Hemorrhoids and Pregnancy

There is definitely one pregnancy symptom that is not at all enjoyable: hemorrhoids. They can show up during pregnancy or in the postpartum period, and up to 35 percent of pregnant women will experience them. Either way, they can be a nuisance.

Hemorrhoids are varicose (or dilated) veins that originate from the anus. If they appear during pregnancy, it is often in the third trimester. This is because of the increased blood flow and pressure in the area. Blood that would normally easily drain from the lower part of your body back up to your heart has a bit of a harder time getting past your uterus. Also, the extra weight that comes with pregnancy puts more pressure on these blood vessels that are already weakened by the effects of progesterone (which increases in pregnancy). This is why varicosities in your legs, vulva, and bottom can be so common.

Hemorrhoids get more pronounced with straining. This is commonly seen in women who are constipated. When else might you strain and bear down repeatedly during pregnancy? You guessed it – in labor. Women who have hemorrhoids may notice they acutely worsen right after delivery, especially if they pushed for a while.

Common symptoms for hemorrhoids include seeing or feeling a bump, minor irritation, itching, pain with bowel movements, fecal incontinence, or noticing blood on toilet paper after wiping. If you do notice any blood, it is important to let your doctor or midwife know so they can make sure the bleeding is not coming from anywhere else that could be concerning.

To prevent constipation and ultimately hemorrhoids, it is important to stay hydrated, eat high fiber foods, exercise, and take stool softeners as needed. Try to stay within the recommended weight gain guidelines to avoid excess weight, which is another hemorrhoid risk factor. If you notice they worsen after being on your feet for a long time, take frequent breaks to sit or lie down to help your blood drain better from the lower part of your body.

Hemorrhoids tend to go away with time, but there are some treatments you can try that are safe in pregnancy. Warm water baths can help relieve pain, and you can buy a sitz bath from a pharmacy to make this easier. Topical preparations that include numbing medication, steroids, and anti-inflammatory agents can all be found over-the-counter in the form of creams, suppositories, sprays, and wipes. Lastly, more invasive treatments like surgery and cryotherapy are reserved for women who have failed more conservative treatments or have very severe cases.

Reviewed by Dr. Jen Lincoln, November 2018

Sources:

• March of Dimes
• Hemorrhoids.
  Staroselsky A, et al
• Hemorrhoids in pregnancy
• Can Fam Physician
• 2008 February; 54(2): 189–190.

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