Hemorrhoids after childbirth – what to do?

Content author: MD. Sara Godyńska, proctologist · Editorial work: Editorial team of Wyspa Medycyny Przyjaznej · Medical review: lek. Sara Godyńska · Date of creation: 07.08.2026 · Date of review: 07.08.2026 · Updated: 07.08.2026

The article is of an educational nature and does not replace a proctological examination or obstetric control after childbirth. Heavy bleeding, fever, chills, severe increasing pain in the perineum or anus, discharge of pus, urinary retention, fecal or gas incontinence, and fainting require immediate medical attention. All medications and preparations during breastfeeding should only be used after consulting a doctor.

The most important information at a glance

• Hemorrhoidal symptoms after childbirth are very common and result from a combination of pregnancy changes and pushing during childbirth.
• In most women, the symptoms gradually subside during the first weeks of the postpartum period.
• The biggest enemy of healing is constipation - and constipation occurs very often in the postpartum period.
• The basis of treatment is soft stool: fiber, hydration, exercise and avoiding pushing.
• Many topical preparations have restrictions during breastfeeding - the selection is up to the doctor.
• A sudden, very painful, hard and blue lump is usually a blood clot, not "ordinary hemorrhoids" - and other treatment options are available in the first few days.
• Surgical treatment is usually postponed until after the postpartum period to give the body a chance to improve on its own.
• Postpartum bleeding requires evaluation - not all bleeding is from hemorrhoids.
• Pain in the perineum after a cut or tear is sometimes confused with hemorrhoids; These are two different causes requiring different treatment.
• Incontinence of gases or stools after childbirth is never the norm during the postpartum period and requires consultation.

Find out more about the specialist

Doctor. Sara Godyńska is a proctologist at Wyspa Medycyny Przyjaznej in Gdańsk. He deals with the diagnosis and treatment of diseases of the anal area, including hemorrhoidal disease. During the postpartum period, the treatment is different than in other patients: some methods must be postponed, and the selection of preparations must take breastfeeding into account.

Meet the doctor. Sara Godyńska

Why after giving birth?

The problem rarely begins on the day of delivery. It usually increases throughout the pregnancy, with childbirth being the point at which symptoms become pronounced.

Several mechanisms work at once during pregnancy. The enlarging uterus presses on the pelvic veins, making it difficult to outflow blood from the anal area. Hormonal changes relax the walls of the vessels and slow down the functioning of the intestines, which promotes constipation. The volume of circulating blood increases. In addition, there has been less physical activity in recent weeks.

Natural childbirth adds a decisive element: long-lasting, intense pushing. A sudden increase in intra-abdominal pressure causes congestion and prolapse of hemorrhoids. In some women, a blood clot develops in the lump.

After giving birth, the problem persists with constipation - very common in the postpartum period due to dehydration, changes in diet, limited mobility, medications taken and the simple fear of the first bowel movement. This fear is understandable, but it leads to postponing bowel movements, harder stools, and even more urgency - exactly what you need to avoid.

It is worth adding that symptoms may also occur after a cesarean section. The changes of pregnancy alone are enough to cause hemorrhoidal disease - the lack of pushing reduces the risk, but does not eliminate it.

What symptoms are typical and what are not

The last line deserves to be emphasized because it concerns a problem that women talk about even less often than hemorrhoids. Difficulty holding gas or stools after giving birth may be due to damage to the sphincters and is not something you "just have to wait out." The earlier the assessment, the better the treatment options.

What can be done right away

There is one goal and everything serves it: the stool should be soft and the bowel movement should be short and without urgency. This is the most effective action in the postpartum period.

• Hydration. During the feeding period, the need for fluids increases, and dehydration immediately translates into harder stools.
• Fiber in the diet. Vegetables, fruits, whole grains, legumes. It is worth introducing changes gradually.
• Don't delay having a bowel movement. The longer the stool stays in the intestine, the harder it becomes.
• Not accepted If it doesn't work, it's better to get up and try later than to wrestle.
• Short visits to the toilet. No phone, no sitting.
• Foot rest. Changes the bending angle and facilitates defecation without pressing.
• Sitting sessions in lukewarm water. Several times a day for several minutes; they relax the sphincter and relieve pain.
• Cool compresses through the material, briefly, in case of severe swelling.
• Gentle hygiene. Washing with lukewarm water instead of rough paper, drying thoroughly.
• Avoiding long periods of sitting. When feeding, it is worth changing positions and taking breaks.
• Movement whenever possible. Even short walks improve peristalsis.

It is worth talking to your doctor about stool softeners, painkillers and ointments - also because some of them have restrictions during breastfeeding. This is not a formality: the selection should take into account both effectiveness and safety for the child.

Breastfeeding and treatment

This question is asked at every postpartum visit and deserves a clear answer: breastfeeding does not mean that nothing can be done. This means that the selection of procedures must take into account an additional criterion.

