Having a hernia repaired is a common surgery, with over 1 million hernia repairs performed each year in the U.S. alone. While hernias can occur in both men and women, some types of hernias are more common in women, such as umbilical and incisional hernias.
If you are a woman who either has undergone or will be getting hernia surgery, you may be wondering how the procedure could impact your fertility and ability to get pregnant afterwards. Here is a comprehensive overview of what women should know about pregnancy after hernia surgery.
- The two main types of hernia repair procedures are open surgery and laparoscopic (keyhole) surgery. Laparoscopic hernia repair generally has a shorter recovery time.
- It’s recommended to wait at least 6 weeks after open hernia surgery before trying to conceive. After laparoscopic surgery, you can start trying again after 2 to 4 weeks.
- Hernia repair should not affect your long-term fertility or chances of future pregnancy. The timing largely depends on allowing your body time to heal properly after surgery.
- Factors like the size and location of the hernia, if surgical mesh was used, and if any complications occurred could influence your surgeon’s specific recommendations for when to try getting pregnant.
How Do Hernias Develop in Women?
A hernia occurs when an organ or fatty tissue pushes through a weak spot or tear in the surrounding muscle or connective tissue. Hernias often develop in the abdomen between the chest and hips.
Some of the major types of hernias that can occur in women include:
- Inguinal hernia: Occurs in the inner groin area when abdominal contents protrude through a weak spot in the inguinal canal. More common in men but can occur in women.
- Incisional hernia: Develops through an incision or scar in the abdomen from a previous surgery or C-section.
- Umbilical hernia: Forms when abdominal contents push through an area of weakness around the belly button.
- Femoral hernia: Protrudes through the femoral canal in the upper thigh/groin which contains blood vessels.
- Hiatal hernia: Part of the stomach pushes up through the hiatus, an opening in the diaphragm.
Hernias may be present at birth due to a natural defect but can also develop later in life. Factors that increase the risk for hernias include pregnancy, straining from constipation, chronic coughing or sneezing, intense physical activity, obesity, and previous C-sections.
Symptoms like pain, swelling, or a visible bulge at the hernia site may occur. However, hernias don’t always cause noticeable symptoms.
Why Hernia Repair Surgery is Performed
There are two main reasons hernia surgery is performed:
1. To Relieve Uncomfortable or Painful Symptoms
Hernias that are causing obvious symptoms often warrant surgical repair. The protruding tissue and abdominal contents can lead to intense pain, especially when straining, bending, or lifting. Strangulated hernias that get pinched off from blood flow need emergency surgery.
2. To Prevent Potential Complications
Even small, asymptomatic hernias that don’t cause pain carry risks like becoming strangulated, growing larger, or developing complications over time. For this reason, elective hernia repair surgery is often recommended even without overt symptoms.
Potential complications from untreated hernias include:
- Increased pain, swelling, or abdominal discomfort
- Bowel obstruction or strangulation
- Tissue death due to loss of blood flow
- Hemorrhage if the hernia sac twists or ruptures
- Abscesses or perforation of bowel
- Recurrence after the hernia spontaneously reduces
Repairing a hernia before complications set in is safer and generally has better surgical outcomes. Letting a hernia go untreated could lead to life-threatening conditions in some cases.
Types of Hernia Repair Surgeries and Procedures
There are a few surgical approaches your doctor may use to treat a hernia, with the best technique depending on the hernia type and size.
Open Hernia Repair Surgery
In open surgery, the surgeon makes an incision near the hernia and pushes the protruding tissue back into place. They will then close the abdominal wall defect using sutures. Sometimes a synthetic mesh is also sewn into place to reinforce the weak spot and prevent recurrence.
Open hernia repair usually causes more post-operative pain and longer recovery than keyhole techniques. But open surgery may be necessary for very large or complex hernias.
Laparoscopic Hernia Repair Surgery
With laparoscopic hernia repair, a small camera is inserted through a tiny incision to visualize the hernia during the procedure. Using the live camera feed displayed on a monitor, the surgeon repairs the hernia using instruments inserted through 3-4 additional small incisions.
