Postpartum hemorrhoids 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 in a few days or weeks with attentive home treatment, such as sitz baths and over-the-counter remedies.
Hemorrhoid 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). External hemorrhoids may simply feel itchy, but they also can be lumpy, tender, and painful. In some cases, particularly following a bowel movement, internal hemorrhoids can cause rectal bleeding (but they are usually not painful). If you had hemorrhoids before you were pregnant, there’s a good chance they’ll come back during pregnancy or post-delivery.
What Causes Hemorrhoids
During pregnancy and the postpartum period, 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 veins in the perineum to pop out. Additionally, all of the hormonal changes that happen during pregnancy and birth affect how these veins work. Pregnancy causes increased production of the hormone progesterone, which also causes veins to relax. Constipation is also common during the postpartum period. 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. While some of these causes are more associated with vaginal delivery, others (like hormone changes and constipation) happen regardless of how your baby was born. So you may experience postpartum hemorrhoids even if you have a C-section.
Home Treatments for Postpartum Hemorrhoids
While most hemorrhoids will go away on their own, you can use these remedies to ease symptoms.
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. Ask about over-the-counter treatments. Topical ointments and suppositories may provide relief. Only use a product approved by a healthcare provider. This is exceptionally important if you’ve had an episiotomy or tear. Discuss how long it’s acceptable to use these treatments (most should not be used for more than one week). Clean the area gently, but thoroughly. Use a peri-bottle (squirt bottle) filled with warm water. Rather than dry toilet paper, pat the area with a wet wipe. Hemorrhoid pads that contain witch hazel are often recommended, as well. Lie down as much as you can. Take the pressure off your backside. Take Tylenol (acetaminophen) or Motrin (ibuprofen). In recommended doses, both are safe painkillers to take while breastfeeding. Try a sitz bath. If you don’t already have a basin for sitz baths, you can purchase one at the drugstore. Sitz baths can be done several times a day. Alternatively, you could simply soak in the bathtub. (Alternate between cold ice packs and warm sitz baths.) Use unscented and dye-free hygiene products. This includes toilet paper, menstrual pads, etc. Add fiber to your diet. Eat lots of fruits, vegetables, and other foods with fiber. Fiber helps to increase bowel movements.
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. Do Kegel exercises to strengthen your perineum area. 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. Avoid straining when you are passing a bowel movement.
When to Call a Doctor
If you are being diligent in your home treatment, you should notice a gradual improvement in your hemorrhoids within the weeks following the birth. However, if your hemorrhoids are aggressively persistent or if you experience rectal bleeding, contact a healthcare provider doctor or midwife. In extreme and rare cases, you may need to consult a specialist, and surgery may be required. As a new parent, 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.
