Hemorrhoids During Pregnancy
Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN
Content reviewed against published ACOG, NIH, March of Dimes guidelines
Last reviewed:
Your health matters just as much as your baby's. If you are dealing with hemorrhoids during pregnancy, here is what you need to know.
The short answer
Hemorrhoids are swollen blood vessels in the rectal area that affect up to 35% of pregnant people. They are caused by increased blood volume, pressure from the growing uterus, constipation, and straining. While uncomfortable, they are very common and usually treatable with conservative measures.
Key takeaways
- Hemorrhoids are swollen blood vessels in the rectal area that affect up to 35% of pregnant people. They are caused by increased blood volume, pressure from the growing uterus, constipation, and straining. While uncomfortable, they are very common and usually treatable with conservative measures.
- Usually normal when: Mild itching, discomfort, or swelling around the anus
- Call your doctor if: Heavy rectal bleeding that soaks pads or does not stop
- Varies by age — see the age-by-age breakdown below
“About 1 in 8 women experience symptoms of postpartum depression. If you have symptoms of depression that last longer than 2 weeks, tell your health care provider.”
This is one of the most common questions parents ask. Searching for answers means you care.
What Parents Should Know
According to ACOG, NIH, March of Dimes guidelines, hemorrhoids are swollen blood vessels in the rectal area that affect up to 35% of pregnant people. They are caused by increased blood volume, pressure from the growing uterus, constipation, and straining. While uncomfortable, they are very common and usually treatable with conservative measures. At Second trimester, hemorrhoids may develop as blood volume increases and the uterus begins to put pressure on pelvic veins. Preventing constipation is the best way to prevent hemorrhoids. Eat plenty of fiber, drink adequate water, and avoid sitting for prolonged periods. Witch hazel pads and warm sitz baths can soothe symptoms. It is generally considered normal when mild itching, discomfort, or swelling around the anus. However, you should contact your pediatrician promptly if heavy rectal bleeding that soaks pads or does not stop.
Normal vs. Concerning
By Age
What to expect by age
Second trimester
Hemorrhoids may develop as blood volume increases and the uterus begins to put pressure on pelvic veins. Preventing constipation is the best way to prevent hemorrhoids. Eat plenty of fiber, drink adequate water, and avoid sitting for prolonged periods. Witch hazel pads and warm sitz baths can soothe symptoms.
Third trimester
Hemorrhoids are most common and often worst in the third trimester due to maximum pressure from the growing uterus. Kegel exercises can improve blood flow to the rectal area. Use a step stool to elevate your feet while on the toilet to reduce straining. Your provider can recommend safe topical treatments.
Labor & delivery
Pushing during vaginal delivery can worsen existing hemorrhoids or cause new ones. This is very common and expected. Ice packs, witch hazel pads, and sitz baths in the days after delivery can help. Let your care team know about hemorrhoid discomfort so they can help manage it.
Postpartum
Hemorrhoids that developed during pregnancy or delivery usually improve significantly within weeks to months after birth. Continue with stool softeners, fiber, and sitz baths. Most pregnancy-related hemorrhoids resolve without surgical treatment. If they persist or are very painful, talk to your provider about additional treatment options.
What to Tell Your Pediatrician
- Describe when you first noticed hemorrhoids during pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if hemorrhoids are very painful, large, or prolapsing (protruding from the anus).
- Mention if you are having recurrent bleeding with bowel movements.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Mild itching, discomfort, or swelling around the anus
- Small amount of bright red blood on toilet paper when wiping
- Symptoms improve with sitz baths, witch hazel, and fiber intake
- Hemorrhoids developed during pregnancy and are manageable
- Hemorrhoids are very painful, large, or prolapsing (protruding from the anus)
- You are having recurrent bleeding with bowel movements
- Over-the-counter treatments are not providing adequate relief
- Heavy rectal bleeding that soaks pads or does not stop
- A hard, extremely painful lump at the anus that is blue or purple, suggesting a thrombosed hemorrhoid that may need medical treatment
What You Can Do at Home
- Keep track of when you notice hemorrhoids during pregnancy — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that mild itching, discomfort, or swelling around the anus — this is generally within the range of normal.
- At Second trimester, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
- While monitoring at home, seek immediate care if heavy rectal bleeding that soaks pads or does not stop.
