Hemorrhoids During Pregnancy

By: Dr. Edward F. Group III, DC, Ph.D, ND, DACBN
updated on 06/06/2006 at 12:31PM

Hemorrhoids are essentially varicose veins of the rectum. Just as your legs are more susceptible to varicose veins during pregnancy, so to is the anal area. Hemorrhoids during pregnancy typically occur when a strain is placed on the anal area. Constipation, lack of exercise, and prolonged sitting or standing are all common causes of hemorrhoids, and all common complaints during pregnancy. Hormonal changes during pregnancy an increase in blood volume, and pressure on the uterus are also contributing factors to the development of hemorrhoids during pregnancy. And even though you will have plenty of other things to think about during your postpartum, if hemorrhoids are still present when you go into labor, it is likely that the pushing and strain of labor will make them worse. But there are some techniques that you can try to alleviate the symptoms of postpartum hemorrhoids.

Hemorrhoids and Child Birth

Hemorrhoids develop when excessive pressure is placed on the veins of the pelvic and rectal area. And never will the pressure be greater in this area than during child birth. Normally, blood fills the veins around the rectum during a bowel movement to aid in defecation. But during childbirth, the pressure against these veins becomes very intense. As the veins stretch and swell, the surrounding tissue will no longer be able to support them, and a hemorrhoid will develop. If you had hemorrhoids during pregnancy, it is likely that the intense pushing associated with labor will make them worse. And if you were free of hemorrhoids before child birth, it is entirely possible that you will be going home with yet another thing to care for in the postpartum period.

Alleviating Postpartum Hemorrhoids

Avoid Constipation: The best way to avoid hemorrhoids during pregnancy is to avoid the straining during bowel movements caused by constipation. And contrary to popular belief, constipation is not a necessary component of pregnancy or of postpartum recovery. Increasing water and fiber consumption will help keep soften the stools and move waste through the system.
Get A Little Fresh Air: Daily exercise will stimulate the digestive muscles to prevent constipation. It can also be amazingly therapeutic during the postpartum period to place your baby in a stroller or Snuggli and go for a walk. The air and change of scenery will be good for you and your baby.
Avoid Rectal Pressure: All of the veins of a woman's body have been stressed during pregnancy. And the rectal veins are no exception. The postpartum period is a time to bond with your newborn, and allow your body to heal from pregnancy and child birth. Try to sleep on your side and not your back. Don't strain during bowel movements or linger on the toilet (Although sometimes it feels nice just to sit down, exposing the rectal veins to this kind of pressure can cause or aggravate hemorrhoids.) If constipation is a problem, try sitting on the toilet with your feet on a step stool to make evacuation easier. Also, avoid long hours of sitting and standing that may put pressure on the rectal veins.
Practice Kegel exercises regularly to prevent Hemorrhoids During Pregnancy. You probably thought you were finished with Kegel exercises once labor and delivery were over. But Kegel exercises improve circulation to the rectal area and can prevent or alleviate the symptoms of hemorrhoids. To do Kegels, firmly tense the muscles around the vagina and the anus (as if you were trying to suppress the urge to urinate.) Hold the tense muscles for as long as you can, working up to a limit of eight to ten seconds for each repetition. Slowly release the muscles and relax. Try to do at least twenty-five repetitions of this exercise at various times throughout the day. (Doing Kegel exercises every time you breastfeed or give your baby a bottle will keep you on a regular schedule throughout the day…and it may be the only quiet time you get!)

Caring For Postpartum Hemorrhoids

You will be very busy during the postpartum period. But try to carve out a little time here and there to catch your breath and care for yourself. With a little care, hemorrhoids during pregnancy can be treated at home without medical intervention. Try these methods to ease the symptoms of postpartum hemorrhoids.

Take a warm sitz bath: The warmth and moisture associated with a sitz bath can alleviate the pain and itching of hemorrhoids. The key is to submerse the rectal area in hot water, either in a regular bath tub or in a specially purchased "sitz bath" that can be affixed to the toilet. Make the water hotter than your usual bath water and be sure to sit in enough to cover the affected area. It's best to sit in the bath for twenty to thirty minutes, two to three times a day. But realistically, for a new mom, you will probably be happy if you do this once a day and combine it with your regular bath!
Witch hazel soaks or ice packs may soothe inflamed hemorrhoids during pregnancy.
Natural Products: The natural product O2-Zap available at Global Helaing center is a great hemorrhoid cream. Hematrex can be taken after pregnancy but not during breast feeding.

Avoid topical medications, mineral oil, laxatives, or stool softeners unless they are recommended by your OBGYN.
Keep the rectal area clean: Anal hygiene is particularly important when hemorrhoids during pregnancy are present, as debris can irritate the sensitive tissues. Wash the anal area with a warm, wet washcloth or baby wipe, always remembering to wipe from front to back. Avoid rough toilet paper or paper that has dyes or perfumes.
Get off your feet: Lie down on you side several times a day. Try to watch TV, breastfeed, and rest with your baby in this position to alleviate pressure on the rectal area that can aggravate hemorrhoids during pregnancy.