Hemorrhoids During Pregnancy: Causes and Prevention

Hemorrhoids — swollen veins in the anus and rectum — are common during pregnancy, especially in the third trimester when the enlarged uterus puts pressure on the veins.

Hemorrhoids can be painful. They may also itch, sting, or bleed, especially during or after a bowel movement.

While your body is going through all sorts of physical changes during pregnancy, hemorrhoids can be one more unwanted irritation. But the good news is that they generally aren’t harmful to your health or the health of your baby, and they’re usually a short-term problem. Though pushing during labor can worsen hemorrhoids, they typically go away on their own after you give birth. (1)

Some women get hemorrhoids for the first time when they’re pregnant. But if you’ve had hemorrhoids before, you’re more likely to get them again when you’re pregnant.

What Can Cause Hemorrhoids During Pregnancy

As your unborn baby grows, your uterus gets bigger and begins to press against your pelvis. This growth puts a lot of pressure on the veins near your anus and rectum, and these veins may become swollen and painful as a result.

The increase in the hormone progesterone during pregnancy can also contribute to the development of hemorrhoids, as it relaxes the walls of your veins, making them more prone to swelling. An increase in blood volume, which enlarges veins, can also contribute to hemorrhoids during pregnancy. (1)

Three common additional causes of hemorrhoids during pregnancy include:

• Straining during bowel movements
• Straining from carrying extra pregnancy weight
• Sitting or standing for long periods of time

Hemorrhoids are most common in pregnant women who experience constipation.

As many as 38 percent of pregnant women become constipated at some point during their pregnancy, according to research published in the journal BMJ Clinical Evidence. (2)

One cause of constipation during pregnancy may be when the growing uterus pushes against the bowel. Iron supplements you may take can also contribute to constipation, so it’s worth trying to get the iron you need naturally through your diet. (3)

Pregnancy hormones can also slow down the movement of food through the digestive tract, making constipation more likely.

How to Prevent Hemorrhoids During Pregnancy

Avoiding constipation is key to preventing hemorrhoids during pregnancy. Here are some tips for preventing constipation:

Eat lots of high-fiber foods. There are plenty of good ways to incorporate more fiber into your diet. Fiber-filled foods include fruits like pears (especially when you include the skin), avocados, and berries; vegetables such as broccoli, artichokes, and Brussels sprouts; whole grains such as oatmeal, brown rice, quinoa, and even popcorn; legumes including various kinds of beans, lentils, and green peas; and don’t forget nuts and seeds.

RELATED: 11 High-Fiber Foods to Add to Your Diet

Drink plenty of fluids. Aim for 10 8-ounce glasses of water each day.

Use the toilet as soon as you feel the urge. “Holding it in” can contribute to constipation.

Try not to sit or stand for long periods of time. If you sit down at work, make sure to get up and walk around for a few minutes every hour. At home, try to rest on your side when reading or watching TV, to relieve downward pressure on your rectal veins.

Ask your doctor about using a stool softener. This can help if other methods fail to ease your constipation. Using laxative pills for constipation is not recommended during pregnancy, as they can cause dehydration and might stimulate uterine contractions. (3)

Do Kegel exercises daily. Kegel exercises strengthen the pelvic floor muscles that help support your rectum and can improve circulation in the rectal area. You can do Kegel exercises just about anywhere — at home, in your car, at the office — but first you need to make sure you’re isolating and contracting the correct muscles.

Identify the right muscles by stopping urination midstream. (This is strictly for the purpose of identifying which muscles we’re talking about — you don’t want to do Kegels while urinating, as this could increase your risk for a urinary tract infection). (4)

Once you know which muscles to use, tighten them and hold the contraction for five seconds. Then relax for five seconds. Work up to holding the contraction for 10 seconds. Try to do at least three sets of 10 reps a day.

RELATED: 10 Foods to Help Relieve Constipation

RELATED: Constipation Causes, Symptoms, and Relief

How to Treat Hemorrhoids During Pregnancy

Hemorrhoids usually get better on their own after pregnancy, but there are a number of things you can do to ease any itching and pain in the meantime:

Soak your rectal area in warm water several times a day. A sitz bath, or small basin that fits over the toilet seat, can help. These devices can be purchased at most drug stores. You can also fill your regular bathtub with a few inches of warm water to create a similar effect.

Apply ice packs or cold compresses to the area several times a day. The cold can reduce swelling and help relieve pain.

Keep the anus clean and dry. Try using moist towelettes or baby wipes to gently clean the area after bowel movements. This can be more gentle than dry toilet paper.

Be sure to pat — not wipe — the area dry after bathing or making a bowel movement. Excess moisture can cause irritation.

Apply baking soda (wet or dry) to the area to alleviate itching. (3)

Apply treatments containing witch hazel. Products like Tucks Medicated Cooling Pads can help keep the area clean and relieve pain and itching around the anus.

But before you use any products, be sure to ask your doctor or healthcare provider to recommend a topical hemorrhoid cream or medicated wipe that’s safe to take during your pregnancy.

Additional reporting by Deborah Shapiro.