Hernias After a Cesarean Delivery

Hernias After a Cesarean Delivery

What is a Cesarean Delivery?

Caesarean section, also known as C-section or caesarean delivery, is the use of surgery to deliver one or more babies. The procedure involves making an incision in a woman’s abdomen and uterus to access the baby. Your doctor may recommend a cesarean delivery or a variety of reasons, including if your baby is breech or if you have had a cesarean delivery before. A caesarean section is often necessary when a vaginal delivery would put the baby or mother at risk.

What is a Hernia?

A hernia occurs when part of the intestines or stomach protrudes through a weakness in the abdominal wall, creating a bulge. A hernia that occurs after surgery is called an incisional hernia.

Cesarean Sections and Hernias

In the case of an incisional hernia, a person’s abdominal lining comes through the surgical incision from a cesarean delivery. A hernia is therefore one of the possible (but rare) complications of a cesarean delivery.

What are the Symptoms?

The most common symptom of a hernia after a cesarean delivery is an unusual bulge of tissue near 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.

Hernias don’t always develop immediately after your cesarean delivery, and it is therefore possible to notice this bulge months after you have had your baby. 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, and is usually 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

Other Less Common Symptoms Include:

  • Pain and discomfort after the normal healing time from a cesarean delivery
  • Nausea and/or constipation

Strangulated Hernias:

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 cesarean delivery should go to the emergency room.

Are they Common?

Hernias following a cesarean delivery are rare, as demonstrated in two recent studies:

  • 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 cesarean deliveries.
  • Another 2014 study of women in Denmark estimated that 0.2 percent of women who had a cesarean delivery needed a hernia repair within 10 years. The risk was higher in the first 3 years after the birth.

What are the Risk Factors?

Factors that increase the likelihood of a person experiencing an incisional hernia after cesarean delivery include:

  • Previous cesarean delivery. The risk of having a hernia is higher among women who have multiple cesarean deliveries.
  • Length of time. A hernia can occur any time after cesarean delivery, but it is more likely in the 3 years after surgery.
  • History of abdominal hernias. People who have a history of abdominal hernias may be more likely to experience a hernia after cesarean delivery, as there may be an existing weakness in the abdominal wall.

In addition, women are more at risk for a hernia after a cesarean section if they:

  • Are obese (the extra weight puts added pressure on the stomach)
  • Have a larger cesarean incision
  • Have diabetes
  • Have tissue that isn’t as strong

What are the Treatments?

Although incisional hernias don’t usually cause symptoms beyond their physical characteristics, they won’t go away without treatment. Surgical intervention is the only treatment for an incisional hernia after a cesarean delivery.

Even if a hernia is not yet strangulated, most doctors still recommend removal to prevent this from occurring in the future.

Doctors often recommend surgery if a patient is experiencing the following symptoms:

  • Hernia is getting much bigger and more noticeable
  • Hernia is causing discomfort that makes it hard for a woman to complete her daily activities
  • Hernia is incarcerated (bowel is trapped in the hernia and doesn’t get much blood flow, usually causing a lot of pain)

If you have had a cesarean section and are experiencing the symptoms of a hernia, the hernia experts at Avalon Hernia can evaluate your hernia and recommend a specific surgical approach to repairing it. Call (626) 310-0772 today for a consultation.




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