What to Do About Hemorrhoids After Birth

Solutions you can try at home

Hemorrhoids are veins that have become swollen and engorged with blood (varicose veins). Many women experience them for the first time during pregnancy or the post-partum period for several reasons, including a rush of hormones, internal pressure, and constipation. They can range from irritating to quite painful, but the good news is that for the most part, hemorrhoids aren't serious. Most tend to go away with attentive home treatment.

Treating postpartum hemorrhoids
Illustration by Jessica Olah, Verywell

Types and Symptoms

These swollen tissues appear in the rectal area and can vary from the size of a pea to that of a grape. There are internal hemorrhoids (affected veins are inside the sphincter), as well as external hemorrhoids (affected veins protrude outside the anal opening).

Hemorrhoids may simply feel itchy, but they also can be painful. In some cases, particularly following a bowel movement, they can cause rectal bleeding.

If you had hemorrhoids before you were pregnant, there's a good chance they'll come back post-delivery.

What Causes Them

For pregnant or postpartum moms, hemorrhoids are often a result of stress on the perineum in the months before, and during, delivery. Veins work like valves to push blood back up to the heart, and when those "valves" become weakened, they can swell with blood.

You can probably imagine how the stress of carrying a baby, and then pushing a baby out during vaginal delivery, can cause the veins to pop out. Additionally, all of the hormones going through your body during pregnancy and birth affect how these veins work. Pregnant mothers have an increased production of the hormone progesterone, which also causes veins to relax.

For several reasons, new moms are also prone to experience constipation after birth. This can start a vicious cycle of needing to exert pressure to have a bowel movement, experiencing a resulting flare-up of the hemorrhoids, fearing having to go again, and retaining stool, which then hardens, starting the process all over again.

Home Treatments

There are several things you can do to treat your hemorrhoids at home:

  • Apply ice. Wrap ice or a cold pack in a cloth and apply for about 10 minutes. If you had a hospital or birth center delivery, you may have been given postnatal ice packs to bring home.
  • Several times a day, try a sitz bath. If you don't already have one, you can purchase one at the drugstore. Alternatively, you could simply soak in the bathtub.
    (Alternate between the cold ice packs and the warm sitz baths.)
  • Clean the area gently, but thoroughly. Use a peri-bottle (squirt bottle) filled with warm water. Rather than using dry toilet paper, pat the area with a wet wipe. Hemorrhoid pads that contain witch hazel are often recommended, as well.
  • Use unscented and dye-free hygiene products (toilet paper, menstrual pads, etc.)
  • Talk to your doctor about possible over-the-counter hemorrhoid treatments, such as topical ointments and suppositories. Be sure you know how long it's acceptable to use a product (most should not be used for more than one week). Only use a product approved by your health care provider. This is exceptionally important if you've had an episiotomy or tear.
  • Lie down as much as you can to take the pressure off your backside.
  • For temporary relief, you can take Tylenol (acetaminophen) or Motrin (ibuprofen) in the recommended dosage. Both are safe painkillers for breastfeeding mothers.

If you want to speed things along, there are a few other things you can do in addition to your home treatments:

  • Avoid and/or treat constipation.
  • Use the bathroom when you have the urge to go. Don't "hold it" for fear of causing more pain. The longer you wait, the harder your stool may get, and the more going might aggravate your hemorrhoids.
  • Do Kegel exercises to strengthen your perineum area.

When to Call Your Doctor

If you are being diligent in your home treatment, you should notice gradual improvement in your hemorrhoids within the weeks following the birth. However, if your hemorrhoids are aggressively persistent or if you experience rectal bleeding, you definitely want to talk to your doctor or midwife. In extreme and rare cases, you may need to consult a specialist and surgery may be required.

As a new mom, hemorrhoids are the last thing you want to be dealing with. But with a little bit of self-care, you should be feeling—and sitting—better in no time.

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