Some activities are completely safe and do not require any restrictions: hydration, diet, sit baths, cold compresses, hygiene, avoiding pushing, physical activity. They form the basis of treatment during this period.

With topical preparations and oral medications, the situation is more complex. Some substances pass into milk, others have limited safety data in lactation. Therefore, the rule is: no preparation - including those available without a prescription or "herbal" - should be used during this period without consultation.

It is also worth knowing that information about feeding is crucial for the doctor, not additional. Providing it at the beginning of the visit allows you to choose the right solutions right away, instead of changing the recommendations after the fact.

How long does it last and when will it get better?

For most women, symptoms gradually improve during the first weeks after giving birth. The pressure on the pelvic vessels disappears, the hormonal balance normalizes, movement and regular bowel movements return - and with this the congestion and swelling disappear.

However, the process is not the same for everyone. Improvement is delayed primarily by persistent constipation, as well as previous hemorrhoidal disease from before pregnancy, subsequent pregnancies, long second stage of labor and high birth weight of the child.

This is why surgical treatment is usually postponed until after the postpartum period. Not out of formal caution, but for a simple reason: it is worth first giving the body a chance to improve itself, because the picture after a few weeks can be completely different than right after giving birth. The exception are situations requiring urgent intervention.

If symptoms still persist after the postpartum period - loss of lumps, bleeding, itching, foreign body sensation - it is the right time for a full proctological assessment and discussion about treatment. Definitely better than putting it off until "someday, when the child grows up."

When not to wait

Most postpartum symptoms are not sudden. However, the following symptoms require urgent contact with a doctor:

• fever and chills,
• throbbing pain, increasing day by day instead of decreasing,
• redness spreading to the buttock or perineum,
• discharge of purulent or foul-smelling content,
• heavy bleeding from the anus or bleeding with clots,
• sudden, very painful, hard lump that cannot be drained,
• urinary retention,
• incontinence of gases or stools,
• severe weakness, paleness, dizziness, palpitations,
• dehiscence of the wound perineum or increasing pain in this area.

Note on anemia. In the postpartum period, many women have low iron levels due to perinatal blood loss. Additional, even minor, rectal bleeding may aggravate this situation, and the symptoms - weakness, shortness of breath, heart palpitations - can easily be attributed to the fatigue of caring for a newborn. It is worth reporting it and checking its morphology.

Not all pain is hemorrhoids

In the postpartum period, the perineum and anus area can be a source of pain of various causes, and the distinction determines the treatment.

• Wound after an incision or tear in the perineum. The pain is in the perineum, not the anal canal; requires obstetric control and proper wound care.
• Anal fissure. Sharp, cutting pain during and after defecation, with a small amount of light blood. Very common in puerperal constipation.
• Blood clot in the hemorrhoid. Sudden, hard, blue lump, very painful, appearing within hours.
• Perianal abscess. Pulsating pain, fever, diffuse redness - requires urgent intervention.
• Damage to the sphincters. Difficulty holding in gas or stools; requires specialist assessment.
• Skin folds. Soft, painless remnants of swelling or a previous blood clot - do not require treatment for medical reasons.

Therefore, if symptoms persist, it is worth undergoing examination instead of assuming the diagnosis. Treatment for a fissure, clot and hemorrhoidal disease is different, and treatment for hemorrhoids will not work in each of these situations.

The most common myths

• "It's normal after giving birth, you have to wait it out." Common - but not all ailments go away on their own, and some require urgent help.
• "Nothing can be used while feeding." No. The basis of treatment is completely safe, and the preparations are selected by the doctor taking into account lactation.
• "Since I had a cesarean section, hemorrhoids don't affect me." No. The changes of pregnancy alone are enough to cause hemorrhoidal disease.
• "Bleeding in the postpartum period is normal." Bleeding from the genital tract yes, but bleeding from the anus requires determining the cause.
• "You have to avoid having a bowel movement so that it doesn't hurt." Vice versa. Deposition leads to hardening of the stool and stronger tenesmus.
• "The procedure must be done immediately." Usually no. Surgical treatment is postponed until the end of the postpartum period, except in urgent situations.
• "Incontinence of gas after giving birth is normal." It is not. It requires an assessment and the sooner the better.
• "It's not appropriate to go to the doctor right after giving birth." It's out. This is one of the most common postpartum ailments.

Symptoms do not go away after childbirth or you don't know what you can use while breastfeeding?

A proctological consultation allows you to determine the cause of the symptoms and select safe treatment during lactation. If you have sudden symptoms, do not wait for an appointment - report urgently.

Proctology at the Island of Friendly Medicine in Gdańsk

At the Island of Friendly Medicine doctor. Sara Godyńska consults patients with ailments in the anal area, including those after childbirth. The visit includes an interview, proctological examination and determining whether the symptoms result from hemorrhoidal disease, a fissure, a blood clot or another cause requiring separate treatment.

