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Pregnancy is truly an incredible feat. Our bodies shift and change so much to accommodate our babies, from hormone levels to ligaments that stretch to organs that move to make room. However, as any pregnant woman will tell you — not all of those incredible changes are enjoyable, and neither are their secondary effects. Today, we’re talking about one of the most common and least fun parts of pregnancy: hemorrhoids.

What are hemorrhoids?

Hemorrhoids occur when the veins in or around your anus swell. When the swelling vein is positioned inside your rectum, it’s called an internal hemorrhoid. Internal hemorrhoids are not typically serious – in fact, you may not even be aware that you have them. However, bowel movements can irritate them, which could cause discomfort or bleeding. In more severe cases, internal hemorrhoids can become prolapsed, which may require treatment. 

When the swelling vein is on your anus, it’s known as an external hemorrhoid. Because they’re located on the outside of your rectum, where you have more nerve endings, they may be more uncomfortable or painful, especially when sitting down, doing activities, or using the bathroom.

Both types of hemorrhoids can be painful – or at the very least, uncomfortable. Hemorrhoids affect both men and women, especially as we age, but pregnancy is another leading cause of this unpleasant situation. 

If you’re dealing with symptoms like these, you may have hemorrhoids: 

• Pain during bowel movements

• Persistent itching in and around your anus

• Bloody stools (or bloody toilet paper when wiping after a bowel movement) 

• A small, swollen mound or lump protruding from your anus

Rectal bleeding, anal pain and anal itching can also be symptoms of anal fissures, which can also occur during pregnancy. To determine the cause of your symptoms, talk to your provider or go in for a check up. Don’t panic: most bleeding from these causes is minor and harmless, but it’s a good idea to chat with your doctor anytime you notice blood during pregnancy. 

Why does pregnancy cause them?

As your pregnancy progresses, you’re more likely to experience hemorrhoids. In the third trimester and the first month postpartum, about 1 in 3 women report having hemorrhoids. They form when your bowels experience added pressure and weight, causing your veins to swell under the impact. Pregnant women experience hemorrhoids for three main reasons:

• Your baby. As you move into the third trimester, your abdominal cavity faces pressure from both the size and weight of your baby. As your baby grows, your pelvic floor and digestive tract can be pressed, which causes veins to temporarily swell. 

• Constipation. All of those hormonal changes in your body can cause irregular bowel movements and slow down your digestion in general. It’s common to experience constipation during pregnancy, but there are ways to keep your digestive system healthy and moving. 

• Increased blood volume. As your baby grows, your body creates more blood than your veins typically carry. This can lead to added pressure on those veins, which can lead to hemorrhoids. 

Will my symptoms resolve after I give birth? 

Most women who experience hemorrhoids during pregnancy do experience symptom relief after they give birth — although often, it doesn’t happen right away. Hemorrhoids are also a common postpartum symptom, particularly due to constipation. (If you’re dealing with constipation, I wrote a blog with 4 simple ways to ease your symptoms!)

6 ways to treat hemorrhoids during pregnancy

1) Avoid constipation. 

If you want to ease your hemorrhoid symptoms during bowel movements (or even better, potentially avoid developing hemorrhoids at all), keep your digestive tract on a regular schedule to the best of your ability. My best tips include drinking plenty of water, eating at least 25g of fiber each day, and implementing a stool softener when needed. Check with your provider first, of course, but this brand is my top recommendation. 

2) Avoid straining. 

Straining during bowel movements is an incredibly common thing — most people do it without even thinking, especially if you’re pregnant. But creating even more pressure on the veins in this area is the fast track to hemorrhoid aggravation, so try to let your bowel movements happen naturally. If you haven’t, now is a great time to invest in a squatty potty! 

3) Relax your pelvic floor. 

If your pelvic floor is tight, you’ll be bearing down on your digestive system and anus more than you even realize. My course, Movement through Pregnancy, includes educational modules and exercises to help you prepare your pelvic floor for birth — and those same movements can help you relax your pelvic floor to relieve hemorrhoid symptoms, too. 

4) Learn to properly manage intra-abdominal pressure.

Your diaphragm, pelvic floor, abdominals, and lower back muscles all work together to maintain proper intra-abdominal pressure in your belly. This protects your internal organs — and, when pregnant, your baby! When that pressure isn’t balanced, you could be left with hemorrhoid pain, along with other common pregnancy woes like diastasis and lower back pain. To manage intra-abdominal pressure, master diaphragmatic breathing. Finding a local pelvic floor physical therapist can be a fantastic resource as you learn techniques that will help you during (and long after) pregnancy.  

5) Take a Sitz bath.

For pain and itch relief, there’s no remedy like a Sitz bath. You can pick these up from your local pharmacy or order them online! This warm water bath can reduce pain and swelling from hemorrhoids. It’s also great to have on hand for your postpartum days. 

6) Try cooling pads. 

If you’re dealing with uncomfortable itching or burning, cooling pads with witch hazel can provide some serious relief. This is my favorite brand — and these are another great thing to have nearby after you give birth, too. 

If you’re dealing with hemorrhoids, know that you didn’t necessarily do anything to cause them. Sometimes, they’re just an unpleasant side effect of being pregnant. Treat them with my tried-and-true tips, and trust that you won’t deal with them forever. If you want to avoid hemorrhoids during pregnancy (or minimize your symptoms if you get them), my Movement Through Pregnancy course can help. 

In addition to weekly workouts to keep you strong and active through each trimester, the program offers lots of educational modules that help with common pregnancy and pelvic issues. During Movement Through Pregnancy, you’ll learn how to relax your pelvic floor, manage intra-abdominal pressure, and develop the right posture to support your body during pregnancy. There are even toilet tips to help make “going” less uncomfortable! Get started with Movement Through Pregnancy now, and hang in there, mama — you’re doing great!