What hemorrhoids actually are
Hemorrhoids are not a foreign body but vascular cushions in the rectum that are present in everyone. They help the anus form a fine seal. Symptoms occur when these cushions swell, protrude outward, or become inflamed.
In everyday language, "hemorrhoids" is often used as a catch-all for anything that itches, hurts, or bleeds at the anus. That’s exactly why a clear distinction is useful so you don’t treat the wrong problem.
Why hemorrhoids are so common after childbirth
In the postpartum period several factors come together. Pregnancy increases pelvic pressure, the tissues are more blood-filled, and the veins are strained. Pushing and stretching during delivery add to this.
After birth, very practical things often worsen symptoms: fear of pain, less movement, an unfamiliar toilet routine, and constipation. If stool is hard or you have to strain, the vascular cushion is additionally irritated.
Typical aggravating factors in the postpartum period
- Constipation and hard stool, often due to stress, lack of sleep, insufficient fluids, or iron supplements
- Straining during bowel movements
- Prolonged sitting, especially on hard surfaces
- Pain or scarring in the perineal area that causes unconscious tightening during toilet visits
How hemorrhoids can feel
Many people mainly notice pain during bowel movements, burning, itching, or a feeling of pressure in the anal area. Sometimes there is bright red blood on the toilet paper or on the stool. That can be alarming, but with hemorrhoids it is often superficial.
Common symptoms
- Pain during or after bowel movements
- Itching, burning, irritated skin
- A feeling of pressure or a lump at the anus
- Bright red streaks of blood, usually small amounts
A good basic overview of how hemorrhoids develop and common self-care measures is provided by the NHS. NHS: Piles (haemorrhoids)
Important: not everything is a hemorrhoid
In the postpartum period hemorrhoids are often confused with two other conditions. That's not being picky — it's practical, because the treatment can differ.
Anal venous thrombosis
This is a sudden, very painful lump at the anus, often with a strong feeling of pressure. It can look bluish-violet and usually hurts independently of bowel movements. Sometimes this is called an external hemorrhoid, but it is a different condition.
Anal fissure
An anal fissure is a small tear in the skin. Typical is a sharp stabbing pain during bowel movements, often like a cut, and sometimes persistent burning afterward. Here keeping stool soft and reducing irritation are especially important.
Safe relief: what usually helps in the postpartum period
The goal is not to make everything disappear. The goal is less pressure, less irritation, and a bowel movement without straining. When that is achieved, the situation improves for many people within days to a few weeks.
Keep stool soft without drama
- Drink fluids regularly throughout the day
- Get fiber from foods, for example oats, fruit, vegetables, and psyllium with enough water
- Keep toilet time short; avoid sitting for long periods
- If necessary, and in consultation with your care team, use a stool softener—especially if straining is otherwise unavoidable
The NIDDK explains well why softer stool and avoiding straining are key measures for hemorrhoids. NIDDK: Hemorrhoids
Sitz baths, cold packs, and heat
A sitz bath can be soothing if you keep it short and use lukewarm water. Some people benefit more from cold, others from heat. The important thing is that it calms the area and does not dry out or sting.
- Keep sitz baths short and lukewarm, then gently pat dry
- Use cool compresses for swelling, but not ice-cold and not directly on bare skin
- Use heat rather for muscle tension when it feels comforting
Ointments, suppositories, and what to consider
Many ask about an ointment because they expect quick relief. Topical products can reduce symptoms like itching and burning, but they don’t fix the underlying problem if you continue to strain. Use them for short periods, with a clear indication and good tolerability. If you are breastfeeding or unsure, a pharmacist is a good resource to choose an appropriate product and avoid interactions.
Hygiene without irritation
- After bowel movements, clean with water if possible or with 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’s often the small things that make a difference. If you have pain, you may unconsciously tense up, hold your breath, and end up straining anyway.
Practical relief
- Use a soft seat cushion or sit slightly to the side if direct sitting hurts
- Get up by rolling onto your side instead of pushing straight up to reduce downward pressure
- Place your feet on a small stool while on the toilet to make bowel movements easier
- If you notice you’re straining, stop briefly, exhale, and try again
When evaluation is advisable
Many cases are uncomfortable but manageable. Still, there are clear situations when you should not just wait, because something else could be behind it or you may be suffering unnecessarily.
See a clinician if
- you have heavy bleeding or blood in the stool that becomes more frequent or heavier
- you experience dizziness, severe weakness, or a racing heart
- you have a fever or the area is very red, hot, 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 measures to reduce pressure
If your symptoms are keeping you from daily life during the postpartum period, that alone is a good reason to seek help. You don’t have to endure it to prove anything to yourself.
Myths and facts in the postpartum period
- Myth: An ointment alone will solve the problem. Fact: Relief mainly comes from soft stool and less straining.
- Myth: Blood always means something dangerous. Fact: Bright red blood can occur with hemorrhoids, 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 shouldn't talk about bowel movements. Fact: Talking about them is often the lever that brings the quickest relief.
Conclusion
Hemorrhoids after childbirth are common, especially when constipation and straining occur. The safest measures are keeping stool soft, reducing irritation, and adapting daily habits to decrease pressure. Sitz baths and ointments can reduce symptoms, but the most important step is a stress-free bowel movement. If bleeding increases, large painful lumps develop, or there is no improvement, seek evaluation.
