Haemorrhoids in pregnancy

Haemorrhoids (sometimes called piles) are swollen veins in and around your bottom, and they’re very common in pregnancy — especially in the later weeks and after birth. They can be uncomfortable, itchy, or ache, and you might notice a small amount of bright red blood when you go to the toilet. They’re not dangerous, but they can be a real nuisance, so it’s worth knowing how to ease them.

They crop up in pregnancy for a few reasons: the extra blood volume and pressure from your growing uterus, the pregnancy hormones that relax and dilate your veins, and constipation and straining, which make them more likely. That last one is the most manageable — so a lot of preventing and easing haemorrhoids comes down to keeping your bowels comfortable.

Preventing and easing them overlaps a lot with managing constipation: plenty of fibre (wholegrains, fruit, vegetables, legumes), lots of water, and regular movement to keep things soft and regular, so you’re not straining. Don’t put off going when you feel the urge, and avoid sitting on the toilet for long stretches — a footstool to raise your knees helps you pass a motion without pushing hard.

For the discomfort itself, a few things soothe: a cool pack or a cloth-wrapped ice pack against the area, a warm bath, and keeping the area clean and gently patted dry (wet wipes made for the purpose can be gentler than dry toilet paper). Lying down and taking the weight off, and not standing for long periods, help too. Your pharmacist can suggest creams or ointments that are safe in pregnancy to relieve the pain and itch — it’s worth asking rather than guessing, and worth mentioning to your midwife or GP so they know.

It’s a good idea to have these things checked rather than self-diagnosing, because bleeding from your bottom is usually haemorrhoids but should be mentioned to your GP or midwife to be sure. See them promptly if the pain is severe, if a haemorrhoid becomes very swollen and hard (it can occasionally develop a clot), or if the bleeding is heavy or doesn’t settle.

It also helps to avoid sitting or standing for very long stretches, as both add to the pressure — take breaks, move about, and lie on your side when you can to ease the load. Some people find a doughnut-shaped cushion more comfortable for sitting, and a few minutes with your bottom raised (lying down with a pillow under your hips) can help too. Gentle pelvic floor exercises improve blood flow to the area, which may also help. But the single most useful habit is simply not straining: keep your stools soft with fibre and fluids, and never force it.

Take heart that haemorrhoids usually improve after your baby is born, as the pressure eases — though they can flare in the early postpartum days, when the same measures (fibre, fluids, not straining, cool packs, safe creams) apply. In the meantime, be gentle with yourself; it’s a common, treatable part of pregnancy that plenty of people quietly deal with.