Postpartum hernia: A common occurrence following a C-section

January 19, 2020

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By Dr Patricia Lim Su Lyn,
Obstetrician and Gynaecologist,
KPJ Tawakkal Specialist Hospital.

Postpartum hernia is a common condition that occurs after any type of surgery, but it is more prevalent after a caesarean section. While it is rare in a transverse incision, it is more common in a midline incision.

Postpartum hernia can be caused by weak collagen and tissues in the patient's body, making them more prone to the condition. It can also be a result of the patient resuming vigorous activities too quickly after surgery. To prevent postpartum hernia, patients should avoid any strenuous activities, including exercise and heavy lifting, for at least six weeks after surgery.

During the first six weeks, patients are encouraged to wear a girdle to support their abdominal muscles. The tissue in our tummy is likened to a mesh, and when a midline incision is made, the healing process is slower and the blood supply is reduced. This can lead to a deficiency in the area, causing a protrusion of the abdominal muscles when the patient coughs.

If the hernia is small, the patient may be asked to wear a girdle and return to their gynaecologist for a follow-up to ensure that the hole has closed. However, if the hernia is large, surgery may be required to repair it.

However, if the patient ignores the hernia and becomes pregnant again, it can cause discomfort as the womb grows and puts pressure on the hernia. This can lead to the bowel coming out and becoming strangulated, which can result in infection.

Patients who constantly exert pressure on their tummy, such as those with chronic cough or constipation, are at a higher risk of developing postpartum hernia. To prevent this, patients are usually given stool softeners after a caesarean section.