you and your baby.

The guidance provided in this article follows general rules that should be discussed with your doctor. This article is for informational and educational purposes only. It does not substitute for medical advice. If in doubt, always consult your doctor.

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References

This site is not intended as a substitute for professional medical care. Only your physician can diagnose and appropriately treat your symptoms. BD does not recommend the use of any particular physician or team of physicians. Please consult your healthcare provider for advice regarding who should be part of your hernia repair team.

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