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.

Incisional herniaShare 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.

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.

These include:

  • 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.