Hemorrhoids from birth

Common Conditions - After Delivery - Obstetrics - UR Medicine Obstetrics & Gynecology

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Common Conditions

Constipation

Normally, bowel movements will resume within the first few days following your baby's birth. Constipation can occur after having a baby. If you experience postpartum constipation, here are a few suggestions:

• Drink at least eight to ten large glasses of fluid a day.
• Try eating prunes - they are a natural mild laxative.
• Get plenty of rest every day.
• Drink warm liquids each morning.
• Eat foods such as bran, fruits, green vegetables and whole grain cereals and breads.
• A mild laxative or fiber supplement can be used if other measures do not work.
• Call your health care provider if you do not have a bowel movement by the third or fourth day after having your baby.

Hemorrhoids (Piles)

A hemorrhoid is a painful swelling of a vein in the rectum. After having a baby - especially after a vaginal delivery - many women develop hemorrhoids. Symptoms include pain, rectal itching, bleeding after having a bowel movement, or a swollen area around the anus.
How to treat:

• You can use a sitz bath (a basin filled with warm water) or a bath to soak yourself in warm water. This will help hemorrhoids to shrink. Do this two to four times a day.
• Apply witch hazel to the hemorrhoids to soothe. Keep the witch hazel cool in the refrigerator, then apply with cotton balls.
• Sit on a pillow or waffle cushion to relieve pressure on the rectum. Sitting in a rocking chair or recliner may also be more comfortable than sitting in a straight chair.
• Hemorrhoid creams, ointments, suppositories or sprays are available over-the-counter and can produce short term relief. Your health care provider can recommend a brand that is best for you.
• Increase dietary fiber and your intake of fluids. This will help to prevent constipation.
• You may be prescribed a stool softener, and this may take a few days to work. Drinking extra water will also help keep your stools soft.
• If the pain does not go away within a few days, contact your health care provider for further assistance.

Vaginal Bleeding

Every woman experiences postpartum discharge - or lochia - following the birth of a baby. Initially, the bleeding will be bright red with a few small clots - similar to a heavy menstrual period. This should last only through the first week. Over the first two to six weeks following birth, the color will turn from bright red, to pinkish brown then fade to cream or white.

In the hospital, your nurses will provide you with sanitary pads. During your hospital stay, you may want to leave your nicer lingerie (panties and nightgowns) at home, in case you experience any leaking.

This bleeding usually stops in three to six weeks. At home, continue to use sanitary pads, and be sure to wash your hands after changing your pad. DO NOT use tampons douches or powders - these may introduce bacteria to your healing uterus and cause infection.

After delivery of the baby, you will be given a peri bottle (plastic bottle) to squirt warm water over your perineum (area of the opening to your vagina) to keep it clean. This not only keeps the area clean, but can also be very soothing following a vaginal birth and/or episiotomy. Fill your peri bottle with comfortably warm water, and use after each time you use the restroom. Squirt the water from front to back, then gently dry yourself (also from front to back). Take a shower or tub bath every day, using soap and water. Do not use bubble bath during this healing time.

Report heavy vaginal bleeding (soaking more than one pad per hour), large clots, a foul odor, or unusual abdominal tenderness to your health care provider.

Postpartum Blues (or "Baby Blues")

The birth of a baby is a joyful and happy time, but for various reasons, many women (60-80%) experience a mild and temporary form of depression commonly referred to as the "Baby Blues." Possible triggers include the sudden hormonal changes following delivery, the stress and lack of sleep that occur while caring for a newborn.

Symptoms of the Baby Blues usually appear within the first week or two following delivery, and may last for several weeks following. Symptoms include: feelings of tiredness; mood swings; feelings of loss, frustration or anger; unexplained weeping; irritability; inability to sleep.

How should you deal with these feelings? First, try to get some help with the baby and some rest. Many mothers find these feelings go away after adequate rest. Share your feelings with your partner, and find a friend or family member to talk to as well. Most of the time, the main thing you need is a hug and a shoulder to cry on.

If you do not feel better within a few weeks, or if you are concerned about the way you are feeling, be sure to call your health care provider.

Postpartum Depression

While many women will experience Postpartum Blues ("Baby Blues"), in some women these feelings of depression will persist - Postpartum Depression (PPD). If these feelings persist or worsen, medical attention is needed to help you get through this time.

Some symptoms of PPD are similar to the Baby Blues, but become more intense. Other symptoms include: insomnia; persistent sadness; lack of interest in nearly all activity; anxiety; change in appetite; persistent feelings of guilt; thoughts of harming oneself or the baby.

You or a family member need to be aware that sometimes the feelings of guilt will keep some mothers from admitting that they are depressed. Partners or other family members may need to be the ones to contact your health care provider.

