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Does Natural Childbirth Increase the Risk of Hemorrhoids?

In this article, we explain in detail how natural childbirth can influence the development or worsening of hemorrhoids. Many women experience this issue after giving birth, especially due to prolonged pushing during labor. The pressure caused by vaginal delivery can lead to congestion in the veins surrounding the anus. This congestion may result in the formation of new hemorrhoids or aggravate existing ones.

Pregnant women should understand the connection between pregnancy, childbirth, and the physical changes in the pelvic and rectal area. In this article, we explore whether natural childbirth is a primary cause of hemorrhoids, and what factors make some women more susceptible than others. We will also cover prevention and treatment methods, especially under the care of specialists like Dr. Daad Al-Taani, a well-known expert in anorectal disorders based in Dubai.

What Are Hemorrhoids? Causes, Symptoms, and Complications

Hemorrhoids are swollen veins in the lower rectum or around the anus. They occur when pressure builds up in these veins, causing them to swell and become irritated. Hemorrhoids are classified into two types:

  • Internal hemorrhoids, which are not visible from the outside and often cause minor bleeding

  • External hemorrhoids, which are visible and can cause severe pain and swelling.

Common symptoms include pain during bowel movements, itching, bleeding, and the appearance of painful lumps near the anus.

Hemorrhoids can be caused by several factors, including chronic constipation, frequent diarrhea, prolonged sitting, obesity, and heavy lifting. During pregnancy, the risk increases due to rising pressure on the pelvic and anal veins, especially in the later months. Pushing during delivery significantly adds to this pressure.

Potential complications include anemia from ongoing bleeding, or blood clots forming within the hemorrhoids — known as thrombosed hemorrhoids — which can be extremely painful and may require medical intervention.

Dr. Daad Al-Taani explains that treatment after childbirth depends on the severity of the hemorrhoids. In mild cases, conservative approaches such as pain relievers and stool softeners may be sufficient. For more advanced cases, non-surgical procedures or minor surgical interventions may be needed.

In the following sections of this article, we continue to explore the relationship between natural childbirth and hemorrhoids in depth. We also discuss whether cesarean delivery may be a better option in certain cases and offer effective tips to help prevent worsening of the condition after delivery.

You can visit our YouTube channel to watch exclusive interviews with Dr. Daad Al-Taani, where she discusses this condition and its treatment in detail.

The Relationship Between Childbirth and Hemorrhoids:

Postpartum hemorrhoids can either be a continuation of pregnancy-induced hemorrhoids or new ones that develop after delivery.

Childbirth itself can cause postpartum hemorrhoids, as the pushing during labor can lead to their formation (or worsen existing hemorrhoids).
During the pushing phase of childbirth, blood flows into the veins surrounding the anus, exerting additional pressure on these vessels. This leads to thrombosed hemorrhoids, where the veins become filled with clotted blood.

Risk factors for hemorrhoids during delivery include:

  • Constipation during pregnancy
  • Pregnancy-related hemorrhoids
  • Previous deliveries
  • Assisted vaginal delivery (e.g., forceps use)
  • Prolonged second stage of labor and extended straining (more than 20 minutes)
  • Baby’s weight exceeding 3800 grams
  • Prolonged pregnancy (beyond 40 weeks)
  • Extended labor (lasting more than 12 hours)

Postpartum hemorrhoids may appear large and alarming immediately after delivery, but they should shrink slightly within the first few days and show significant improvement after two weeks.

Pregnancy, childbirth, and the postpartum period significantly increase the risk of developing hemorrhoids.

Vaginal delivery is a risk factor for pelvic floor disorders.

At least 70% of women with hemorrhoids have had at least one previous pregnancy.

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What is the Preferred Delivery Method for Pregnant Women with Hemorrhoids?

The choice of delivery method depends on the woman’s condition.

The presence of hemorrhoids rarely prevents a woman from delivering vaginally. However, in cases of thrombosed external hemorrhoids, or when additional risk factors exist—such as large baby size and perineal tears—the doctor may opt for a cesarean section.

However, it is still possible for hemorrhoids to develop after a C-section, typically within the first few weeks postpartum.

This is due to constipation, excessive pressure on the rectum and anus during pregnancy, circulatory disturbances, and hormonal changes.

Treatment

If no severe conditions are present, surgical treatment of hemorrhoids is postponed until after pregnancy, childbirth, and breastfeeding.

As a result, internal thrombosed hemorrhoids and perianal thrombosis are usually treated conservatively by prescribing:

  • Pain relievers
  • Laxatives

Patients are also advised to:

  • Avoid constipation
  • Avoid prolonged straining during bowel movements
  • Avoid sitting for long periods on the toilet

If conservative treatment is ineffective, hemorrhoidal thrombosis can be drained under local or general anesthesia.

In the postpartum period, hemorrhoids can be treated using non-surgical procedures, including:

  • Rubber band ligation
  • Sclerotherapy or infrared coagulation

For third- and fourth-degree hemorrhoids, or in cases with large external skin tags, surgical treatment is recommended.

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