Postpartum Hernia: Causes, Treatment, and Prevention

Welcoming a new baby into the world is a joyful and transformative experience, but it can also bring unexpected physical challenges for new mothers. One such issue that might arise is a postpartum hernia, a condition that occurs when an internal part of the body pushes through a weakened spot in the muscle or tissue wall. Below, we explore the causes, symptoms, and various treatment options for postpartum hernias, as well as effective strategies for prevention. 

What Causes Postpartum Hernia and What Does It Feel Like?

Postpartum hernias, although not discussed as widely as other post-birth conditions, can cause significant discomfort and affect a mother's ability to care for her newborn.

What Causes Postpartum Hernia?

A postpartum hernia typically arises due to the physical strain of childbirth. During delivery, especially with prolonged pushing, there is significant pressure on the abdominal muscles. This pressure can lead to weaknesses or tears in the abdominal wall, where internal tissues or organs may protrude, forming a hernia. It's most common in women who have had multiple pregnancies, which further stretch and weaken the abdominal structure.

Another significant contributor is diastasis recti, a condition where the left and right abdominal muscles separate during pregnancy. This separation can weaken the abdominal wall and make it more susceptible to hernias. Surgical interventions during childbirth, such as a cesarean section, also heighten the risk of developing a hernia postpartum. The incision through the abdominal wall may not heal strongly, leaving a vulnerable area prone to herniation.

What Does a Postpartum Hernia Feel Like?

If you're experiencing a postpartum hernia, the most noticeable symptom will likely be a visible bulge or lump near your abdomen or groin. This bulge may be more pronounced when you stand up, cough, or strain, and it might disappear when you lie down. Besides the physical appearance, hernias can be accompanied by discomfort or sharp pain at the site, especially when you're engaging in activities that increase intra-abdominal pressure such as lifting or bending.

The sensation can vary from mildly irritating to severely painful, impacting your ability to perform daily tasks. Some women also report a feeling of heaviness or pressure in their abdomen, which can be particularly challenging when caring for a new baby and recovering from childbirth.

If you notice any of these symptoms, it's important to consult with your healthcare provider. Early diagnosis and management can prevent complications such as hernia entrapment or strangulation, which are medical emergencies.

Diagnosis of Postpartum Hernia

If you suspect you might have a hernia due to symptoms like a noticeable bulge or pain in your abdomen, consulting your healthcare provider is essential. 

It all begins with a detailed discussion with your doctor. You'll need to describe all your symptoms when they occur, and any activities that make them worse. This conversation is crucial as it guides the subsequent steps and helps rule out other possible postpartum complications.

After your initial consultation, your doctor will perform a physical examination. During this exam, they will look for any visible bulges on your abdomen, particularly those that become more apparent when you stand, cough, or strain. The doctor might ask you to lie down, sit up, or stand during this examination to see how the bulge behaves in different positions. This hands-on assessment is often very effective in identifying the presence and type of hernia.

However, while a physical exam can provide strong indications of a hernia, imaging tests may be necessary to confirm the diagnosis and to understand the exact nature and location of the hernia. The two most common imaging tests used are:

• Ultrasound: This test uses sound waves to create images of the inside of your body. It is particularly effective for diagnosing hernias because it can visualize soft tissues and can be performed while you are in various positions to see how the hernia moves.
• Computed Tomography (CT) Scan: A CT scan provides a more detailed look and is useful if the ultrasound is inconclusive or if the hernia is complex. It can help to determine the size of the hernia and the exact tissues involved.

In some cases, especially where complications are suspected, your doctor might also recommend an MRI (Magnetic Resonance Imaging) scan. This is particularly useful if there’s a need to get detailed images of the soft tissues surrounding the hernia.

Once that is done, your primary doctor might refer you to a surgeon who specializes in hernia repair. This typically happens if the hernia is large, painful, or has characteristics that might require surgical intervention.

After diagnosis, your healthcare provider will discuss the best treatment options with you, based on the size, type, and symptoms of your hernia. It’s important to follow their advice closely and keep them informed about any changes in your condition.

Treatment Options

Once diagnosed with a postpartum hernia, you may feel a mix of relief and anxiety—relief at having identified the cause of your discomfort but anxiety about what comes next. 

For many new mothers with a postpartum hernia, the initial approach may involve non-surgical treatments, especially if the hernia is small and not causing significant discomfort. These treatments aim to support the body's healing process and prevent further complications:

• Lifestyle Adjustments: Simple changes in your daily activities can help manage hernia symptoms. Avoiding heavy lifting and strenuous activities that increase abdominal pressure can prevent the hernia from worsening.
• Physiotherapy: Engaging with a physiotherapist can be extremely beneficial. A program tailored to strengthen the abdominal muscles and improve core stability may help reduce the hernia size and alleviate symptoms. 
• Hernia Belts or Support Garments: Wearing a hernia support belt or garment can provide temporary relief by holding the hernia in. This is often used to manage symptoms during physical activity or while waiting for surgical treatment.

