Hernias after pregnancy

Why does my abdomen look and feel different after pregnancy? When you are pregnant, the abdominal muscles relax and partially separate to accommodate the growing fetus and uterus. After the pregnancy the muscles are designed to “recoil” back to their normal position. Unfortunately, like a rubber band that loses its strength after being stretched too far, too many times, often the abdominal muscles don’t come back together, leaving what is called a rectus diastasis (separation of the rectus muscles). Because the muscles are separated an area of weakness develops at and above the belly button, often leading to umbilical hernias. A hernia is a hole in the abdominal wall, allowing something to bulge through the hole from where it is supposed to be. So what can be done?



We recommend fixing most umbilical hernias, especially if they are causing discomfort, and to prevent the hernia from getting worse with time, potentially trapping your intestine within the hernia opening. Most general surgeons will fix hernias but a personalized approach by someone experienced in complex hernia repairs can provide the best outcomes to restore both normal function and appearance.

Most hernias today are fixed by placing a patch over the opening. This covers the opening and the patch allows the body to grow tissue into the area to make it stronger and prevent anything from bulging through again. This is typically done as a laparoscopic repair using 2-3 small incisions. Patients who have a significant rectus diastasis however, often find that this repair does not restore normal function of the abdominal wall, leading to persistent abdominal or back pain after the surgery. In women with an umbilical hernia and significant diastasis, I often recommend an open hernia repair where we can bring the abdominal muscles back together AND place a patch to make it stronger.

This requires a small incision just above and below the umbilicus (belly button) but the recovery time is similar to a laparoscopic repair. This is not an abdominoplasty (tummy tuck) but a slight modification to an umbilical hernia repair whereby we close the opening and repair the muscle layers independently. In my experience this has provided better outcomes in terms of function and appearance after the repair. If your abdomen doesn’t look or feel right after pregnancy make an appointment with Dr Farrow to find out whether you have an umbilical hernia and/or rectus diastasis and discuss your treatment options. Don’t let a hernia slow you down- get back to being you!