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Hemorrhoids in pregnancy: by trimester

Published 13 March 2026 ·Last reviewed 13 March 2026 by the editorial team ·How we create our content

A composite account, drawn from many real anonymised experiences. It is not any one person's story.

Hemorrhoids in pregnancy: by trimester

What this experience covers

This experience follows the pattern of hemorrhoids through each trimester of pregnancy and into the postpartum period. It draws from many anonymised accounts to show how the condition typically develops, changes, and resolves across this timeline.

Understanding the trimester-by-trimester pattern helps people anticipate what is coming and take preventive action early.

The pattern

First trimester

Most people do not develop significant hemorrhoids in the first trimester, but the groundwork is being laid:

  • Progesterone levels rise, relaxing blood vessel walls
  • Constipation may begin, particularly if iron supplements are started
  • People with a history of hemorrhoids may notice mild early symptoms
  • Prevention opportunity: establishing fibre, hydration, and toilet habits now pays off later

Second trimester

Hemorrhoids often first appear or become noticeable:

  • The growing uterus begins pressing on pelvic veins
  • Blood volume increases significantly
  • Constipation may worsen
  • People describe the first awareness of swelling, itching, or discomfort
  • Management: sitz baths, stool softening, positioning. Conservative measures are the mainstay

Third trimester

This is typically when hemorrhoids are most problematic:

  • Maximum uterine pressure on pelvic veins
  • Weight and pressure at their peak
  • Constipation often at its worst
  • Hemorrhoids may prolapse or thrombose
  • Sitting and sleeping become difficult
  • Management: all conservative measures plus positional strategies (left-side lying), cushion use

Labour and delivery

  • Pushing during delivery can significantly worsen hemorrhoids
  • New hemorrhoids may appear
  • Existing hemorrhoids may thrombose
  • This is often the peak of the condition
  • The focus is on delivery — hemorrhoid management happens afterwards

Postpartum

  • The mechanical cause (uterine pressure) resolves immediately
  • Most hemorrhoids begin to improve within days to weeks
  • Postpartum constipation can delay improvement
  • Maintaining fibre and hydration postpartum is critical
  • Most people describe significant improvement by 6 to 8 weeks postpartum

What people wish they had known

  • That starting prevention in the first trimester is genuinely effective
  • That hemorrhoids during pregnancy are extremely common and not something to be embarrassed about
  • That the pushing during labour is temporary — even if hemorrhoids worsen at delivery, they typically improve afterwards
  • That mentioning hemorrhoids at any antenatal appointment is completely normal and gets practical help

If you are managing hemorrhoids during pregnancy and want to talk through your situation, our chat is here.

When to contact your midwife or doctor

Seek guidance if:

  • Bleeding is heavy or you are unsure whether it is rectal or vaginal
  • A lump becomes very painful, hard, or dark-coloured
  • Symptoms are not improving with conservative measures
  • Any symptoms concern you during pregnancy
When to seek care Heavy bleeding or feeling faint? Get emergency help now. Emergency: 911

Not sure how urgent it is? Get help today.

  1. Emergency

    Heavy bleeding, black tarry stools, feeling faint, severe pain or trouble breathing.

    Call 911 or go to the ER.

  2. Today

    Fever, pain getting worse, a hot swollen lump, or trouble passing urine.

    Call your doctor or go to urgent care.

  3. Soon

    Bleeding or bowel changes nobody has checked, or anything lasting 3 weeks.

    Book a doctor’s appointment.

Feeling overwhelmed? Call or text 988, any time.

See all the signs

For this topic, get medical advice if you notice:

  • Severe or worsening pain
  • Heavy bleeding
  • Fever
  • Black stools
  • Fainting or dizziness
  • Pus or unusual discharge
  • Inability to pass stool or gas
  • Unexplained weight loss

Recording how you feel is not the same as being checked. These are the signs that need a doctor’s attention.

Call 911 or go to the emergency room now if you have:

  • bleeding that will not stop, a lot of blood (the toilet water turns red, or you pass large clots), or any bleeding with feeling faint or dizzy
  • fainting, a racing heart or trouble breathing
  • confusion or slurred speech, extreme shivering, no urine in a day, or blotchy skin
  • sudden severe belly pain, or a swollen, hard belly with vomiting or not passing stool or gas
  • you cannot pass urine at all, or your bladder feels full and painful and you can’t empty it
  • redness, swelling or severe pain spreading quickly around your anus, genitals or groin, especially with a fever or feeling very ill
  • a fever with a painful swelling near your anus if you have diabetes or a weakened immune system (for example, from chemotherapy or transplant medicines)
  • black, tarry stools

Call your doctor or go to urgent care today (or the ER if you can’t be seen today) if you have:

  • a temperature of 100.4°F (38°C) or higher, chills, vomiting, or feeling generally unwell
  • pain that is getting worse over days, or severe pain that stops you sitting or sleeping
  • a hot, swollen or very tender lump near your anus or at the top of the crease between your buttocks, or foul-smelling discharge
  • trouble urinating
  • bleeding that is getting heavier or more frequent, or blood mixed into your stool
  • feeling much more tired than usual, looking pale, or getting out of breath more easily than you used to
  • not passing stool for several days, or new belly pain

Make an appointment with your doctor if:

  • you have never had these symptoms checked by a doctor or nurse — whatever your age
  • you have had rectal bleeding for more than 3 weeks
  • your bowel movements have been looser, thinner or more frequent than usual for 3 weeks or more, or you have lost weight without trying
  • symptoms have not settled after a week or so, or keep coming back
  • you notice a new lump near your anus, between your buttocks or in your belly, or an itch or discharge that does not clear
  • you have new leakage or trouble controlling your bowels
  • you are 45 or over, or have a family history of bowel cancer or inflammatory bowel disease, and any of these symptoms are new for you

If you are unsure, it is always reasonable to ask. If things feel overwhelming, call or text 988 (Suicide & Crisis Lifeline) or chat at 988lifeline.org, any time. If you don’t feel safe, call 911.

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Discreet symptom tracking

Symptoms that come and go? Keep track, day by day.

For hemorrhoids, fissures, fistulas and other anal and rectal problems. A short, discreet email asks how things have been, and saves each answer, so you can look back at every flare and every good week in your own words. If you haven’t had your symptoms checked, see your doctor first.

  • About ten seconds a check-in. No app, no password.
  • Nothing in the subject or preview says what it’s about.
  • Each Sunday, a link to your week, ready for your next appointment.
Start tracking →

Your notes

Your check-in

Takes about ten seconds.

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