Up to half of pregnant women develop hemorrhoids, most often in the third trimester and after delivery. Almost nobody warns you. Here is why they happen, what is safe to do about them while pregnant, and when the problem deserves a specialist rather than another tube of cream.
Pregnant or postpartum and uncomfortable? Dr. Chung offers pregnancy-safe evaluation and treatment.
Book a virtual consultThree things happen at once. The growing uterus presses on the pelvic veins and the inferior vena cava, so blood pools in the veins of the rectum. Progesterone relaxes vein walls, which lets them swell more easily, and it also slows the bowel, which means harder stool and more straining. Add the weight gain and the extra blood volume of pregnancy, and the vascular cushions in the anal canal stretch. That is a hemorrhoid.
Labor is the second hit. Pushing during a vaginal delivery puts enormous pressure on the anal canal, which is why many women who sailed through pregnancy discover hemorrhoids in the first days postpartum. Read what new moms need to know about hemorrhoids after childbirth.
Hydrocortisone creams are generally considered low risk for short external use but should be cleared with your obstetrician. Avoid oral NSAIDs such as ibuprofen in the third trimester. Skip herbal supplements marketed for hemorrhoids unless your obstetrician approves them; most have not been studied in pregnancy.
Most pregnancy hemorrhoids are managed with the steps above and improve after delivery. See a specialist for a thrombosed hemorrhoid causing severe pain, since removing the clot in the office within the first few days brings immediate relief and is safe in pregnancy; for prolapse that will not go back in; for persistent bleeding; or for hemorrhoids that are still a problem three months postpartum.
Office procedures such as rubber band ligation are usually deferred until after delivery. Postpartum, they are quick and highly effective. Larger hemorrhoids can be treated with laser hemorrhoidoplasty. Women with postpartum bowel control problems should also know that fecal incontinence after childbirth is treatable and worth mentioning.
Pregnancy hemorrhoids are common, uncomfortable, and mostly manageable with fiber, water, sitz baths, and stool softeners. A painful lump, ongoing bleeding, or hemorrhoids that outlast the postpartum period deserve an exam. Dr. Albert Chung in Rancho Santa Margarita treats pregnant and postpartum patients with options that fit each stage.
The growing uterus compresses pelvic veins, progesterone relaxes vein walls and slows the bowel, and constipation and weight gain add pressure. Pushing during delivery adds a second strain, so hemorrhoids often appear in the third trimester or right after birth.
Fiber, water, sitz baths, docusate stool softeners, witch hazel pads, and cold compresses are safe. Short external use of hydrocortisone is generally low risk but should be cleared with your obstetrician. Office procedures are usually deferred until after delivery, except for treating a painful thrombosed hemorrhoid.
Most shrink substantially within a few weeks after delivery as pressure and hormones return to normal. Hemorrhoids that are still symptomatic three months postpartum are unlikely to resolve on their own and can be treated in the office.
Yes. Removing the clot under local anesthesia in the office is safe in pregnancy and gives immediate relief, ideally within the first 72 hours of symptoms.
Dr. Albert Chung offers pregnancy-safe relief now and definitive treatment after delivery. Virtual consults make the first visit easy.
Book a virtual consultCall (714) 988-8690