Sometimes a hernia becomes strangulated, or constricted. This can occur if herniated tissue becomes trapped, or incarcerated. A strangulated hernia will cut off the blood supply to vital organs in the stomach, including the intestines.
What to know about hernias after a C-section
A hernia is a rare complication of a C-section, also known as cesarean delivery. Being aware of the signs and symptoms can help people to get proper medical treatment.
A hernia that occurs after surgery is called an incisional hernia. The C-section is a surgical procedure that can create a weakness in the abdominal wall. A hernia occurs when part of the intestines or stomach protrudes outward through this weakened area, creating a bulge.
In this article, we explain how to identify a hernia following a C-section. We also cover the risk factors, treatment, and recovery.
Share on Pinterest A slowly intensifying pain in the stomach can be a symptom of a strangulated hernia.
The primary symptom of an incisional hernia is an unusual bulge near or attached to the site of the surgical incision. The bulge can be as small as a grape in size, or it can be very large. A hernia may change position or grow over time.
Sometimes a person can only feel a hernia, but it is often possible to see a visible bulge when looking at the stomach. The bulge is usually the same color as the skin.
Hernias can develop many years after the surgery. If this is the case, the individual may notice a bulge along a faint scar.
Sometimes a hernia becomes strangulated, or constricted. This can occur if herniated tissue becomes trapped, or incarcerated. A strangulated hernia will cut off the blood supply to vital organs in the stomach, including the intestines.
The symptoms of a strangulated hernia include:
- slowly intensifying pain in the stomach
- tenderness or pain on or near the hernia
- nausea and vomiting
- redness and swelling of the stomach
A strangulated hernia is a medical emergency. Anyone who experiences pain or gastrointestinal problems following a C-section should go to the emergency room.
Hernias following a C-section are rare.
A 2014 study of 642,578 women in Australia found that just 0.2 percent of participants needed a hernia repair. The likelihood of hernia repair surgery increased with the number of C-sections.
Another 2014 study of women in Denmark estimated that 0.2 percent of women who had a C-section needed a hernia repair within 10 years. The risk was higher in the first 3 years after the birth.
A doctor should usually be able to diagnose a hernia by examining the area. Sometimes a hernia is only visible in certain positions, or when coughing, so a doctor may touch the incision and ask the individual to bend forward or cough.
Share on Pinterest A general anesthesia is required for emergency hernia removal.
When a hernia becomes strangulated, it requires emergency surgery.
A person may also need treatment for the side effects of a complex hernia, which may include bowel perforations or infections. They may require additional surgery, antibiotics, or monitoring in the hospital.
Even if a hernia is not yet strangulated, most doctors still recommend removal to prevent this from occurring in the future. This type of surgery is called elective surgery, and people can schedule it at their convenience.
Emergency hernia removal requires general anesthesia. The person will be fully asleep and unaware of what is happening. Sometimes, local anesthesia may be sufficient for elective hernia removal, depending on the hernia and its location. With local anesthesia, the individual is awake, but the area around the hernia is numb.
A surgeon may perform the hernia removal through either a cut in the stomach or keyhole surgery, also called laparoscopic surgery. Laparoscopic surgery uses a tiny incision, often in the bellybutton. These incisions tend to heal more quickly and allow a more rapid recovery.
It is important to discuss the relative merits of each type of surgery with a doctor. In some cases, it may only be possible to treat the hernia through a large incision.
Most people recover quickly from hernia repair surgery. Unless the hernia was large or complex, they are usually able to walk around and go home on the day of surgery. Experiencing pain and tenderness following the procedure is normal.
Remaining active following surgery can help to speed up healing and reduce the risk of complications such as blood clots.
People should notify their doctor if they develop a fever, notice excessive bleeding, or experience extreme pain.
People who work in offices can usually return to work within a week or two. Those who work in more physically demanding environments may need to wait longer. A doctor will discuss the recovery time and restrictions with the individual before surgery.
Share on Pinterest Multiple C-sections can be a risk factor for a hernia.
Certain factors increase the likelihood of a person experiencing an incisional hernia after a C-section.
The risk of having a hernia is higher among women who have multiple C-sections. According to a 2014 study, having two C-sections makes a hernia three times more likely, while having five C-sections increases the risk sixfold.
A hernia can occur any time after the C-section, but it is more likely in the 3 years after surgery.
