Belly Button Pain in Pregnancy

The stomach pain rules still apply

Before anything else, belly button pain is stomach pain, and the NHS test for stomach pain applies to it: "It's probably nothing to worry about if the pain is mild and goes away when you change position, have a rest, do a poo or pass wind."

Call your maternity unit immediately if you have stomach pain and any of these:

• vaginal bleeding or spotting
• regular cramping or tightenings
• lower back pain
• unusual vaginal discharge, or fluid leaking from your vagina
• pain when you pee, or needing to pee suddenly or more often than usual
• pee that looks cloudy, pink, red or brown
• pain that is severe, or does not go away after resting for 30 to 60 minutes

The HSE adds, for the third trimester, that severe pain or a tummy that feels tender when you touch it warrants contact, as does pain higher up in the stomach or chest alongside a headache, swelling or blurred vision.

Why the navel hurts

Nothing exotic is happening. The abdominal wall is being stretched from the inside, and the navel is the thinnest, least supported point in it. Three things happen there at once.

• Skin stretch. The NHS notes that the first sign of stretch marks people often notice is "itchiness around an area where the skin is becoming thinner". The same thinning around the navel produces stinging, itching and a raw sensitivity to waistbands.
• Pressure from behind. As the uterus rises out of the pelvis it pushes directly against the abdominal wall. Most people notice navel discomfort start in the second trimester and peak in the third.
• Separation of the abdominal muscles. The two vertical strips of muscle down the front of the abdomen move apart as the bump grows, leaving less support behind the navel. This is ordinary and largely recovers after birth.

Why it pops out

An innie becoming an outie is one of the most common and least discussed changes of the third trimester. The pressure behind it simply pushes it inside out. It is not a sign of anything, it is not related to how big your baby is, and it usually reverts in the weeks after birth, though it can stay slightly looser than before.

Piercings are the practical complication. Jewellery that fits comfortably at 20 weeks can pull and catch by 34 weeks, and a stretched or sore piercing site is easier to prevent than to treat.

When a bulge is a hernia

This is the distinction worth understanding. An umbilical hernia is when tissue pushes through a weak spot in the abdominal wall at the navel. The NHS describes hernias generally as producing "a lump or swelling" that may disappear when you lie down, and that can often be pushed back in.

Pregnancy raises abdominal pressure for months, so it is a classic time for a small pre-existing weakness to become obvious. Most umbilical hernias in pregnancy cause little more than a soft bulge and some discomfort, and are reviewed after birth rather than during pregnancy.

The version that is urgent

The NHS names the complication to know about: a hernia can become trapped (incarcerated) or have its blood supply cut off (strangulated), and that needs emergency treatment. Get urgent medical help if a hernia lump:

• becomes firm, hard or tender and cannot be pushed back in
• is suddenly, severely painful
• comes with being sick, or with a tummy that is swollen and not passing wind or stool

This is rare, and it is worth knowing precisely because the everyday version is so common and so harmless.

What helps

There is no national guidance devoted to navel pain, so the measures below are low-risk and follow from the mechanism rather than from trials.

• Change what sits on it. High-waisted, soft-band maternity clothing rather than anything with a seam or button at navel height.
• A soft dressing or plaster over the navel stops friction from clothing where the skin has become raw.
• Moisturiser. The NHS is clear that no cream is proven to prevent stretch marks, and ACOG says using a heavy moisturiser may help keep skin soft but will not remove them. It does help the itch, which is the honest reason to use it.
• Support. A maternity support band can reduce the drag on the abdominal wall for some people, particularly if you are on your feet a lot.
• Roll, do not sit up. Getting out of bed by rolling onto your side first, rather than curling straight up, takes a surprising amount of strain off the front of the abdomen.
• Remove piercing jewellery or switch to a flexible retainer before it becomes sore rather than after.

Pain around, but not in, the navel

Two common patterns get described as belly button pain and are worth separating.

Sharp pain to one side, low down. The NHS describes ligament pain as feeling like "a sharp cramp on one side of your lower tummy", often triggered by standing up quickly, coughing, sneezing or rolling over. It is harmless.

Pain above the navel, high in the stomach. The HSE names "pain higher up in your stomach or chest" as a pre-eclampsia sign when it comes with a headache, swelling of the hands, feet and face, or blurred vision. That combination is not a navel problem and needs a call.

Everything else — aching, stinging, itching, sensitivity to clothing, and a navel that has turned itself inside out — is the ordinary consequence of a body being stretched in a direction it was not designed to be stretched, and it resolves.