So how do you know when the baby Blues have become PPD, and you need to seek medical attention? Contact your health care provider:

• If you or your family suspect that you are experiencing postpartum depression;
• If the "Blues" do not seem to go away two to three weeks following delivery, or feelings seem to intensify;
• If you do not want to be with your baby;
• If you become so angry or frustrated that you worry that you may harm yourself or your baby;
• If you are overeating or not eating at all;
• If you are having increased difficulty coping with everyday frustrations;
• If you are experiencing little satisfaction and enjoyment with motherhood.

How to Manage Postpartum Hemorrhoids

Written by WebMD Editorial Contributors

Reviewed by Dan Brennan, MD on March 16, 2021

In this Article

• What Causes Postpartum Hemorrhoids?
• Symptoms of Postpartum Hemorrhoids
• What to Do When You Have Postpartum Hemorrhoids

Hemorrhoids, also known as piles, are veins in or around your anus that have become swollen. Many women will experience hemorrhoids for the first time during pregnancy or after giving birth. While this can be an extra discomfort while taking care of your new baby, there are several ways to ease your symptoms.

What Causes Postpartum Hemorrhoids?

Hemorrhoids are common during the third trimester of pregnancy and one month after delivery. In a study of 280 women who gave birth, 43% had hemorrhoids. Many of these women had related conditions, such as constipation during pregnancy, and pushing for more than 20 minutes during delivery. 

Hemorrhoids are caused by pressure on the veins in your rectum or anus. Veins have valves to help the blood flow toward your heart. But when these valves are weakened because of pressure, blood can pool in the veins. This makes them swell up, similar to the way varicose veins form. 

Pregnant women have the additional weight of their baby sitting on their abdomen and pelvis. This makes it hard for the blood to return from the pelvis area.  

Many pregnant women also have constipation, or fewer than three bowel movements a week. This can be due to:

• Hormonal changes that affect the digestive system
• Diet changes during pregnancy
• Moving less 
• Too much iron due to taking iron supplements
• The growing baby pressing on the mother’s intestines and affecting digestion

Constipation is also common after giving birth. In many women, this could be caused by a combination of changing hormones, pain medication, dehydration, or a fear of pain from their hemorrhoids or episiotomy site (a surgical cut made between the vagina and anus as you give birth).

Hemorrhoids can get worse with straining and constipation. If you have hemorrhoids when you’re pregnant, you'll likely experience worse postpartum hemorrhoids. 

Symptoms of Postpartum Hemorrhoids

Hemorrhoids can be internal, where they form inside the rectum. They can also be external, located around the anal opening. Symptoms of postpartum hemorrhoids include:

• Pain in the anal area
• Itchiness in the anal area
• Bleeding during bowel movements
• Sensitive lumps near the anus 

What to Do When You Have Postpartum Hemorrhoids

There are a number of ways to help relieve the discomfort from your hemorrhoids, including:

Eat a high-fiber diet. Try to soften your stools by eating foods that are high in fiber. High-fiber foods include vegetables like broccoli and green peas, fruits like pears and apples, legumes like lentils and black beans, as well as whole grain cereals and breads.

Drink lots of water. If you’re breastfeeding, you’ll need at least eight cups of water a day. Have a glass of water every time you nurse your baby.

Stool softener. Talk to your doctor about using a stool softener to ease pain during bowel movements. Stool softeners make the stool easier to pass and are generally considered safe during and after pregnancy.

Don’t sit too long. Sitting for long stretches of time increases pressure on the veins in your anus. Instead, lie down as much as possible, such as when you’re nursing.

Use a pillow. When you have to sit down, sit on a pillow or foam doughnut. 

Get some exercise. Try to move around more, even if it’s just a short walk. Exercise can also help prevent constipation. Check with your doctor before you start any exercise program after giving birth. 

Apply ice. A study of 200 postpartum women found that cold gel pads relieved pain during recovery and increased their comfort. Apply an ice pack for 20 to 30 minutes, several times a day. Wrap the ice pack in a cloth so that it isn’t in direct contact with your skin.

Witch hazel.Witch hazel can help reduce the swelling and provide cool relief. Store your witch hazel in the refrigerator. Apply using cotton balls or pads. You can also add some witch hazel when you soak in your tub.

Warm water soak. Soak in a tub or take a sitz bath. Fill the tub with warm (not hot) water. It only takes a couple of inches of water for a sitz bath. Soak for about 15 minutes, a few times a day. This will help your hemorrhoids to shrink. 

Most cases of postpartum hemorrhoids improve after a few days or weeks. If not, contact your doctor.

Proctologist Nikolaev ☑ Surgeon ☑ Doctor Ryabets Dmitry Nikolaevich