People who have a history of abdominal hernias may be more likely to experience a hernia after having a C-section, as there may be an existing weakness in the abdominal wall. However, because hernias are rare, no recent research has shown a direct link between previous hernias and the likelihood of an additional one.
It is important to discuss risk factors with a doctor. People who have had hernia surgery previously should ensure that their doctor is aware of this.
In some cases, a small hernia can heal on its own. However, there is a risk of the hernia becoming trapped or strangulated, so it is essential to seek medical care.
The primary complication of a hernia is strangulation, which can be life-threatening. It may cause problems such as:
- perforated bowels
- blockages in the bowels
- internal bleeding
- fluid in the abdominal cavity
Some people go into shock when experiencing a strangulated hernia. People awaiting elective surgery for a hernia should ask their doctor about the warning signs and symptoms of a strangulated hernia. If they experience any of these, they must seek emergency medical care.
Surgical repair of hernias following a C-section is usually effective, but people should discuss the possibility of recurrence with a doctor.
According to the American College of Obstetricians and Gynecologists (ACOG), people who attempt a vaginal birth following a previous C-section have a 60–80 percent chance of success. Therefore, a person who is concerned about experiencing another hernia may prefer to avoid surgery and attempt a vaginal delivery instead.
Hernias are rare after a C-section, so there is little data available on the rate of recurrence. It is not possible to predict whether or not a person will develop another hernia.
With proper care, the majority of people recover from incisional hernias following a C-section. Most will be able to have healthy subsequent births, and vaginal delivery might be possible.
Last medically reviewed on June 27, 2018
- Emergency Medicine
- GastroIntestinal / Gastroenterology
- Pregnancy / Obstetrics
- Parenthood
- Post Delivery
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- Aabakke, A. J. M., Krebs, L., Ladelund, S., & Secher, N. J. (2014, September 30). Incidence of incisional hernia after cesarean delivery: A register-based cohort study. PLoS One, 9(9), e108829
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182598/ - ACOG releases new guidance aimed at making VBAC available to more women. (2017, October 24)
https://www.acog.org/About-ACOG/News-Room/News-Releases/2017/ACOG-Releases-New-Guidance-Aimed-at-Making-VBAC-Available-to-More-Women - Ansari, P. (2017, January). Hernias of the abdominal wall
https://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/hernias-of-the-abdominal-wall - Miller, J. (n.d.). Incisional hernia information sheet
http://www.parathyroid.com.au/pdf/handout-incisional-hernia-surgery.pdf - Shand, A. W., Chen, J. S., Schnitzler, M., & Roberts, C. L. (2014, November 28). Incisional hernia repair after caesarean section: A population based study. Australian and New Zealand Journal of Obstetrics and Gynaecology, 55(2), 170–175
https://pdfs.semanticscholar.org/c0f7/783af83521ccf662e27b29ce1c5985b8625a.pdf
Hernia After C-Section: What Are the Symptoms?
A hernia is when a part of the body protrudes or pushes through another part of the body where it shouldn’t. In rare cases, it can be a complication of a cesarean section (C-section).
A cesarean delivery (C-section) involves making an incision in a female’s abdomen and uterus to access the baby.
There are many reasons your doctor may recommend a cesarean delivery, including if your baby is breech or you’ve had a C-section before.
A C-section-related hernia is a type of postpartum hernia that develops in the area of the C-section scar after birth. It is a type of incisional hernia.
Share on Pinterest An incisional hernia is a complication that can occur after cesarean delivery. Jadhav G S, Adhikari G R, Purohit R S (August 21, 2022) A Prospective Observational Study of Ventral Hernia. CC-BY 4.0.
In the case of an incisional hernia after a C-section, your abdominal lining would come through the surgical incision.
Females are more at risk for this if they:
- are overweight because the extra weight can put added pressure on the stomach
- have a larger cesarean incision
- have diabetes
- have tissue that isn’t as strong
While incisional hernias don’t usually cause symptoms beyond their physical characteristics, they won’t go away without treatment. Surgical intervention is the sole treatment for an incisional hernia after a C-section.
Research shows that females with a midline (up and down) incision are more likely to have a hernia after cesarean delivery than females with a transverse (side to side) incision.
As many as half of the hernias that occur after a cesarean may cause symptoms within the first year. They are usually ventral hernias, which means the hernia bulges through the abdominal muscles.
Are sex and gender the same thing?
People often use the terms sex and gender interchangeably, but they have different meanings:
- “Sex” refers to the physical characteristics that differentiate male, female, and intersex bodies.
