Hemorrhoids are swollen veins located in the anus and lower rectum. They develop when increased pressure causes these blood vessels to bulge and become irritated. Hemorrhoids are common, and many pregnant individuals experience them due to factors like increased blood volume and pressure on the pelvic area from the growing uterus. About 30% to 40% of pregnant women develop hemorrhoids, with some studies reporting even higher prevalence in the third trimester.
Hemorrhoids and Labor: The Reality of “Bursting”
While the idea of a hemorrhoid “bursting” might sound alarming, it is more accurate to describe it as rupturing or bleeding significantly during labor. The intense pressure and pushing during vaginal delivery can cause existing hemorrhoids to worsen, leading to a rupture or prolapse. This happens because the increased intra-abdominal pressure and straining during labor put considerable stress on the veins around the rectum.
A ruptured hemorrhoid typically presents as sudden pain and bleeding. While seeing blood can be concerning, this is generally a manageable situation and rarely constitutes a severe medical emergency. In some instances, a blood clot might form within an external hemorrhoid, known as a thrombosed hemorrhoid, which can be very painful and feel like a hard lump. Healthcare providers are accustomed to managing such situations during childbirth.
Coping with Hemorrhoid Discomfort During Labor
Managing hemorrhoid discomfort during labor focuses on alleviating pressure and pain. Changing positions can help, such as lying on your side, which reduces direct pressure on the rectal area. Gentle breathing techniques can minimize straining during contractions and pushing.
Applying cold compresses or witch hazel pads to the affected area can provide soothing relief by reducing swelling and discomfort. It is important to communicate any pain or discomfort from hemorrhoids to your healthcare team so they can offer appropriate support and interventions.
Postpartum Hemorrhoid Management and Recovery
Hemorrhoids often improve in the days and weeks following delivery as the pressure on the pelvic veins decreases. Self-care measures are important for managing symptoms and promoting healing during this period. Taking warm sitz baths several times a day for 10 to 15 minutes can soothe the area and help reduce swelling. Increasing dietary fiber intake through fruits, vegetables, and whole grains, along with drinking plenty of water, helps soften stools and prevent straining during bowel movements.
Over-the-counter topical creams, ointments containing ingredients like hydrocortisone or witch hazel, and stool softeners provide relief from pain, itching, and inflammation. Maintaining gentle hygiene by using soft, unscented wipes or a peri bottle after bowel movements can prevent further irritation. Lying down when resting or nursing can reduce pressure on the rectal veins. Postpartum hemorrhoids typically resolve within a few weeks.
When to Consult a Healthcare Provider
Consult a healthcare provider for hemorrhoid concerns beyond typical discomfort. Seek medical attention if you experience severe, persistent pain that is not relieved by home remedies. Heavy or continuous rectal bleeding, or any bleeding accompanied by lightheadedness or faintness, requires immediate medical evaluation.
Signs of infection, such as fever, chills, or pus leaking from the hemorrhoids, require prompt medical consultation. If you have a prolapsed hemorrhoid that remains outside the anus and cannot be gently reinserted, or if symptoms do not improve after about a week of home care, contact your doctor.