Postpartum Hemorrhoids Are Very Real — Here's How to Treat Them

FACTS TO KNOW
  • 25-30%

    Almost a third of people get hemorrhoids during pregnancy.

  • The good news: Most hemorrhoids go away after a few weeks.

  • Helpful Tips

    • Pain relievers, suppositories and cold packs are your friend.
    • Avoid sitting on hard surfaces and instead sit on a soft pillow or donut-shaped cushion.
    • Use stool softeners or laxatives as needed to help avoid constipation and straining.

What is this?

Hemorrhoids are swollen veins, either inside the rectum or under the skin around the anus. They can cause pain, itching and bleeding after bowel movements. Hemorrhoids can be caused by hormonal shifts and increased pressure on the veins during pregnancy, bowel movements or vaginal delivery.

How common is it?

Like many pregnancy health topics, hemorrhoids are understudied. One study found that between 25-35% of pregnant women get hemorrhoids. Another study, which had a small sample size of 50 participants, found that 85% of women got hemorrhoids during their second and third pregnancies.

How long does it last?

Hemorrhoids usually clear up on their own after a few weeks. To help promote healing, make sure to increase fiber and water intake, and avoid straining and sitting on hard surfaces.

What can be done about it?

Here are some remedies that provide temporary relief and may speed healing:

Pain relievers
What

Ibuprofen and/or acetaminophen

How

As directed by an OB-GYN or midwife, who may suggest that you “pair” them, or alternate between them, since they target different pain receptors.

Why

To relieve pain. These are considered safe if a woman is breastfeeding.

Hydrocortisone suppositories and hemorrhoid creams
What

Over-the-counter pain relief

How

As directed by an OB-GYN or midwife.

Why

Helps relieve pain and itching, and reduces swelling directly in the rectum or anus.

Cold packs
What

Ice packs or cold gel packs

How

Apply to the area as needed.

Why

Cold packs can provide temporary numbing for pain relief.

Witch hazel
What

Wipes or frozen maxi pads

How

Apply (alcohol-free) witch hazel wipes or soak maxi pads with witch hazel and freeze. Place the frozen pad on top of a dry maternity pad in your underwear to absorb any bleeding and leakage. (Pro tip: Make a bunch of these so they’re ready to go.)

Why

Witch hazel has been shown to be as effective as anesthetic sprays and other pain relievers.

Numbing spray
What

Perineal spray (natural) or Dermoplast (conventional OTC)

How

Spray your numbing agent of choice on the area to provide a temporary cooling or numbing relief.

Why

Numbing spray can provide temporary pain relief.

Sitz baths
What

A shallow tub that sits on top of the toilet

How

Soak the vulva, vagina and buttocks for 10–20 minutes, once or twice a day, in warm water.

Why

Sitz baths can reduce pain and swelling, as well as keep the perineum clean. There is some evidence that adding Epsom salts, lavender oil or olive oil to the water can promote healing. In fact, a 2018 study of 495 pregnant women found that using a Sitz bath filled with Epsom salt water three times a day cleared up hemorrhoids in 100% of the study participants using that remedy, compared to 85% using topical hemorrhoid cream.

Donut-shaped cushions
What

A device to prevent sitting on hard surfaces

How

Sit on a soft pillow or donut-shaped cushion.

Why

Hard surfaces compress wounds and inhibit blood flow to healing areas.

Peri bottles
What

A handheld water bottle with a spray nozzle

How

Spray a gentle stream of water over the vaginal area while peeing to dilute the stinging effects of urine on healing areas. It also helps to avoid using toilet paper.

Why

A peri bottle helps to keep wounds clean, reduces inflammation and prevents abrasions. Adding witch hazel or soothing oils to the peri bottle water may also provide pain relief.

Stool softeners
What

Magnesium citrate (natural), prune juice (natural), Colace (docusate sodium, conventional OTC), Miralax (polyethylene glycol, conventional OTC)

How

As directed by an OB-GYN or midwife.

Why

Stool softeners or laxatives can help avoid constipation and straining that can be painful and irritating to perineal or vaginal areas.

What can be done to prevent it?

Having a vaginal birth or a long push period can increase someone's risk of developing postpartum hemorrhoids. If someone has had hemorrhoids or anal fissures (small tears in the tissue lining the anus) in the past, or if they deliver a baby with a high birth weight, they’re also more at risk.

When should I be worried?

If hemorrhoids don’t clear up after a month, it’s important to talk to your doctor or midwife so they can assess whether a more aggressive treatment like surgery is needed, and to rule out anything more serious.

Sources

https://europepmc.org/article/med/16433160https://www.aap.org/en-us/Pages/Breastfeeding-and-Medication.aspxhttps://www.fascrs.org/patients/disease-condition/hemorrhoids-expanded-version
https://www.jwatch.org/na34828/2014/06/10/hemorrhoids-and-anal-fissures-during-and-after-pregnancy https://www.mayoclinic.org/diseases-conditions/anal-fissure/symptoms-causes/syc-20351424 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2278306/ https://www.ncbi.nlm.nih.gov/pubmed/12865195 https://www.ncbi.nlm.nih.gov/pubmed/15486746 https://www.ncbi.nlm.nih.gov/pubmed/16405552 https://www.ncbi.nlm.nih.gov/pubmed/29055673 https://www.researchgate.net/publication/258013667_A_Clinical_trial_to_compare_the_effectiveness_of_Lavender_essential_oil_and_olive_oil_at_healing_postpartum_mother's_perinea https://www.urmc.rochester.edu/ob-gyn/obstetrics/after-delivery/common-conditions.aspx
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