- “Gender” refers to a person’s identity and how they feel inside. Examples include man, woman, nonbinary, agender, bigender, genderfluid, pangender, and trans. A person’s gender identity may differ from the sex they were assigned at birth.
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The symptoms of a c-section hernia can be categorized as follows:
Abdominal bulge
The most common symptom of hernia after a cesarean delivery is a bulge of tissue that seems to come from an area of your surgical scar. Or you may experience just a bulge of skin in or around your scar.
Hernias don’t always develop immediately after your cesarean delivery, so it’s possible to notice this bulge months after you’ve had your baby. Usually, it’s more noticeable in the following circumstances:
- when you’re standing very straight and tall
- when you’re involved in physical activity, such as lifting an object above your head
- when you’re coughing
The abdomen’s skin (where the uterus shrinks after pregnancy) may appear loose, dimpled, or bulging postpartum. This can make it more difficult to tell if a female has hernia symptoms or is simply healing from a cesarean delivery.
Pain and/or discomfort
Sometimes, an incisional hernia can cause pain and discomfort, especially when the bulge in the stomach is more noticeable. This symptom can be challenging for a new mom to recognize at first.
The healing process after a C-section can cause discomfort. But discomfort from a hernia will continue after the typical healing time from a cesarean delivery.
Nausea and/or constipation
An incisional hernia affects the areas around the stomach, so it can cause stomach upset. This includes nausea and even vomiting.
Constipation is another symptom because the hernia can cause the intestines to move out of place. This makes having a bowel movement more difficult.
Doctors can often diagnose a hernia by looking at its appearance and conducting a physical exam. But some conditions can occur after a cesarean with symptoms similar to a hernia.
Examples of these conditions include:
- abscess
- hematoma
- abdominal wall endometriosis
- uterine rupture
- wound infection
Doctors sometimes also use imaging studies to rule out other conditions, confirm the diagnosis of a hernia, or assess if the bowel is trapped inside the hernia. Examples include ultrasound or CT scan.
Surgery is the usual treatment for an incisional hernia. But doctors don’t usually recommend surgery unless a female has certain symptoms.
- The hernia is getting much bigger and more noticeable
- The hernia is causing discomfort that makes it hard for a female to complete her daily activities
- The hernia is incarcerated (the bowel is trapped in the hernia and doesn’t get much blood flow, usually causing a lot of pain)
An incarcerated hernia is rare. When it does happen, it’s a medical emergency.
There aren’t any medications you can take to make a hernia smaller. Some females wear an abdominal binder, which is an elastic belt that keeps the hernia from protruding. This won’t make the hernia disappear but it can help alleviate symptoms. Only surgery can definitively reduce the appearance of the hernia.
A surgeon can evaluate your hernia and recommend a specific approach to repair it. For example, some surgeons will use an “open” technique. This involves making a larger incision to repair the hernia. Alternatively, laparoscopic or minimally invasive techniques involve making small incisions to access the affected area.
Typically with both surgical approaches, the doctor will place a piece of surgical mesh over the weak area. This helps to hold it in place properly.
Here are some answers to additional questions about hernia after C-section.
How do I know if I have a hernia after C-section?
If you have a hernia after having a cesarian delivery, you will usually feel or see a bulge of skin or tissue protruding through the area of the C-section scar.
How common is an incisional hernia after a C-section?
According to a 2020 meta-analysis, the rate of occurrence of incisional hernia after a C-section is 0.0-5.6% . An older 2014 research study also found that an estimated 2 out of every 1,000 cesarean deliveries caused a hernia that required surgical repair within 10 years of delivery. It’s possible that more females have hernias after cesarean delivery, but they may not get surgery to fix them for some time or at all.
Can I get another C-section hernia?
About 20% of all incisional hernia surgical repairs are recurrent procedures, which means that one in every five people will experience another incisional hernia after treatment. According to other research, C-section-related ventral incisional hernias after repair can reoccur at a rate as high as 15-40%.
If a person is considering having another baby, she’s at greater risk for recurrence. Sometimes doctors recommend waiting until a female no longer wishes to conceive to reduce the risk of a hernia happening again after surgical repair.
You can get an incisional hernia after delivering a baby via C-section. This means your abdominal lining comes will protrude through the C-section surgical incision.
Often these types of hernias don’t cause any treatment but can be painful in some cases. They can also be distressing due to their appearance. The only way to treat a hernia is to remove it surgically.
Last medically reviewed on October 27, 2022
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