Hemorrhoids in Pregnancy: Safe Treatments
Hemorrhoids affect roughly a quarter to 40% of women at some point during pregnancy or in the weeks after delivery — common enough that it’s worth having clear information ready rather than figuring it out symptom by symptom. This page covers what’s generally considered safe to try, what to check with your provider before using, and when a symptom needs more than home care.
- Hemorrhoids in pregnancy are usually caused by increased pressure on pelvic veins, hormonal changes, and constipation — all things basic self-care can help with.
- Most topical hemorrhoid treatments (creams, wipes, suppositories) are considered low-risk in pregnancy and while breastfeeding, but check with your OB-GYN or midwife before starting any new product, including “natural” ones.
- Postpartum, some anal pain is actually a tear related to delivery rather than a hemorrhoid — worth mentioning to your provider so you get the right treatment.
- Certain symptoms after delivery need prompt medical attention rather than home care — see the list below.
Why pregnancy makes this more likely
A growing uterus increases pressure on the veins in the pelvis and rectum, which can cause existing hemorrhoids to worsen or new ones to develop. Hormonal changes during pregnancy also relax vein walls, and constipation — common in pregnancy for several reasons, including iron supplements — adds straining on top of that. All three factors point toward the same first-line approach: softer stools and less straining.
What’s generally considered safe to try
As always in pregnancy, “generally considered safe” is not the same as “cleared for you specifically” — check with your OB-GYN or midwife before starting anything new, including the items below.
Dietary and lifestyle measures (typically the first recommendation):
- Increasing fiber intake through food, or a fiber supplement if your provider approves one
- Drinking more water
- Avoiding straining and responding promptly to the urge to go, rather than delaying
- Short walks or gentle movement, if your pregnancy allows it
Topical measures:
- Warm sitz baths — shallow, warm soaks — for symptom relief
- Cold compresses for swelling
- Topical treatments containing witch hazel, or protectants like glycerin, are commonly used and generally considered low-risk, but check the label and your provider before use
- Topical lidocaine for pain is commonly used in pregnancy and postpartum, but still worth confirming with your provider given individual circumstances
Medication:
- Stool softeners like docusate are commonly considered safe during pregnancy and lactation, but should still be used on your provider’s advice rather than self-selected
- Fiber supplements, if dietary fiber alone isn’t enough
What to check before using, specifically
- Any oral medication or supplement, including ones marketed as natural remedies — pregnancy changes what’s considered safe in ways that aren’t always intuitive.
- Steroid-containing creams (e.g., hydrocortisone) — often fine for short-term use, but confirm with your provider rather than assuming based on OTC labeling alone.
- Anything long-term — most guidance here is for short-term symptom relief; ongoing symptoms deserve a conversation with your provider rather than continued self-treatment.
After delivery: what’s a hemorrhoid, and what might not be
Postpartum, anorectal pain and bleeding have another possible cause besides hemorrhoids: tearing related to delivery itself, including tears that extend toward or into the anal area. This is a different injury from a hemorrhoid and may need different care and follow-up. If you’re not sure which one you’re dealing with, that’s a reasonable and common question to bring to your postpartum visit rather than something you’re expected to figure out yourself.
Most postpartum hemorrhoids improve within the first couple of weeks as pregnancy-related swelling and blood volume changes resolve, continuing to improve over the following weeks with the same conservative measures used during pregnancy.
When to call your doctor rather than continue self-care
- Bleeding soaks through a pad, or continues beyond what you’d expect from a bowel movement
- Pain is severe enough to interfere with caring for your baby
- A hemorrhoid or tissue that came out cannot be pushed back in
- You notice signs of infection: increasing pain, fever, or discharge
- Symptoms haven’t improved after about six weeks of consistent home care
The broader red flags list — including any first-ever rectal bleeding unrelated to delivery, or a family history of colorectal cancer — still applies during and after pregnancy.
About procedures
Minimally invasive procedures (like rubber band ligation) and surgery are typically not performed during pregnancy, and are generally postponed if you’re breastfeeding, unless symptoms are severe enough that your care team recommends otherwise. If conservative treatment isn’t resolving things after delivery, this is a conversation to have with your OB-GYN or a colorectal specialist about timing — not a reason to assume nothing can be done until you’re done breastfeeding entirely.
This page is for general education and isn’t a substitute for advice from your OB-GYN or midwife, who knows your specific pregnancy, delivery, and health history.