Laparoscopic repair has benefits including:
- Faster recovery with less post-operative pain
- Lower risk of infection
- Smaller scarring
However, not all hernia cases are suitable for a laparoscopic approach.
Hernia Mesh Repair
In some hernia surgeries, the surgeon implants a hernia mesh to add further support to the weakened abdominal wall. The mesh acts as an internal reinforcement or “patch” over the defect.
Mesh repair helps lower the risk of hernia recurrence but also has potential risks like infection or adhesion formation. Your doctor will determine if mesh is appropriate for your situation.
Robotic-Assisted Hernia Repair
Robotic hernia surgery is a technically advanced, minimally invasive approach similar to laparoscopy. The surgeon performs the repair using a robotic system with small, agile instruments for precise movements.
Potential benefits of a robotic-assisted procedure can include smaller incisions, faster recovery, and lower recurrence rates compared to open surgery.
Recovery After Hernia Surgery: What to Expect
Recovery time can vary significantly based on the type of hernia repair procedure performed. Here’s an overview of the typical recovery process:
- First 1-2 weeks: Rest at home with activity restrictions; discomfort, bruising, and swelling improve; follow wound care instructions.
- 2 weeks onward: Gradual increase in activity and light exercise; most can return to desk work within 2-3 weeks; driving after 2 weeks if comfortable.
- 1-2 months: Continued strengthening and wound healing; most patients can resume normal activities including more strenuous exercise around 6-8 weeks post-op.
- 3-6 months: Maximum lifting restrictions apply for about 3 months after surgery before all activities can be resumed.
Factors like your age, health status, hernia size, surgery complexity, and if mesh was used can all impact individual recovery times.
Can a Woman Get Pregnant After Hernia Surgery?
Many women wonder when it’s safe to get pregnant after hernia repair surgery. Here are some general guidelines:
- For open hernia surgery, it’s recommended to wait at least 6 weeks before trying to conceive. This allows time for the deeper abdominal incision to heal and for internal swelling to resolve.
- After laparoscopic hernia repair, you may be able to start trying to get pregnant within 2 to 4 weeks since the recovery period is typically faster.
- If hernia mesh was used during repair, your surgeon may suggest waiting 3 months or longer before pregnancy. The mesh needs time to fully incorporate so the added pressure of pregnancy doesn’t impact the repair site.
- For large or complex hernias, your doctor may advise waiting 6 months or more before conceiving.
The timing will depend on your surgeon’s assessment of the procedure performed and your body’s recovery. Their recommendations are meant to ensure the hernia repair is stable and secure before adding the extra weight and pressure of pregnancy on the abdomen.
Always check with your doctor about when it’s okay for you personally to start trying to conceive after hernia surgery.
Does Hernia Repair Affect Future Fertility or Pregnancy?
In most cases, having a hernia repaired does not affect a woman’s fertility or ability to conceive after she has adequately healed from the surgery.
The factors that contribute to hernia development like aging, obesity, and genetics have no direct bearing on the functioning of the reproductive organs. And the hernia surgery itself is focused on repairing tears or weaknesses in the abdominal wall muscles and connective tissues only.
The sperm, egg, fallopian tubes, uterus, and other reproductive structures are not impacted by standard hernia procedures. Any effects on conception after surgery are related to allowing time to heal rather than long-term fertility problems.
In rare cases, a portion of involved reproductive organs may need to be removed if they become damaged within an abnormally located hernia. But this is not generally the case for routine hernia repairs.
For women who do get pregnant after prior hernia surgery, the repaired area could be at higher risk of recurring during the pregnancy. But this is not inevitable. And surgical techniques like mesh reinforcement help strengthen the site and reduce recurrence risk.
Are There Increased Risks With Pregnancy After Hernia Repair?
While hernia repair surgery itself does not inherently make pregnancy riskier, there are some factors to consider after surgery that could influence issues like hernia recurrence or C-section probability.
Hernia recurrence – Pregnancy places greater pressure and tension on the abdomen which could predispose a previous hernia repair site to recur, especially during the 3rd trimester. Using mesh reinforcement reduces this risk. Let your obstetrician know about any prior hernias.
