Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Pregnant with a pre-existing umbilical hernia. I don't know much yet, and I have questions.Age/sex: 29F | Height: 5ft 0in | Weight: 117 lbs (~105lbs before pregnancy) | Race: whiteI am 16 weeks pregnant with my first child. I live in the US.Yesterday, I had my 16wk OB appointment. We measured baby's HR at 140bpm, woo! But I have also been referred to a surgeon regarding my umbilical hernia, which, to my knowledge and limited understanding, I got in infancy (my mom watched my bellybutton "pop out" during a screaming fit). Yesterday, before the OB measured baby's HR, I told her about my "outtie" belly button and how it's already doubled in size since pregnancy; also about a day last week when I scraped a bathroom stall door against my bellybutton while opening it, which immediately caused sharp, downward shooting pains and overall abdominal discomfort that lasted for the rest of the day. She kind of wrote it off ("bellybuttons sometimes get sensitive during pregnancy"), until I laid down for her to get the heartbeat. She then looked closely at my bellybutton and asked me to do a sit up, then mentioned that she would be referring me to general surgery for an umbilical hernia. I asked her what the medical implications of an umbilical hernia with pregnancy would be, and she just said, "a lot of pain that we can't do anything about."So that was scary, and made me question why even see a surgeon now? Just to confirm it's a hernia? But then I did some googling, and have further confused and worried myself.My consultation with the surgeon isn't for another month, coincidentally the same day as my 20 week ultrasound._________________________________Here's some more info about my experience that might be relevant:-My bellybutton has always been sensitive, even as an adult. It was much bigger as a kid and got smaller as a I grew up, but definitely still an "outtie." When I was a kid, I remember it filling up and getting "hard" when I had gas. I would "pop" it and it would "deflate." That stopped happening by the time I was like 7 y/o.-I have struggled with constipation on and off throughout the years, but I wouldn't say it's generally "severe." I have had occasions when I'd go 4-6 days without a BM where it seemed like nothing helped, but overall, if I pay attention to lifestyle/proper nutrition, I don't go more than 1-2 days without a full BM.-Only today have I noticed a bulging under my bellybutton. And it's only when I lean back far enough so the rest of my belly/organs/fat go down so I can see it. I've never noticed this before, and I assume it's due to the pregnancy.-I've always had a pretty strong core with visible muscle tone and minimal stomach fat._________________________________I would really appreciate any comments/information about what to expect, what possible outcomes are, other experiences, etc. But some of my specific questions are:-Does this pretty much guarantee I'll need a C-section delivery? (to avoid the strain of pushing)-Is it possible to not need surgery at all-- neither during pregnancy nor after?-Will a CT scan be necessary?-Will I inevitably be in a lot of pain?-What would make a surgery necessary while pregnant? (I understand there is also an option of having the hernia surgery at the same time as C-section)-What, if anything, should I look out for before my consultation that would constitute an emergency?________________________________________I think that's all, I'll edit if I think of something else I should add.Thank you so much in advance!. ### Response: -Does this pretty much guarantee I'll need a C-section delivery? (to avoid the strain of pushing)No, I don't believe so. I'm not ob/gyn but a general surgeon, so I could be wrong on the indications for a c section.-Is it possible to not need surgery at all-- neither during pregnancy nor after?Depends on if you want it fixed, if its causing you pain, etc. Not mandatory in all cases.-Will a CT scan be necessary?No, usually not unless the surgeon is unsure of something, and a CT is contra-indicated in pregnancy.-Will I inevitably be in a lot of pain?No. Some hernias cause pain, others do not.-What would make a surgery necessary while pregnant? (I understand there is also an option of having the hernia surgery at the same time as C-section)Incarceration or strangulation.-What, if anything, should I look out for before my consultation that would constitute an emergency?hard, very painful lump at your belly button that you cannot push back it and it continues to become more and more painful..