In case your hernia is large, painful, or increasing in size, surgical treatment may be recommended. Surgery is considered the most definitive treatment for hernias as it repairs the weakened area of the abdominal wall:

• Open Hernia Repair: This traditional method involves making a cut over the hernia, pushing the protruding tissue back into the abdomen, and then repairing the weakened muscle area with stitches. Sometimes, a synthetic mesh is used to strengthen the area.
• Laparoscopic Surgery: A minimally invasive approach that uses small incisions and a camera to guide the surgery. This technique is generally associated with faster recovery times, reduced pain, and less noticeable scars compared to open surgery. 

Medications

Over-the-counter pain relievers such as ibuprofen or acetaminophen can be used to manage pain. However, it’s important to consult your healthcare provider before taking any medication, especially if you are breastfeeding.

The choice between non-surgical and surgical treatment will depend on several factors, including the size and symptoms of the hernia, your general health, and your lifestyle needs. It’s essential to discuss all these aspects with your doctor, who can guide you towards the best treatment option based on current medical evidence and your specific circumstances.

Prevention of Postpartum Hernia

While not all hernias can be prevented, especially those due to genetic factors or complications from surgical procedures, there are proactive steps you can take to minimize your risk and ensure your body is as strong and resilient as possible during the postpartum period.

Strengthening Core Muscles

One of the most effective prevention strategies is strengthening your core muscles. The abdominal muscles, which are often stretched and weakened during pregnancy, can benefit significantly from targeted exercises. When you engage in a postpartum exercise regimen that includes pelvic tilts, bridges, and gentle abdominal contractions, it can restore muscle tone and reduce the risk of hernia.

It's, however important to start slowly and increase the intensity of your workouts gradually. We highly recommend working with a physiotherapist who specializes in postpartum recovery since they can provide you with personalized exercises that safely strengthen your core without overstraining it.

Proper Lifting Techniques

Postpartum women are often required to lift their baby multiple times a day, which can strain the abdominal muscles if not done correctly. Here are some tips for safe lifting:

• Always squat down to the level of the object you are lifting and use your legs and knees to stand up, rather than bending at the waist and using your back and abdomen.
• Keep the object close to your body as you lift.
• Avoid twisting your body while holding heavy objects; instead, turn your whole body to the side.

Weight Management

It is also essential to maintain a healthy weight after giving childbirth. This is because excess weight can put additional pressure on your abdominal wall, which is already vulnerable after childbirth. It is best to switch to a balanced diet rich that is in fruits, vegetables, whole grains, and lean proteins. This can help you return to a healthy weight gradually without compromising your nutritional needs, especially if you are breastfeeding.

Lastly, regular medical check-ups post-delivery are crucial. These allow your healthcare provider to monitor your recovery and catch any potential complications early. If you notice any bulging or pain around your abdominal area, discuss it with your doctor immediately.

Special Considerations

When you are dealing with something as potentially complicated as a hernia that too after childbirth, there are special considerations to keep in mind.

Firstly, it’s important to recognize the impact that physical health issues like hernias can have on your mental health. The postpartum period can be emotionally challenging, and dealing with a hernia may add to feelings of stress and anxiety. It is essential to be aware of your physical symptoms and seek support if you feel overwhelmed. Don’t hesitate to discuss these feelings with your healthcare provider who can offer or recommend counseling services and support groups.

In case you have experienced a postpartum hernia and are considering more children, planning becomes even more critical. Future pregnancies can increase the risk of a recurrent hernia or complicate an existing one. We highly recommend consulting with a specialist who understands the nuances of hernias in the context of pregnancy. They can advise on strategies to strengthen your abdominal muscles before another pregnancy and monitor any pre-existing hernias closely. It’s often recommended to delay subsequent pregnancies until your body has adequately healed and to consider surgical repair of the hernia before becoming pregnant again.

If you become pregnant again and have a pre-existing hernia or its repair, special monitoring will be necessary. Pregnancy can put additional pressure on the repair site or the hernia, potentially leading to complications. Make sure you arrange regular check-ups with your doctor to assess the integrity of the hernia repair and the surrounding tissues as your pregnancy progresses. 

Remember, every woman’s body and postpartum recovery are unique. It’s essential that the treatment and prevention strategies for hernias are personalized. What works well for one person may not be suitable for another. Always ensure that your care plan is tailored to your specific needs, taking into account your medical history, lifestyle, and overall health.

If you are looking for expert care to manage or prevent a postpartum hernia, our team at Hernia Innovations can help. We specialize in cutting-edge treatments and personalized care plans to ensure your recovery is smooth and swift. Don’t let a hernia stand in the way of your postpartum journey—contact Hernia Innovations today to take the first step toward better health.