C-section probability – If abdominal mesh was used during hernia repair, a vaginal delivery may be risky since pushing could damage the mesh. Your OB/GYN will determine if a C-section is recommended.
Surgical complications – If you developed any postsurgical complications like infection, chronic pain, or bowel obstructions, this could influence pregnancy risks and delivery plans.
Poor wound healing – Defective wound healing after hernia surgery may lead to concerns about the integrity of the repair during pregnancy.
While not all women will experience complications when pregnant after hernia surgery, these are factors your women’s health doctor will take into consideration when advising you prenatally.
How is Pregnancy Managed After Hernia Repair Surgery?
If you are planning to become pregnant after hernia surgery, there are some things you can do to help ensure a healthy pregnancy:
- See your OB/GYN and surgeon for a preconception checkup to confirm you are fully recovered from surgery and cleared for pregnancy.
- Monitor the hernia repair region for signs of recurrence like pain or bulging, and promptly report concerns.
- Avoid heavy lifting, intense exercise, and added abdominal strain during pregnancy to reduce pressure on the repair site.
- Manage pregnancy-related constipation to avoid bearing down and follow dietary/lifestyle recommendations to prevent strain.
- Closely control coughing or sneezing by splinting the repair region with a pillow or hands.
- Gain pregnancy weight through diet only, not calorie surplus, to limit unnecessary added pressure.
- Work with providers to decide if a C-section is warranted based on your hernia details and mesh placement.
- Address any chronic post-surgical pain prior to pregnancy that could be amplified by the added weight.
Taking these kinds of precautions can help support the hernia repair and may lower risks during pregnancy after surgery.
- Recovering fully from hernia surgery before getting pregnant is vital, with 6 weeks minimum for open procedures and 2-4 weeks for laparoscopic methods recommended.
- In most cases, hernia repair does not negatively impact long-term fertility or the ability to carry a pregnancy.
- However, pregnancy does place more strain on the surgery site, so risks of recurrence may be elevated and require close monitoring.
- Surgical mesh, complicated hernia repairs, and certain postoperative complications can also influence pregnancy risks and delivery plans.
- Preconception counseling and following your surgeon and OB/GYN’s advice can help ensure the best possible pregnancy outcomes after hernia surgery.
Frequently Asked Questions About Pregnancy After Hernia Repair Surgery
Can I have a vaginal birth after hernia mesh repair surgery?
Vaginal delivery is often possible after hernia mesh repair, but depends on the mesh location. If the mesh is near the pubic bone, many OBs recommend scheduled C-section to avoid damaging the mesh since pushing could dislodge or tear it.
Should I opt for open or laparoscopic hernia surgery if I may want to get pregnant after?
Laparoscopic hernia repair generally has a shorter recovery time and may be preferable if you are planning to conceive within the next few months after surgery. Open repair requires more healing time but may be recommended for complex hernias.
Is hernia repair surgery ever cause for delaying planned pregnancy?
If possible, it may be prudent to postpone planned pregnancy attempts for around 6 months after hernia surgery to allow for the strongest healing and lowest recurrence risk during pregnancy. Discuss the best timing with your surgeon.
Can hernia mesh erode into reproductive organs like the uterus?
Hernia mesh erosion is very rare with less than 1% incidence. Mesh that directly contacts reproductive structures could potentially erode over time. But currently there is no evidence of fertility or pregnancy risks due to mesh implantation for standard hernia repairs.
Undergoing hernia surgery does not have to mean indefinitely putting off pregnancy plans. With adequate recovery time for healing based on the procedure performed, most women can go on to get pregnant and deliver vaginally or via C-section after hernia repair as recommended by their care providers.
Some increased risks like hernia recurrence exist with the added abdominal pressure of pregnancy. But steps can be taken to closely monitor and support the previous repair site.
In the majority of cases, past hernia surgery and use of surgical mesh should not notably impact fertility or prohibit carrying a healthy pregnancy. Being evaluated pre-pregnancy and communicating with your OB/GYN ensures you can conception after hernia repair as safely as possible.