What haemorrhoids actually are
Haemorrhoids are not a foreign body but vascular cushions in the lower rectum that are present in everyone. They help to provide a fine seal of the anus. Symptoms occur when these cushions swell, protrude outward or become inflamed.
In everyday language, “haemorrhoids” is often used as a catch-all term for anything that itches, hurts or bleeds at the anus. That is why a precise classification is helpful, so you do not treat the wrong problem.
Why haemorrhoids are so common after childbirth
Several factors come together in the postpartum period. Pregnancy increases pressure in the pelvis, tissues are more blood-filled and the veins are under more strain. During labour, pushing and stretching add to this.
After delivery, practical factors often worsen symptoms: fear of pain, less movement, a changed toilet routine and constipation. If stool is hard or you need to strain, the vascular cushion is irritated further.
Typical aggravating factors in the postpartum period
- Constipation and hard stool, often due to stress, lack of sleep, inadequate fluid intake or iron supplements
- Straining during bowel movements
- Long periods of sitting, especially on hard surfaces
- Pain or scarring in the perineal area that causes you to tense up unconsciously during toilet visits
How haemorrhoids can feel
Many people notice pain during bowel movements, burning, itching or a sensation of pressure around the anus. Sometimes there is bright red blood on the toilet paper or on the stool. This can be alarming but is often superficial with haemorrhoids.
Common symptoms
- Pain during or after stool
- Itching, burning, irritated skin
- A feeling of pressure or a lump at the anus
- Bright red blood streaks, usually small in amount
A good basic overview of how haemorrhoids develop and common self-help measures is provided by the NHS. NHS: Piles haemorrhoids
Important: not everything is a haemorrhoid
In the postpartum period haemorrhoids are often confused with two other conditions. That is not being fussy; it is practical because the treatment may differ.
Anal vein thrombosis
This is a sudden, very painful lump at the anus, often with intense pressure. It can look bluish‑violet and usually hurts regardless of bowel movements. It is sometimes called an external haemorrhoid but is a different condition.
Anal fissure
An anal fissure is a small tear in the skin. Typical signs are a sharp, stabbing pain during bowel movements, often like a cut, and sometimes persistent burning afterwards. Here the main focus is on keeping stool soft and reducing irritation.
Safe relief: what usually helps in the postpartum period
The goal is not to make everything disappear instantly. The aim is less pressure, less irritation and a bowel movement without straining. When that is achieved, the situation improves for many within days to a few weeks.
Keep stool soft without drama
- Drink fluids regularly throughout the day
- Eat fibre-rich foods such as oats, fruit, vegetables, and psyllium husk with plenty of water
- Keep toilet sitting time short; avoid prolonged sitting on the toilet
- If necessary, discuss a stool softener with your healthcare team, especially if straining is otherwise unavoidable
The NIDDK explains clearly why softer stool and avoiding straining are central measures for haemorrhoids. NIDDK: Hemorrhoids
Sitz bath, cooling, heat
A sitz bath can be soothing if kept short and the water is lukewarm. Some people benefit more from cooling, others from warmth. The important point is that it soothes and does not dry out or sting.
- Keep sitz baths short and lukewarm, then pat gently dry
- Cool compresses for swelling, but not ice-cold and not directly on bare skin
- Use heat more for muscle tension when it feels comforting
Ointment, suppositories and what to consider
Many ask about an ointment because they expect quick relief. Topical products can reduce symptoms such as itching and burning, but they do not fix the underlying problem if you continue to strain. Use them for a short duration, with a clear indication and good tolerability. If you are breastfeeding or uncertain, the pharmacy is a helpful place to get advice on a suitable product and to avoid interactions.
Hygiene without irritation
- After bowel movements, clean with water if possible or use soft, fragrance-free toilet paper
- Avoid harsh wet wipes with fragrances or alcohol
- Wear breathable underwear and avoid tight seams that rub
Everyday tricks that are often underestimated
In the postpartum period it is often the small things that make a difference. When you are in pain, you may unconsciously tense, hold your breath and end up straining.
Practical relief
- A soft seat cushion or sitting slightly to one side if direct sitting is painful
- Getting up by rolling onto your side rather than pushing straight up, to reduce downward pressure
- Putting your feet on a small stool during bowel movements to make it easier
- If you notice you are straining, stop briefly, breathe out and try again
When evaluation is advisable
Many cases are unpleasant but manageable. Nevertheless there are clear situations when you should not just wait because something else could be the cause or because you are suffering unnecessarily.
Seek evaluation if
- you have heavy bleeding or blood in the stool that becomes more frequent and heavier
- you experience dizziness, severe weakness or a racing heart
- you have fever or the area is very red, warm and increasingly painful
- you develop a suddenly very painful, hard lump
- you have no noticeable improvement after one to two weeks despite soft stool and relief measures
If your symptoms disrupt daily life in the postpartum period, that alone is a good reason to seek help. You do not have to endure it to prove something to yourself.
Myths and facts in the postpartum period
- Myth: An ointment alone will solve the problem. Fact: Relief comes mainly from soft stool and less straining.
- Myth: Blood always means something dangerous. Fact: Bright red blood can occur with haemorrhoids, but heavier or persistent bleeding should be evaluated.
- Myth: Sitz baths must be hot. Fact: Lukewarm is often better tolerated; too hot can irritate.
- Myth: You should not talk about bowel movements. Fact: Discussing it is often the key to the quickest relief.
Conclusion
Haemorrhoids after childbirth are common, especially when constipation and straining occur. The safest measures are to keep stool soft, reduce irritation and adapt daily routines to reduce pressure. Sitz baths and ointments can ease symptoms, but the most important step is having bowel movements without stress. If bleeding increases, very painful lumps develop or there is no improvement, evaluation is advisable.
