A postpartum hernia may occur during the tiring weeks after you bring your baby home, usually as a soft bump near the navel or along a scar from a caesarean section. Weakened tummy muscles, together with the strain of pregnancy and birth, can allow tissue to push through the abdominal wall. Although not always painful, early recognition of the signs and symptoms of postpartum hernia is important. Most mums cope well with sensible recovery practices and the advice of a GP or midwife. This guide includes details on the causes and UK care pathways, treatment and how to recover safely.
A hernia occurs when the bowel, fat or another tissue bulges through a hole in the muscle under the skin. This weakness may be associated with stretched rectus muscles after delivery, hormonal weakness of connective tissues or slow healing after abdominal surgery. Hernias that occur after pregnancy lie at the belly button, those following a C-section or other scar lie along the scar, and inguinal hernias occur near the groin but are not common in women. Small hernias can remain stable with activity, but true hernias will not close completely without support or surgical correction.
Sometimes, postpartum bulges are confused with diastasis recti , which is a separation of the six-pack muscles instead of the passage of tissue through a hole. Your clinician will be able to distinguish on examination.
Postpartum hernias are not common, but frequent enough to be observed at postnatal examinations. In the case of caesarean birth, incisional hernia is reported to occur in 0.2% to 5% of women, depending on the incision type, the closure method and healing. Umbilical hernias are more likely to occur after multiple pregnancies, if the baby is large, and/or if there is a lot of pressure on the belly button area. The total risk is relatively low, and it is important to identify a post-pregnancy hernia and make an appointment for review even if the swelling appears small.
The typical symptom is a soft, bulging area of skin, often around the belly button or at the C-section scar. It can become more noticeable when you are coughing or standing up, when lifting your baby, or climbing stairs. Some women experience pain or pressure in the local area, whereas others may only experience a change in the shape of the belly button. If the skin appears firm, tender or discoloured, or you become nauseous or vomit, this can be a serious complication and requires immediate assessment; refer to NHS guidance on hernia symptoms .
Be relaxed and then cough slightly, or make a belly-button tightening movement while gazing at, or touching, the navel and scar. Hernias tend to show up more when you strain. If you have a new lump after delivery, or an "outie" navel where it was flat before, this should be discussed at the six-week GP and postnatal appointment. Imaging is not necessary initially, but any recurrent bulge should be assessed clinically.
Descriptions vary. Many mums talk about dragging or pressure, particularly after long days of holding and feeding. A painful strain may occur with the use of a car seat and/or when getting on and off the toilet. In general, a lump that is reducible and presses down when you lie down is common. If a lump is hard and painful and will not move, seek same-day medical advice.
It is usually diagnosed from a physical examination of the abdomen by your GP or surgeon, when you stand up and cough. In most cases, that is a physical test alone. If it is unclear or there is any suspicion of complications, you may be sent for an ultrasound, CT scan, or MRI. Early diagnosis guides you to watchful waiting, supportive care or surgery repair.
Due to the increased pressure of the uterus during pregnancy, the abdominal wall may become separated or weakened in the rectus muscles. Childbirth by delivery or Caesarean section adds further stress. Then tissue protrudes through natural faults or through surgical openings.
Umbilical hernia: During pregnancy, the navel ring stretches and may not close completely after birth.
Incisional hernia: When the fascial layer is not completely re-strengthened, tissue protrudes through the healing wound.
Ventral hernia : A bulge above the belly button ( specialist hernia centres classify these with umbilical defects after pregnancy as common postnatal types).
Inguinal hernia: Less common in women, but can be caused by heavy lifting or pressure on the groin when a woman is pregnant.
Caesarean cuts through muscle and fascia. When healing is slow, or the tissue gets infected, or the person resumes full weight bearing the tissue can form inside the scar. This risk can be reduced by following NHS recovery advice on driving and lifting, and by having check-ups as a postnatal patient, but cannot be eliminated. If you are curious about the mechanics of a C-section hernia, take a look at our guide on hernia after a C-section .
If you notice any new 'bulge' in the abdomen, make sure to get a check-up at regular intervals in the first weeks following childbirth. If the pain gets severe or sudden, or if the lump becomes hard or if the skin above it is red or dusky or if you vomit several times or cannot open your bowels and the pain in your tummy worsens, it may be a sign of trapped or strangulated tissue and requires urgent treatment. Call NHS 111 or attend A&E as directed if you have a hernia and experience pain, bloating, fever or confusion – this is an emergency. If you are unsure whether surgery is needed , seek assistance from your GP from the outset if you have mild discomfort without any red flags.