During the postpartum and breastfeeding period, recommendations are selected taking into account lactation, and surgical treatment is usually planned after the postpartum period - except in situations requiring urgent intervention. The current scope of treatments, availability of dates, prices and rules of preparation for the visit should be confirmed during registration.

Find out more about the medicine. Sara Godyńska Proctological consultation Treatment of hemorrhoids

What to ask during the visit?

• Are my symptoms due to hemorrhoids or some other cause?
• Is this an anal fissure or blood clot?
• Which preparations can I use while breastfeeding?
• Which stool softener is right for me?
• How long can I wait for spontaneous improvement?
• When should you consider surgical treatment?
• Should I do a blood test for anemia?
• Does my bleeding require additional diagnostics?
• How to take care of the perineum and anus area in the postpartum period?
• Are pelvic floor muscle exercises recommended for me and from when?
• What to do to reduce the problem during the next pregnancy?
• What symptoms mean I should come in immediately?

FAQ - hemorrhoids after childbirth

Why do hemorrhoids appear after childbirth?

Pregnancy changes - the pressure of the uterus on the pelvic vessels, the influence of hormones and constipation - prepare the ground, and the intense pushing during labor causes congestion and prolapse of hemorrhoids.

Will it go away on its own?

For most women, symptoms gradually subside during the first weeks of the postpartum period. However, the condition is to prevent constipation - persistent pressure effectively delays improvement.

What can I use while breastfeeding?

No limits: hydration, a diet rich in fiber, sitz baths, cold compresses, gentle hygiene and avoiding pushing. Topical preparations and oral medications are selected by the doctor taking into account lactation.

Can they also occur after a cesarean section?

Yes. The changes of pregnancy alone are enough to cause hemorrhoidal disease. The lack of labor pressure reduces the risk, but does not eliminate it.

I'm afraid of having my first bowel movement - what should I do?

The most important thing is not to put it off and not to push it. Hydration, fiber, a foot rest and — after consultation — a stool softener help. Postponing bowel movements leads to hardening of the stool and worsens the situation.

When can the procedure be performed?

Surgical treatment is usually postponed until after the postpartum period to give the body a chance to improve on its own. The exception are urgent situations that require quick intervention.

Is rectal bleeding normal?

Requires evaluation. Most often it comes from a hemorrhoid or fissure, but the source must be determined. Additionally, after perinatal blood loss, even minor bleeding may worsen anemia.

I have a painful, hard lump - what is it?

A sudden, hard, blue and very painful lump at the edge of the anus is usually a hemorrhoid clot. It is worth reporting quickly because different treatment options are available in the first few days than later.

Is gas incontinence after childbirth normal?

No. This is a symptom that requires evaluation because it may result from damage to the sphincters. You shouldn't wait it out - earlier diagnosis means better treatment options.

Will this come back in my next pregnancy?

Subsequent pregnancies increase the risk of recurrence. However, they are reduced by maintaining regular, soft bowel movements, physical activity and earlier treatment of persistent symptoms.

Is proctological examination in the postpartum period painful?

The test takes a short time and is performed gently, using a gel. In case of painful lesions, local anesthesia is used or part of the examination is postponed. The patient can stop it at any time.

Who consults such ailments at WMP?

On the WMP website, MD. Sara Godyńska is described as a proctologist dealing with the diagnosis and treatment of diseases of the anal area. The scope of treatments and availability of dates are confirmed by registration.

Sources

• Island of Friendly Medicine, MD. Sara Godyńska: https://www.wyspamedycynyPrzyjaznej.pl/pl/sara-godynska-proktolog
• Wyspa Medycyny Przyjaznej, proctological consultation: https://www.wyspamedycynyPrzyjaznej.pl/pl/konsultacja-proktologiczna-gdansk
• Wyspa Medycyny Przyjaznej, treatment of varicose veins anus and hemorrhoids: https://www.wyspamedycynyPrzyjaznej.pl/pl/leczenie-zylakow-odbytu-hemoroidow-gdansk
• NHS, Piles (haemorrhoids): https://www.nhs.uk/conditions/piles-haemorrhoids/
• NHS, Piles in pregnancy: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/piles/
• NHS, Constipation: https://www.nhs.uk/conditions/constipation/
• NHS, Anal fissure: https://www.nhs.uk/conditions/anal-fissure/
• NHS, Your body just after the birth: https://www.nhs.uk/conditions/baby/support-and-services/your-post-pregnancy-body/
• NHS, Bowel incontinence: https://www.nhs.uk/conditions/bowel-incontinence/
• NHS, Iron deficiency anemia: https://www.nhs.uk/conditions/iron-deficiency-anaemia/
• NICE Clinical Knowledge Summaries, Haemorrhoids: https://cks.nice.org.uk/topics/haemorrhoids/
• Royal College of Obstetricians and Gynaecologists, information for patients: https://www.rcog.org.uk/for-the-public/