Let's get real when it comes to pregnancy & haemorrhoids

The facts on haemorrhoids first

Haemorrhoids are swollen veins in your anus and lower rectum.¹ There are two types of haemorrhoids namely external and internal. External can be felt under the skin around the anus and internal are hidden from view inside the rectum.¹

The symptoms depend on the type of haemorrhoid

With external haemorrhoids you might experience irritation and itching in the anal region as well as pain or discomfort. There may also be swelling around the anus or bleeding.¹

Internal haemorrhoids rarely cause discomfort but straining or irritation when passing stool can lead to painless bleeding during bowel movements. You’ll notice a small amount of bright red blood on your toilet paper or in the toilet.¹

You may also hear of thrombosed haemorrhoids. These haemorrhoids develop when blood pools in an external haemorrhoid and forms a clot (thrombus). These haemorrhoids cause severe pain, swelling, inflammation and a hard lump near the anus.¹

The results are in

Haemorrhoids usually occur during the third trimester of pregnancy and 1 – 2 days after giving birth.² A study demonstrated that after the first pregnancy, haemorrhoids occur in 37.9 % of women and after other pregnancies this number increases.² Childbirth increases the risk of haemorrhoids almost eight times. Women who give natural birth are more likely to have haemorrhoids when compared to women that undergo caesarean section.²

The most common causes of haemorrhoids are:

Pregnancy, childbirth and the postpartum period definitely increase the risk of haemorrhoids.²

Constipation due to low fluid intake and insufficient amount of fiber in the diet.²

Difficult defecation.²

Venous statis due to increased abdominal pressure with increasing uterus.²

Increased volume of blood circulation.²

Hormonal factors (progesterone).²

Obesity²

Sedentary lifestyle.²

Haemorrhoids and constipation go hand in hand

Postpartum constipation is a common condition.³ Symptoms of postpartum constipation include pain or discomfort, straining and hard stools ³ Haemorrhoids can increase the risk of postpartum constipation² but constipation can also cause haemorrhoids.¹ One of the causes of haemorrhoids is straining during bowel movements,¹ which is the same with constipation.³

Tips to help relieve postpartum constipation:⁴

Drink at least eight to ten large glasses of fluid a day.

Try eating prunes.

Drink warm liquids each morning.

Eat foods such as bran, fruits, green vegetables, whole grain cereals and bread.

A mild laxative or fiber supplement can be used when these measures don’t work but speak to your health care professional before using these methods.⁴

How to treat postpartum haemorrhoids at home ^2,4

You can use a sitz bath (a basin filled with warm water) or a bath to soak yourself in warm water. It helps to shrink the haemorrhoids. You can do this two to four times a day.

Sit on a pillow or waffle cushion to relieve pressure on the rectum.

There are over-the-counter medication that can be used to provide relief but speak to your health care professional to recommend a cream, ointment or suppository that works for you.

Drink water to help keep your stool soft.

Wash up each time after defecation.

Avoid constipation.

Sitting for long periods of time increases pressure on the veins in your anus, which can lead to haemorrhoids. Instead, lie down as much as possible when you’re nursing.⁵ Witch hazel can help reduce swelling and provide relief. Store it in your refrigerator to keep it cool. You can apply it using cotton balls and pads. You can also add witch hazel to your bath.⁵ Speak to your health care professional before using this.

It is important to remember that you are not alone and that there are home remedies and medically approved treatment to help with haemorrhoids. Please note the suggestions above are only to manage the symptoms of haemorrhoids, speak to your health care professional for further advice on how to manage and treat your haemorrhoids. Don’t let haemorrhoids negatively affect your quality of life and the time spent with your newborn.

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References: 1. Mayo Clinic. Haemorrhoids. 2021. [Updated 12 May 2021; Cited on 1 September 2022]. Available from: URL: https://www.mayoclinic.org/diseases-conditions/haemorrhoids/symptoms-causes/syc-20360268#:~:text=Haemorrhoids%20are%20swollen%20veins%20in,rectum%2C%20similar%20to%20varicose%20veins. 2. Buzinskiene D, Sabonyte-Balsaitiene Z, Poskus T. Perianal Diseases in Pregnancy and After Childbirth: Frequency, Risk Factors, Impact on Women’s Quality of life and treatment Methods. Front Surg. 2022;(9):doi:https://doi.org/10.3389/fsurg.2022.788823. 3. Turawa EB, Musekiwa A, Rohwer AC. Interventions for preventing postpartum constipation (Review). Cochrane Database of Systematic Reviews 2015; 9):DOI:10.1002/14651858.CD011625.pub2. 4. University of Rochester Medical Center. Common Conditions: Constipation. [cited on 1 September 2022]. Available on: URL: https://www.urmc.rochester.edu/ob-gyn/obstetrics/after-delivery/common-conditions.aspx#:~:text=After. G5.row by WebMD. What to Do if You Have Postpartum Haemorrhoids. 2021. [Updated 16 May 2021] [Cited on 1 September 2022]. Available at: URL: https://www.webmd.com/baby/what-to-do-if-you-have-postpartum-haemorrhoids.