Haemorrhoids, often called piles, are swollen veins in the anal passage.
They can occur near the surface of the anus (external haemorrhoids) or higher in the anal canal (internal haemorrhoids). Sometimes, haemorrhoids can protude outside the anus (prolapsing haemorrhoids).

Symptoms include bleeding from the anus, particularly when having a bowel movement; pain; itching and burning.

Why do they occur during pregnancy?

Up to 50% of women suffer from haemorrhoids in pregnancy.
The growing weight of the baby, combined with an increase in circulating blood volume, puts extra pressure on blood vessels and causes the veins to dilate, leading to haemorrhoids.
Constipation, which often accompanies pregnancy, can also cause or aggravate haemorrhoids.

Labour and childbirth often make the problem worse, especially if you have a prolonged second stage and are pushing for a long time as this puts extra strain on the anal veins. If you need to have perineal stitches, this can also aggravate haemorrhoids.

If you suffered from haemorrhoids during a previous pregnancy you are more likely to get them again in subsequent pregnancies.

Fortunately, haemorrhoids usually reduce or disappear after your baby is born.

How can I prevent haemorrhoids?

One of the most effective ways to prevent haemorrhoids developing is to avoid becoming constipated:

• Eat a high-fibre diet
• Drink at least eight glasses of water a day.
• Take gentle, daily Pelvic floor exercises concentrating on the anus two or three times a day will help the blood flow and help to relieve pressure.

Will they go away after the birth?

Haemorrhoids that have developed during pregnancy usually disappear after the birth of your baby - but this will not be immediate.
Haemorrhoids are often at their worst during the first two weeks after childbirth. They may be very painful during this time. In the early days after the birth applying ice packs to the area to reduce swelling and sitting on an inflatable ring will help ease the discomfort. Lubricating the anus before bowel movements will also help ease pain and discomfort.

How can I relieve the discomfort?

To relieve the discomfort of haemorrhoids:

• Relax in a warm bath to relieve the itching and pain.
• Apply ice packs to the area a couple of times a day.
• Avoid sitting or standing for long periods as this puts more pressure on the rectal veins.
• Wash and dry the area carefully every time you have a bowel movement.
• Lubricate the anus with a haemorrhoid cream to assist the passage of stools. If the haemorrhoids prolapse outside of the anus they can be gently pushed back in using some lubricating haemorrhoid cream.
• Ask your midwife or doctor to recommend safe topical anaesthetics or medicated suppositories.
• Local application of haemorrhoid creams and painkillers may help relieve the symptoms.

If you are finding the discomfort intolerable or there is rectal bleeding talk to your midwife or doctor. In some cases minor surgery is required to remove the haemorrhoids.