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Q. I am 30 weeks pregnant with my third child. I was diagnosed with an umbilical hernia around 20 weeks. I wrap my belly with a thick bandage for support, but still have much discomfort not only in the navel area, but also in the center above my navel all the way up to the breast bone. My doctor says natural delivery will not affect the hernia, although I told him it hurts to cough or sneeze! Walking, sweeping and picking up my two-year-old hurts! How can all the pushing from labor not make it worse and more painful? Should I be concerned about having further effects sustained from the labor/delivery?
A. I, too, had an umbilical hernia during my second pregnancy and had the same concerns about the state of my navel during childbirth. I'm happy to report that labor and a vaginal delivery had no effect on the hernia. In fact, I didn't have discomfort in the navel area from the onset of labor until a few weeks after my baby was born.
You may notice that your hernia is more painful when a bit of innards poke out through that hole in the muscle wall. Certain motions, like picking up a two-year-old, can make those innards pop out and-…ouch, that hurts! My theory is that during labor and delivery, the pressure and hardness of the contracting uterus prevent your innards from getting anywhere near the hole in the muscle wall of the abdomen.
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Q. My doctor says my umbilical hernia should be fixed by a surgeon a few months after delivery. He does not want to fix it for me unless he does tubal ligation (which my husband and I are considering). I would rather it be done right after delivery so I don't have to go through surgery later. Is there a chance it will go away on its own after delivery? If surgery is not done right away, what will my navel look like? Will it still protrude? Will surgery make the navel look flat again?
A. Your umbilical hernia probably won't go away after childbirth, but it may improve a little in feeling and appearance. After your uterus returns to its former size, much of the pressure will be taken off your navel area.
I'm still living with my umbilical hernia and it's been over two years since my diagnosis during my second pregnancy. I eventually will have the surgery done to repair it and do wish that I did it earlier. I wanted to see if I could strengthen my stomach muscles enough to compensate for the hole in the muscle wall. In my case, sit ups and crunches did help a little, but I still have an occasional episode of painful guts popping out. Also, I'm still unhappy with the look of my belly button. Although it no longer protrudes like Pinocchio's nose, the skin appears stretched and flaccid.
If you are considering abdominal surgery like the tubal ligation, having your hernia repaired at the same time would be ideal. If you decide to wait and have the surgery done later, there are advantages there, too. You may decide you can live with your hernia or you may want to incorporate the hernia surgery with a tummy tuck. Another thing to consider is whether or not you are really done with having children. Most surgeons will recommend only having this procedure if you are finished with your childbearing years.
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Q. I am 36 1/2 weeks pregnant with my third child. I went in for my check-up and found out that my fundus height is not up to par. My doctor sent me to have an ultrasound and I found out that our baby is only 4lbs., 2oz. My other two were 6.2 and 6.4. I also have low amniotic fluid and the baby is in a footling breech position. I'm being monitored every 3-4 days with Non-Stress Tests and ultrasounds. I do not drink, smoke, etc. Everything is normal with the baby except the weight. What would be the cause of low fluid? My doctor wants me to increase my sodium and do kick counts. I am a little out of sorts because I had completely normal pregnancies and deliveries the first two times.
A. It's not always known what causes low amniotic fluid or oligohydramnios. Some causes in the third trimester can be due to:
• Leaky or ruptured membranes - You might have a small tear in the amniotic sac that allows fluid to leak out. The tear may heal on its own and the fluid will return to normal. Otherwise, your practitioner will need to watch you carefully for the rest of your pregnancy. As long as there are no signs of infection and all is well, you and your baby should be fine.
• Placenta problems - The placenta may have a problem that keeps it from supplying enough blood and nutrients to the baby, which could cause the baby to stop recycling fluid. If you're diagnosed with this kind of problem you may be told to go on bed rest to try to preserve as much fluid as possible.
• Medications - Certain drugs may cause oligohydramnios, including ACE inhibitors (used for management of high blood pressure) and prostaglandin inhibitors such as indomethacin or ibuprofen. As with most drugs during pregnancy, these should be avoided.
