I Have an Umbilical Hernia That Hurts when I Cough or Bear Down.

If you have a hernia that doesnot reduce, you may be at risk for an incarceration or basically a "stucK" piece of bowel or fat. This can cause tissue death of the piece that is incarcerated.  It may be advisable to have it repaired ASAP.  But, I would talk to a general surgeon.

A umbellical hernia is a danger when abdominal contents get caught within the space and the blood supply is blocked (strangulated).  A smaller hernia is actually more risky than a large one because it can entrap tissues and not allow an escape. Pain with exercise might signal that tissue is being intermittently caught. Plastic surgeons often repair umbillical hernias at the time of a tummy tuck, but this would not be a consideration if you are planning pregnancy.  The rate of having an acute abdomen from your hernia may be relatively low but your safest option is to have it fixed sooner rather than later.