Guide to postpartum haemorrhoids: signs, symptoms & WTF to do

Pregnancy produces some incredible (and incredibly brutal) changes to your body. Sure, you get lush locks and bountiful boobs. But, you’re also gifted with less desirable transformations like abdominal separation, bigger feet, and (drum roll) haemorrhoids.  

Haemorrhoids are, quite literally, a pain in the bum. But, they don’t have to be. 

From what causes haemorrhoids to how to treat them, read on for everything you ever wanted to know about them (and a few things you didn’t).

What are haemorrhoids

Simply put, haemorrhoids are swollen veins around your anus. They’re affectionately known as the varicose veins of the bum (cute, right?) and they can occur inside your rectum (internal haemorrhoids) or beneath the skin around your butthole (external haemorrhoids). 

If you do get them, you’re not alone—nearly 3 out of 4 people will experience them at some point. They happen to all genders, at all stages of life, and are generally caused by too much pressure on that part of the body. This can be because of straining – whether that’s through constipation or weight lifting. Or it can be because you’re carrying a few extra kilos. With all the extra weight of pregnancy, it’s hardly surprising 25 to 35 per cent of women get haemorrhoids, either while pregnant or following delivery – especially when these elements are factored in: 

  • Softening hormones like relaxin 
  • Greater blood volume
  • Bigger babe on board
  • Expanding uterus
  • Vaginal delivery
  • Pushing for more than 20 minutes
  • Constipation

What are the symptoms of postpartum haemorrhoids?

Your undercarriage may well feel like a Mr PotatoHead toy that’s been dragged over concrete and put back together by someone wearing a blindfold, so it can be easy to miss the signs of haemorrhoids. This means you might be in pain for longer than you need to be. To avoid that, here are the signs to look out for. 

  1. Your butt will feel (and look) weird. You’ll have pain and swelling thanks to sensitive lumps near your anus. 

  1. You’ll have an itchy bum. Depending on the type of severity of your haemorrhoids, you might also feel itchy down there. 

  1. You might bleed while, or after, doing a poop. Bleeding from haemorrhoids* will be hyper-localised, bright red and only the amount you’d expect from a scratch. On the other hand, lochia (normal bleeding and discharge after birth), is more of a steady flow.

    *Mama, take note: For any bleeding that fills a pad in 60 minutes or less or any clots bigger than a plum, call an ambulance immediately.  

Because some of the symptoms associated with haemorrhoids can be similar to more sinister conditions, such as bowel cancer, if you notice any of these signs, go and get yourself checked out with your health professional. 

Your GP or health professional will ask about your symptoms, diet, and bowel habits – and perform a physical exam. Yep, they’ll look around (and maybe even up) your bum, but it’ll be worth it – promise. The sooner you get treated, the sooner you can feel like yourself again. 

What are they looking for, and what do haemorrhoids look like? External or prolapsed haemorrhoids can look like a bunch of tiny grapes (yeah, we’re never looking at grapes the same again either), so they’ll look for that. If they do need to put a finger up your bum, it’s so they can check your muscle tone and for any lumps or internal haemorrhoids. Your doctor might refer you for further internal examinations like an endoscopy to rule out more serious causes of bleeding. Next up: how to treat a haemorrhoid. 

How to get rid of haemorrhoids

In good news, most haemorrhoids with mild symptoms will go away after a few days – and they can do this all by themselves. The bad news? They might come and go for a while. 

The best treatment for haemorrhoids is targeting pain and inflammation: 

  • Haemorrhoid creams. There are plenty of over-the-counter options that can help reduce pain and inflammation, and your pharmacist or GP can advise if you aren’t sure what haemorrhoid cream to use postpartum. The good news is, haemorrhoid cream and suppositories are considered safe while breastfeeding. If your symptoms are severe, you might need a prescribed cortisol cream.

  • Ice. Icing your behind can also help. Use a regular ice pack, grab a perineum cooling strip from the chemist, or make your own padsicle.

  • Take a warm soak. Relaxing in a bathtub or a ‘sitz’ bath can help soothe pain and irritation.

  • Be kind to your bum. When you go to the loo, use a peri bottle (a spritzing and cleansing mist for your lady bits made from warm water, witch hazel and lavender oil) and extra-luxe toilet paper or wipes. 

How to avoid haemorrhoids

There’s a lot you can do to prevent postpartum haemorrhoids. (And these tips are great for your general health, too.)

Eat a high-fibre diet 

Nutrition can support your postpartum recovery. Eating a diet rich in fibre (prunes, pears and figs, plus leafy greens, oats and flaxseed) will help keep you regular. Less constipation equals less risk of haemorrhoids. Added perk? A high-fibre diet can also help you maintain a healthy weight and help ward off diabetes, heart disease and some types of cancer. Still feeling stagnant? Try Metamucil for a fibre boost and Movicol (a stool softener) to get things moving again. 

Drink plenty of water

Half-hourly urination breaks can be a pain when pregnant, but haemorrhoids are worse, so keep up that fluid intake, Mama. During pregnancy, your body needs that extra water to do important stuff like flush out toxins, make amniotic fluid, produce extra blood, not get constipated, and more. 

Breastfeeding? Every time you feed your babe, gulp down a large glass of water. More water means softer stools, and that means less strain and less chance of haemorrhoids. 

Get moving

Exercise during pregnancy and postpartum will work wonders for helping kickstart your metabolism and avoiding constipation. Reducing excess weight also reduces strain on your organs. Everyone’s a winner, baby. 

Don’t sit

Where possible (and practical), swap sitting for laying down or walking. Sitting puts extra pressure on all the areas you don’t want to. If you do need to sit down, you can use a pillow or a foam doughnut for added comfort. 

Don’t strain

Instead of forcing a bowel movement, or holding on for too long, embrace your inner toddler and go whenever you feel the urge.

Don’t breathe

Just kidding! Pregnancy and childbirth are hard on your body, so go gently, Mama. Be kind to yourself, and remember: heaps of peeps get haemorrhoids (you’re not alone!).

Read next: 14 postpartum essentials every mum needs

Mayo Clinic, Hemorrhoids – Symptoms and causes

Web MD, Vaginal Bleeding After Birth: When to Call a Doctor 

The Royal Women’s Hospital, Medicines in breastfeeding 

Healthline, Hemorrhoids Home Remedies and OTC Treatment 

Mayo Clinic, Dietary fiber: Essential for a healthy diet 

Better Health Channel, Haemorrhoids

Australian Government Department of Health, Haemorrhoids

HealthDirect, Endoscopy

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