When you're near delivery, low fluid may increase your risk for complications during labor. The fluid may get so low that your baby will compress the umbilical cord and cut off the oxygen supply. If your practitioner thinks your baby is at risk, labor may be induced. If your doctor believes that labor will cause further constriction of the cord, you might have a Cesarean delivery.
Try not to worry. With close monitoring, as your doctor is practicing, you have a very good chance for delivering a perfectly healthy baby.
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Q. I am 22 and pregnant with my second child. Last night I was sleeping on the couch and I sat up using mostly my stomach muscles with a little bit of help from my arm. When I lay back down, my whole stomach was shaking like the baby was having a spasm. This lasted for about 15 seconds. Could I have hurt the baby when I did this? I still feel fetal movements, but the whole shaking thing really scared me as I never had that in my first pregnancy.
A. I imagine you must have woken your baby from a sound sleep, causing him or her to spasm. You may have even interrupted a dream. Whatever the case, the contraction or use of your stomach muscles most likely had no ill effect on your baby.
Q. I am in my 19th week of pregnancy and just returned from a week in the Caribbean. I noticed that while on the trip there were many days where my stomach felt quite hard and I thought that I had finally "popped." I had a bout of diarrhea yesterday as well as this morning. I woke this morning not feeling pregnant anymore. My stomach felt normal. I could suck it in when in weeks previous I hadn't been able to, and I am wearing a pair of smaller pants with ease. Could it have been that I was extremely bloated and that's what the hard stomach was? Could something I have eaten there have affected the baby? Why am I not feeling pregnant anymore?
A. I think your self diagnosis sounds right– you must have been gassy and bloated, which made your midsection larger and harder. I can remember being extremely bloated for weeks at a time before I got some relief. After the pressure of the gas passed, my belly, like yours, was no longer as big. Unless you go down another size in pants, I wouldn't worry about your slightly shrinking belly.
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Q. I just found out recently that I was about a week and a half pregnant. My stomach started to get hard after a week and a few days. Is that normal?
A. The "hardening" feeling you may experience in your uterus during early pregnancy is very normal. It almost feels as if the uterus turns to stone. For me, it was my first symptom of pregnancy with both my babies.
Q. I've had three C-sections. After my last one I asked if I could have one more and was told yes. Then I mentioned that I have two hernias, one inguinal, and one incisional. I feel that I've had the inguinal for a long time. It has not bothered me for eight months, and my incisional has never bothered me. I just have this awful-looking pouch and you can feel a very small hole. I know that I did too much after giving birth to my last child (picking up my little ones, etc.). All of my kids are 21-22 months apart. My OB then said that she thinks I am a candidate for a uterine prolapse. I had pain with all three pregnancies and I thought that it was normal. Do you think it is possible to have one more baby? I am 38 and plan on having the surgery soon.
A. Without being a medical professional and knowing the extent of your hernias, it's hard for me to give you a solid answer. I do know that once you have the surgery to close the hernias, you should not get pregnant again because it could tear the stitches and create a bigger problem. If you really want to carry another pregnancy, I think you should get another opinion before making a final decision on having the surgery now or after a fourth pregnancy. Maybe you should just do what your "gut" tells you is the right choice.
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Q. I had my baby almost five months ago. He was ten pounds and I gained almost 50 pounds. I still have about 10 pounds to lose but my concern is my sagging belly. I still have a pretty big layer of fat, but it is saggy. Once I lose the weight will the skin still sag?
A. I, too, gained quite a bit of weight during my first pregnancy – about 60lbs. I found my saggy, fatty belly did tighten up a bit when I finally lost all of the pregnancy weight. And, it also tightened up a bit more when I started doing sit-ups and abdominal crunching exercises. Unfortunately, the skin still is very loose, scarred with stretch marks and a bit saggy looking. I'm quite envious of my friend, Kelly, who had twins and now has her perfectly taught, pre-pregnancy-looking belly back. I think the elasticity of your skin all depends on heredity. If your mother had a loose, saggy belly after childbirth, you probably will too. Just chalk it up to another battle wound of pregnancy, I always say!
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