To say the body goes through a lot throughout pregnancy, labor, and delivery is a serious understatement. There are all kinds of conditions that a new mom can experience as a result of giving birth — such as postpartum hernia. This type of hernia can range in severity from something that’s no big deal to a complication that needs surgical treatment, and it’s something that affects more women than you may realize.
What Is Postpartum Hernia & What Causes It?
There are two situations that are often associated with a postpartum hernia, one of which is an actual hernia that results after a c-section, and the other is diastasis recti. In an interview with Romper, OB/GYN Nisha Verma, MD, explains that while a lot of new moms experience diastasis recti, a true incisional hernia is far less common, and usually much more serious. “A hernia is a protrusion or bulge or projection of an organ or part of an organ through the wall of the body that normally contains it,” she explains, “Anytime you have incisions in your belly, [such as in a c-section], you can get an incisional hernia.” Verna further explains that physicians are typically very careful to ensure sutures are no more than a centimeter apart to prevent a hernia like this. In this case, it’s typically improper healing that causes this type of hernia.
Diastasis recti is often thought of as a hernia as well, though it’s not nearly as serious as an incisional hernia. In this case, the abdomen muscles separated during pregnancy and never fully came back together, which allows internal organs to push out where they otherwise would be tucked in behind the muscles. “What’s happening is that the muscles are working but... there’s no musculature holding in the internal organs, essentially,” OB/GYN, Jonathan D. Jaqua, DO, tells Romper in an interview, “There’s still material there that keeps everything in place, but [the organs are] not being held back by muscles.”
What Are Symptoms Of Postpartum Hernia?
In the case of an incisional hernia, Verna says patients will notice something bulging around their incision area, and it is usually associated with pain. Patients are usually well aware that something is wrong when they experience this kind of hernia (and they should let their doctor know right away).
As for diastasis recti, Jaqua says patients usually notice a bulging out in the center portion of their abdomen. “As you look up and down [your abdomen] you’re going to see some varying level of pooching out specifically when you’re lifting something, going from a seated to standing position, or doing some sort of core activation,” he explains. Unlike incisional hernia, you may or may not experience pain with diastasis recti, and it’s not nearly as serious as an incisional hernia.
Is Postpartum Hernia Common?
“[Diastasis recti] is super common,” says Jaqua, “I’d say we see it in most pregnancies, specifically with second and third pregnancies.” Most of the time, the body repairs itself and there are no long-term complications, but sometimes the space between the abdomen muscles doesn’t completely close back up, which is what can cause the hernia-like bulging (and this is less common). Incisional postpartum hernias, on the other hand, are thankfully not at all common, according to Verna, so this is not something most women will experience during their postpartum recovery period.
How Do You Treat Postpartum Hernia?
Patients who experience incisional postpartum hernias will need to have a surgical repair, Verna explains. “The risk is if it becomes an incarcerated hernia, which is when the organ pops through the hole in the connective tissue and gets stuck and oxygen flow gets cut off, that can be really dangerous,” she says, “so we do recommend treatment.” To treat this type of hernia, doctors need to open the incision back up and repair any damaged tissue to ensure the organs can’t break free again.
For patients experiencing diastasis recti hernias, surgical treatment is not always necessary. “Just because you have [diastasis recti], doesn’t mean it’s going to be lifelong,” explains Jaqua, “You can 100% live with it.” If it is bothering you, you may be able to treat it by doing core strengthening exercises. However, if it’s causing you pain or it’s affecting your daily life in some way, then surgical repair is an option. “The repair itself is relatively simple,” Jaqua says, “It’s just a matter of reapproximating the muscles that run up and down the abdomen and putting them back together.”
It’s always important to talk to your provider if you notice any kind of bulging, whether it’s obvious and painful or just a little bothersome, so they can effectively monitor the situation and treat it if needed. Chances are high that you won’t end up in a situation where you will need any kind of postpartum hernia surgical repair. However, you can expect to need to do some postpartum core strengthening exercises — whether you have a postpartum hernia or not.
Jonathan D. Jaqua, DO, ObGyn at Southdale ObGyn in Edina, MN
Nisha Verma, MD, ObGyn and abortion care provider and a Darney-Landy Fellow in the American College of Obstetricians and Gynecologists’ Strategies for Health Equity Department