Treatment will be based on the size of the hernia, symptoms and future pregnancies. Restriction of daily activities for the small, asymptomatic lumps may be warranted, in which case a watch-and-wait approach may be considered, or until they are painful. Rehabilitation will include not lifting heavy loads, gradually strengthening the core with the help of a physio or GP and comfortable abdominal compression. Large or symptomatic hernias are surgery-repaired typically laparoscopically using mesh to strengthen the abdominal wall ( postpartum hernia repair is often a day-long or short-stay surgery).
True hernias are the ones in which the tissues have to go through the opening in the muscle and cannot be pushed back in all the way without some action. Symptoms may get better with time as muscles get stronger, but the gap is usually not cleared up. Very small bulges/swelling or a diastasis should lessen as healing progresses, and your clinician will inform you of which pattern this is for.
Pain varies with the size of the hernia, the surgical technique and your treatment. Caesarean recovery involves uterine cramping and a lower abdominal cut, as well as hernia repair, which can have smaller keyhole cuts, but which still irritates the muscle wall. Both are usually okay with prescribed pain medication, but in many protocols several weeks of activity restrictions follow either procedure, for instance, avoid lifting anything much heavier than your baby for about six weeks after hernia surgery (or as your surgeon advises) . Discuss recovery and child care with your surgical team prior to booking a repair.
Surgery is generally indicated if the hernia enlarges, becomes painful, impairs function, or is a risk of bowel entrapment. Surgeons might recommend waiting until you have completed your family, as a repair may be needed later in pregnancy, but emergency symptoms should not be postponed. Shared decision-making with your GP and surgeon takes into account the burden of symptoms and plans for pregnancy.
Low-impact exercise can be used to start re-establishing stability after 6 weeks PP or after C section (if okay with your clinician). Some good alternatives include: Pelvic tilts, a simple glute bridge, diaphragmatic breathing, modified side-lying support work, and short walks. Always do it slowly, and if it gets larger or painful during or after the workout, stop.
Avoid movements that increase the pressure in the abdomen until you have been evaluated:
Struggling through pain will widen the opening or prevent healing following surgical correction.
Some hernias cannot be prevented, particularly if there is a stretching of the wall due to pregnancy. These practices reduce stress during recovery:
Small and non-painful, it can be treated expectantly for months or years with regular checks. The risk is higher if the lump gets larger, symptoms begin or if you cannot lie down to shrink the size. Please do not wait for pain to follow up with your surgeon.
Yes, many women do, particularly when the defect is small and stable. Lifestyle modifications and supportive clothing may be all that is needed. Surgical repair is only considered when a hernia is causing problems to the individual's quality of life, the hernia is increasing in size or when complications are suspected (see the NHS living with a hernia overview for general information).
A hernia does not happen because of not eating anything, but it can be caused by eating large meals, carbonated beverages, and constipating foods. As long as a balanced diet and enough fluid and fibre are consumed, bowel habits should be comfortable; consult a GP before embarking on a strict elimination diet.
A physiotherapist can perform a three-finger-width check across the linea alba to assess for a gap, which may look like, or be accompanied by, an umbilical bulge. It is a screening instrument, not a diagnostic tool. Your GP or women's health physio can show you how it's done safely after pregnancy.
Likewise, a two-finger gap at the belly button during a soft crunch-like action can indicate diastasis. Hernia overlaps but is not the same as diastasis and is differentiated by examination by the clinician.
Diastasis recti, swelling after birth, a granuloma originating from the scar, lipoma or, very rarely, other abdominal masses may appear similar. Any lumps or changes that persist or occur should be checked by your GP or clinician when you notice a new lump—do not rely on self-diagnosis alone.
Yes. There is additional pressure on the abdomen with each pregnancy. Recurrence or worsening is increased with prior hernia, multiple cesarean sections, large babies or obesity. If you have a history of hernia repair or an untreated bulge, you should plan antenatal care early, as women may develop another defect in the same area if they become pregnant again.
Not all hernias are caused directly by pregnancy, but weak spots are revealed. Strain from a growing bump and delivery often expose or exacerbate defects that were without symptoms prior to conception.
Although a postpartum hernia may be concerning during the early days of parenthood, proper information and prompt NHS treatment can help manage this situation. Know the signs of a postpartum hernia, keep your tummy safe during recovery, and seek assistance when warning signs are present. Over time, most mums restore their confidence and strength with sensible exercise and with support from good posture and the use of suitable products like a well-fitted postpartum belt if needed.
The information provided in this article is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider regarding any medical condition. Momcozy is not responsible for any consequences arising from the use of this content.
