What Can Cause an Outie Belly Button in Pregnancy? Is It an Umbilical Hernia?

A hernia occurs when an internal organ pushes through the rectus abdominis muscle wall, which is thin and weakened.  As the uterus grows and amniotic fluid and other retained fluid increase, pressure builds and pushes behind the belly button, which may lead to pushing outward.  Don’t worry.  This is very normal.  Usually, it will rectify within a few months after pregnancy.  If you are having problems later on and pelvic floor exercises are not resolving them, it is worth having a review with a consultant to see whether an umbilical hernia is present and whether surgery may help.

Is Surgery Required and What Happens?

Surgery is usually done if the belly button becomes symptomatic with soreness, but it can also be done for cosmetic reasons. It is usually best to wait until the pregnancy is over before correcting an outie belly button, as the problem may recur during pregnancy. Also, be wary of rushing into wanting surgery if you have a large hernia, as it is usually recommended to wait a year before becoming pregnant again.   The consultant will decide which option is best for you, either keyhole surgery or inserting a mesh.  It is essential to have physiotherapy before and after to increase muscle strength and support your recovery.

What Are the Changes in the Muscles During Pregnancy?

The whole structure of the rectus abdominis muscle is changed during pregnancy.  The muscles significantly shift in length and separate. Their function is compromised, reducing the ability to stabilize the pelvis as the pregnancy progresses.  In most pregnancies, the separation is resolved by 4 weeks after birth, and muscle function returns to pre-pregnancy levels by 8 weeks after birth.  However, the muscles' ability to stabilize the pelvis remains low at 8 weeks.  These changes in the rectus abdominis can lead to the umbilicus pushing outward.

Effect of Changes in Hormones

Another factor that may contribute to the development of an umbilical hernia is increased relaxin release. This peptide hormone relaxes ligaments around the pelvis and softens and widens the cervix.