Related Conditions
Constipation During Pregnancy
Constipation affects up to 40% of pregnant people and is caused by the hormone progesterone slowing digestive transit, iron supplements, a growing uterus pressing on the intestines, and reduced physical activity. It can be managed with increased fiber, fluids, and gentle exercise.
Varicose Veins in Pregnancy
Varicose veins are swollen, twisted veins that commonly appear in the legs during pregnancy. They affect up to 40% of pregnant people and are caused by increased blood volume, hormonal changes that relax vein walls, and pressure from the growing uterus on pelvic veins. They are usually a cosmetic concern but can cause aching or discomfort.
Related Resources
Postpartum Recovery Guide
Week-by-week postpartum recovery timeline and warning signs.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is hemorrhoids during pregnancy normal?
When should I call the doctor about hemorrhoids during pregnancy?
When is hemorrhoids during pregnancy normal?
What causes hemorrhoids during pregnancy?
What should I mention to my pediatrician about hemorrhoids during pregnancy?
Is hemorrhoids during pregnancy normal at Second trimester?
Is hemorrhoids during pregnancy normal at Third trimester?
Should I go to the ER for hemorrhoids during pregnancy?
Does hemorrhoids during pregnancy go away on its own?
References
- [1]American College of Obstetricians and Gynecologists. Problems of the Digestive System. ACOG FAQ, 2022. ACOG
- [2]National Library of Medicine. Hemorrhoids. StatPearls, 2023. NIH
- [3]March of Dimes. Common Discomforts of Pregnancy. March of Dimes, 2023. March of Dimes
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Hemorrhoids During Pregnancy.
Things to mention
- Describe when you first noticed hemorrhoids during pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if hemorrhoids are very painful, large, or prolapsing (protruding from the anus).
- Mention if you are having recurrent bleeding with bowel movements.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Hemorrhoids are very painful, large, or prolapsing (protruding from the anus)
- You are having recurrent bleeding with bowel movements
- Over-the-counter treatments are not providing adequate relief
Urgent signs to report immediately
- Heavy rectal bleeding that soaks pads or does not stop
- A hard, extremely painful lump at the anus that is blue or purple, suggesting a thrombosed hemorrhoid that may need medical treatment
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of hemorrhoids during pregnancy are normal. Talk to your pediatrician if heavy rectal bleeding that soaks pads or does not stop.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
Was this page helpful?
Related Maternal Concerns
Constipation During Pregnancy
Constipation affects up to 40% of pregnant people and is caused by the hormone progesterone slowing digestive transit, iron supplements, a growing uterus pressing on the intestines, and reduced physical activity. It can be managed with increased fiber, fluids, and gentle exercise.
Varicose Veins in Pregnancy
Varicose veins are swollen, twisted veins that commonly appear in the legs during pregnancy. They affect up to 40% of pregnant people and are caused by increased blood volume, hormonal changes that relax vein walls, and pressure from the growing uterus on pelvic veins. They are usually a cosmetic concern but can cause aching or discomfort.
Dealing with Abnormal Prenatal Screening Results
An abnormal prenatal screening result can be terrifying, but it is important to understand that screening tests are designed to cast a wide net and have significant false-positive rates. Most people with abnormal screening results go on to have healthy babies after further testing confirms the baby is fine. An abnormal screening is a reason for more information, not a diagnosis.
Pregnancy Over 35 (Advanced Maternal Age)
While pregnancy after 35 carries some increased risks (including chromosomal abnormalities, gestational diabetes, and hypertension), the vast majority of people over 35 have healthy pregnancies and healthy babies. The term "geriatric pregnancy" is outdated and does not reflect reality. With appropriate prenatal care and monitoring, outcomes are excellent.
Amniocentesis Questions and Fears
Amniocentesis is a diagnostic test performed between 15-20 weeks that analyzes amniotic fluid to detect chromosomal conditions and genetic disorders with over 99% accuracy. The risk of pregnancy loss from the procedure is approximately 1 in 500-1,000 when performed by an experienced provider. Understanding the actual risks can help you make an informed decision.
20-Week Anatomy Scan Unexpected Findings
The 20-week anatomy scan checks your baby's major organs, structures, and growth. Most scans are completely normal. When unexpected findings are identified, they range from minor variants that resolve on their own to conditions that need further evaluation. Many findings require nothing more than a follow-up ultrasound to confirm the baby is developing well.