It’s common for women to develop hemorrhoids during pregnancy and after childbirth, especially when they have a vaginal delivery. However, you can still develop hemorrhoids after a C-section.
Hemorrhoids are common in pregnancy and childbirth due to constipation and the extra pressure your pregnancy puts on the anus, rectum, and blood circulation.
Some women may notice they started to develop hemorrhoids in the weeks before their baby's delivery. Regardless of when the hemorrhoids occurred, finding an effective remedy is important.
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Hemorrhoids, also known as piles, are enlarged or inflamed veins that appear as swollen lumps in the anus and rectum. Hemorrhoids can be external or internal.
External hemorrhoids occur in the anus. They appear as swollen red or purple lumps under the skin.
The symptoms of external hemorrhoids are:
Itching around the anus
Hard and tender lumps around the anus
Anal pain when sitting or going to the toilet
Internal hemorrhoids differ from external hemorrhoids since they’re inside the body, deeper in the rectum. Due to their different location, the symptoms are slightly different.
Symptoms of internal hemorrhoids are:
Bright red bleeding from the anus after a bowel movement (pooping)
Typically painless unless they prolapse and strangulate (when internal hemorrhoid bulges out of the anus and the blood supply cuts off)
Postpartum hemorrhoids are hemorrhoids that form after childbirth. Some women develop hemorrhoids during their pregnancy, especially in the weeks leading up to delivery.
Up to 85% of pregnant women deal with hemorrhoids, so it's not uncommon. Still, many women worry about treating these hemorrhoids.¹
Since many hemorrhoid treatments require over-the-counter medications or topical creams, it's understandable why many women are concerned. After all, as with any medication, it may pose a risk to your unborn baby, or it might not be safe to use while breastfeeding.
It's always best to obtain your treatment from your doctor or pharmacist. That way, you can double-check with them to ensure it's safe for your baby.
The primary cause of postpartum hemorrhoids is the enlarging uterus:
Changing your blood vessels
Increasing pressure in your abdomen
Compressing the rectum, leading to constipation and straining
A 2022 study found various other factors associated with postpartum hemorrhoids. This include:²
Constipation during pregnancy
History of perianal disease
Straining during delivery for more than 20 minutes
Giving birth to a baby who weighs more than 8lbs 6oz (3.8kg)
The symptoms of postpartum hemorrhoids are similar to those of regular internal or external hemorrhoids.
Bleeding after a bowel movement
Swelling around the anus
External hemorrhoids also can commonly thrombose (become blocked by a blood clot) during pregnancy and after childbirth, which can cause severe and sudden pain.
Although hemorrhoid symptoms can negatively affect your quality of life, they are treatable. Pregnant women tend to have good access to healthcare, including obstetric gynecologists (OB/GYNs), who will understand postpartum hemorrhoid symptoms and how to manage them.
Recommended treatments and lifestyle changes include:
Laxatives or stool softeners (to reduce straining)
Increasing the fiber content in your diet
Maintaining healthy toilet habits
Healthy toilet habits include:
Not delaying trips to the bathroom
Avoiding sitting on the toilet for too long
Avoiding straining when passing stool
Experts also state that topical treatments for hemorrhoids (creams or gels) have not been assessed for safety in pregnancy; however, as they’re topical, your body is unlikely to absorb much of the treatment.
It’s best to consult your doctor or pharmacist before trying any of these options.
If your hemorrhoids require surgery, your doctor will consider this decision carefully. Since some surgical procedures can be pretty invasive, your doctor may avoid surgery until it’s safe to do so after childbirth or lactation.
One home remedy you can try is a sitz bath. A sitz bath is a warm tub of water that you sit in to soak the hemorrhoids. You can add Epsom salt to the sitz bath, but this is optional.
Another home remedy is a small ice pack. Ensure you wrap it with a cloth or paper towel before applying it to the area to avoid the risk of ice burns.
If your hemorrhoids persist for longer than one week, it’s best to seek advice from your doctor. If the swelling or pain worsens before then, don’t hesitate to seek help.
Unfortunately, it can be challenging to avoid postpartum hemorrhoids entirely. That’s because there’s increased intra-abdominal pressure on the anus and rectum during pregnancy.
If you have a history of hemorrhoids or perianal disease, mention this to your doctor in case they can offer further advice or assistance.
Generally, some things you can do to avoid hemorrhoids include:
Increasing fiber in your diet or taking a fiber supplement
Taking a stool softener
Avoiding straining during bowel movements
Avoiding sitting on the toilet for extended periods
Postpartum hemorrhoids refer to hemorrhoids that occur after childbirth. However, it's also possible to experience hemorrhoids during your pregnancy. These types of hemorrhoids may persist for some time after the birth of your baby, as it takes time for your body to recover. It’s a good idea to speak to your doctor to find out which treatment options are suitable for you.
For most women, the problem resolves shortly after birth. In some cases, hemorrhoids may persist for weeks unless you seek treatment.
While the problem may resolve itself, you can try several treatments if the hemorrhoids don’t go away. For example, stool softeners or laxatives may help.
If you have a history of hemorrhoids or perianal disease, you may have recurring hemorrhoids. However, when the same hemorrhoids persist, see a doctor for further treatment and advice.
Hemorrhoids in pregnancy (2008)
Definition & facts of hemorrhoids | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)