Umbilical hernia during pregnancy

By trimester

Weeks 1–13

1st trimester

A preexisting small umbilical hernia may become more noticeable as abdominal pressure starts to rise. A soft, reducible bulge without pain is different from an acutely trapped hernia, but it still belongs on the prenatal problem list.

Weeks 14–27

2nd trimester

If a symptomatic hernia needs planned repair during pregnancy, timing is individualized with obstetric and surgical teams. A narrative review describes the second trimester as a practical window, but also states that no consensus algorithm exists.

Weeks 28–birth

3rd trimester

Many small, uncomplicated hernias can be watched until after birth. Increasing pain, inability to push the bulge back when relaxed, color change, vomiting, rapid heartbeat, or low blood pressure shifts the decision from follow-up to urgent evaluation.

What does the evidence show for umbilical hernia?

• A reducible adult umbilical hernia is usually a navel-area protrusion that can flatten when relaxed, while incarceration or strangulation more often produces an irreducible, tender, sometimes discolored bulge with vomiting or systemic illness. 1
• A pregnancy-focused narrative review found no consensus on elective timing: emergency repair is necessary for incarceration or strangulation, symptomatic uncomplicated hernias may be considered for planned repair, and small asymptomatic hernias can often wait until after birth. 2
• In an ACS-NSQIP review, 126 pregnant patients underwent umbilical hernia repair from 2005 through 2014 and 73 had incarceration or strangulation; the database reported maternal 30-day outcomes but did not establish fetal outcomes or long-term recurrence. 3
• Tenderness, swelling, or discoloration over an umbilical hernia can signal loss of blood supply to trapped tissue and requires emergency assessment rather than home pressure, taping, or watchful waiting. 4
• Adult surgical decisions depend on pain, functional limitation, enlargement, reducibility, hernia size, other abdominal-wall findings, and overall health; imaging is generally reserved for an uncertain examination or concern about the contents. 1

When should I call my provider about umbilical hernia?

Go to emergency care for a navel bulge that becomes suddenly or increasingly painful, firm, tender, swollen, discolored, or impossible to reduce, especially with vomiting, a fast heartbeat, faintness, or low blood pressure symptoms. These features can accompany incarcerated or strangulated tissue and need urgent surgical assessment. Do not repeatedly push on a painful bulge or wait for a routine prenatal visit. If you are ever unsure which side of the line you are on, make the call. Obstetric teams handle these check-ins as routine, not as overreacting.