Pregnancy is a time of incredible change for your body, and unfortunately, hemorrhoids are one of the less pleasant changes many expectant mothers experience. Studies suggest that up to 35% of pregnant women develop hemorrhoids, with the condition being particularly common during the third trimester and immediately after childbirth. If you're dealing with this uncomfortable issue, know that you're not alone and that safe, effective treatment options are available.

This guide is specifically designed for expectant mothers, focusing on treatments and prevention strategies that are safe during pregnancy. We'll explore why pregnancy increases hemorrhoid risk, which remedies you can safely use, and when you should consult your healthcare provider.

Why Pregnancy Increases Hemorrhoid Risk

Several factors during pregnancy create the perfect conditions for hemorrhoid development:

Increased Blood Volume

During pregnancy, your blood volume increases by approximately 50% to support your growing baby. This increased volume puts extra pressure on blood vessels throughout your body, including the veins in your rectal area. The walls of these veins can stretch and swell, leading to hemorrhoid formation.

Growing Uterus Pressure

As your baby grows, your expanding uterus puts increasing pressure on the pelvic veins and the inferior vena cava, the large vein that carries blood from your lower body to your heart. This pressure slows the return of blood from the lower half of your body, causing the veins below your uterus to become more dilated.

Hormonal Changes

Pregnancy hormones, particularly progesterone, cause the walls of blood vessels to relax. While this is beneficial for your growing uterus, it also means that the veins in your rectum can swell more easily. Progesterone also slows digestion, which can lead to constipation, another major hemorrhoid risk factor.

Constipation

Many pregnant women experience constipation due to hormonal changes, iron supplements, and the pressure of the growing uterus on the intestines. Straining during bowel movements is a leading cause of hemorrhoids and can worsen existing ones.

Safe Home Remedies During Pregnancy

Fortunately, many effective hemorrhoid remedies are completely safe during pregnancy. Here are the options you can try:

Sitz Baths

Warm sitz baths are one of the safest and most effective remedies for pregnancy hemorrhoids. Sit in warm (not hot) water for 15-20 minutes, several times a day. This helps reduce swelling, ease discomfort, and keep the area clean. You can use a sitz bath basin that fits over your toilet or simply fill your bathtub with a few inches of warm water.

Cold Compresses

Applying a cold compress or ice pack wrapped in a cloth to the affected area can help reduce swelling and numb pain. Apply for 10-15 minutes at a time, several times daily. Never apply ice directly to the skin.

Witch Hazel

Witch hazel is a natural astringent that's generally considered safe during pregnancy. Apply witch hazel pads or liquid to external hemorrhoids using a soft cloth. It helps reduce swelling, itching, and discomfort. Many pre-moistened hemorrhoid pads contain witch hazel as their active ingredient.

Proper Hygiene

Keep the anal area clean by gently cleansing with warm water after bowel movements. Avoid using rough toilet paper; instead, opt for unscented, moistened wipes or simply rinse with water. Pat the area dry rather than rubbing.

Pregnancy-Safe Topical Treatments

When home remedies aren't enough, certain over-the-counter hemorrhoid treatments are considered safe during pregnancy. However, it's essential to choose products carefully and consult your healthcare provider before using any medication.

Generally Considered Safe

• Witch hazel products: Natural and safe for topical use
• Preparation H (without hydrocortisone): The phenylephrine-based version is generally considered safe
• Products with natural ingredients: Aloe vera and chamomile-based creams
• Glycerin suppositories: For constipation relief, when needed

Use With Caution or Avoid

• Hydrocortisone products: Should only be used under medical supervision during pregnancy
• Products with lidocaine: Generally safe for short-term use, but consult your doctor
• Oral pain medications: Consult your healthcare provider before taking any oral medications

Prevention Strategies

While you may not be able to completely prevent hemorrhoids during pregnancy, these strategies can significantly reduce your risk:

Eat a High-Fibre Diet

Aim for 25-30 grams of fibre daily from sources like whole grains, fruits, vegetables, and legumes. Fibre helps keep your stools soft and regular, reducing the need to strain. Good choices include:

• Whole grain breads and cereals
• Fresh fruits with skin (apples, pears)
• Vegetables, especially leafy greens
• Legumes like lentils and chickpeas
• Prunes or prune juice (a natural laxative)

Stay Well Hydrated

Drink at least 8-10 glasses of water daily. Adequate hydration keeps stools soft and helps fibre work effectively. This is especially important during pregnancy when your body's fluid needs are higher.

Exercise Regularly

Gentle exercise like walking, swimming, or prenatal yoga helps stimulate bowel function and reduces pressure on rectal veins. Aim for 30 minutes of moderate activity most days, unless your doctor advises otherwise.

Don't Delay Bathroom Trips

When you feel the urge to have a bowel movement, go promptly. Delaying can lead to harder stools and more straining. Also, avoid sitting on the toilet for extended periods.

Practice Good Positioning

When possible, lie on your left side. This takes pressure off the rectal veins and improves blood flow. Also, avoid standing or sitting for long periods, and take breaks to walk around throughout the day.

Managing Hemorrhoids During Labour and Postpartum

Labour, particularly vaginal delivery, can worsen existing hemorrhoids or cause new ones to develop due to the intense pushing involved. Here's what to expect and how to cope:

During Labour

It's common for hemorrhoids to flare up during delivery. Your healthcare team is experienced with this and can provide comfort measures. Try not to let concerns about hemorrhoids distract you from the delivery process.

Postpartum Recovery

Hemorrhoid symptoms often peak in the days immediately following delivery but typically improve within a few weeks. Continue using safe home remedies:

• Continue sitz baths for comfort
• Use witch hazel pads after bowel movements
• Take stool softeners as recommended by your healthcare provider
• Maintain high fibre intake and hydration
• Rest when possible and avoid heavy lifting

When to Seek Medical Attention

While hemorrhoids during pregnancy are usually manageable with home care, certain situations require medical attention:

• Severe pain: Especially if it's constant or worsening
• Heavy bleeding: More than a small amount of bright red blood
• Thrombosed hemorrhoid: A hard, extremely painful lump that may appear bluish
• Signs of infection: Fever, pus, or spreading redness
• No improvement: Symptoms don't improve after 1-2 weeks of home treatment
• Inability to have bowel movements: May indicate a more serious problem

Your healthcare provider can offer additional treatment options if home remedies aren't providing sufficient relief. In rare cases, more significant interventions may be needed, but these are typically postponed until after delivery when possible.

Moving Forward

Hemorrhoids during pregnancy are uncomfortable, but they're manageable with the right approach. Focus on prevention through diet and lifestyle, use safe home remedies for symptom relief, and don't hesitate to talk to your healthcare provider if you're struggling. Most importantly, remember that this is a temporary condition that will improve after your baby arrives.

For help finding pregnancy-safe hemorrhoid products, our product comparison tool allows you to filter for pregnancy-safe options.