Rectal bleeding during pregnancy

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

At a glance

Rectal bleeding during pregnancy is common, usually caused by hemorrhoids or anal fissures that develop or worsen due to the physiological changes of pregnancy. While it is common, it should always be mentioned to your midwife or GP to confirm the source and rule out other causes.

This guide covers why rectal bleeding happens during pregnancy, the most common causes, safe management approaches, and when to seek urgent attention.

Why pregnancy causes rectal bleeding

Hemorrhoids

The most common cause. Pregnancy promotes hemorrhoid development through:

  • Increased blood volume — more blood flowing through the body, including the pelvic veins
  • Pelvic pressure — the growing uterus puts weight on the pelvic veins, impeding blood return and causing engorgement
  • Progesterone — this hormone relaxes smooth muscle in vein walls, making them more prone to swelling
  • Constipation — hormonal changes slow bowel motility; iron supplements compound this
  • Straining — from constipation, leading to increased pressure on hemorrhoidal veins

Hemorrhoid bleeding in pregnancy is typically bright red, associated with bowel movements, and often painless (from internal hemorrhoids) or accompanied by a painful lump (thrombosed external hemorrhoids).

Anal fissure

The second most common cause:

  • Hard stools from pregnancy-related constipation cause tears in the anal lining
  • The characteristic pattern: sharp pain during bowel movements with bright red blood
  • Tends to respond to stool management, though many fissure treatments are restricted in pregnancy

Constipation

Hard, dry stools can cause minor bleeding from abrasion of the rectal lining, even without a defined fissure or hemorrhoid.

Safe management during pregnancy

Stool management (the foundation)

  • Fibre: increase gradually to 25 to 30 grams daily from fruits, vegetables, whole grains, and safe supplements
  • Water: at least two to three litres per day — increased demand during pregnancy
  • Pregnancy-safe stool softeners: osmotic laxatives are generally considered safe; discuss specific products with your midwife or GP
  • Iron supplements: if causing constipation, discuss alternative formulations with your midwife

Sitz baths

  • Warm water for 10 to 15 minutes, particularly after bowel movements
  • Completely safe during pregnancy
  • Provides comfort and reduces swelling

Toilet habits

  • A footstool to raise the knees
  • Never straining — if the bowel movement does not come easily, try again later
  • Responding to the urge promptly
  • Limiting toilet time

Topical care

  • Plain barrier creams (zinc-based) for protection
  • Discuss any medicated creams with your midwife or GP before use
  • Many over-the-counter hemorrhoid products have not been studied in pregnancy

When to seek attention

Routine mention at next appointment

  • Small amounts of bright red blood associated with bowel movements
  • Hemorrhoid or fissure symptoms that are manageable

Prompt assessment

  • Rectal bleeding that is heavy or increasing
  • Dark red or black blood
  • Blood mixed through the stool
  • Bleeding with abdominal pain or cramping
  • Bleeding with dizziness or faintness
  • Any vaginal bleeding — this is distinct from rectal bleeding and always needs urgent assessment in pregnancy
  • Any bleeding that concerns you

Important distinction

During pregnancy, distinguishing between rectal and vaginal bleeding is important. If you are unsure of the source, contact your midwife or GP promptly. Vaginal bleeding during pregnancy can indicate conditions that need immediate assessment, and it should never be assumed to be rectal without confirmation.

After delivery

Rectal bleeding patterns typically change after delivery:

  • Pregnancy-related hemorrhoids often improve as pelvic pressure reduces and hormone levels normalise
  • Delivery itself — particularly vaginal delivery, especially with forceps or prolonged pushing — can worsen hemorrhoids or cause new fissures
  • The postpartum period is a time to continue stool management
  • Breastfeeding increases hydration needs — maintain water intake
  • If symptoms persist or worsen after delivery, treatments that were restricted during pregnancy may become available — discuss timing with your GP

Common questions

Is rectal bleeding normal during pregnancy?

Rectal bleeding is common during pregnancy, most often caused by hemorrhoids or constipation-related fissures. While it is common, it should still be mentioned to your midwife or GP so they can confirm the source and ensure it is not something that needs further attention.

How can I tell the difference between rectal and vaginal bleeding?

Rectal bleeding comes from the anus and is usually associated with bowel movements. Vaginal bleeding comes from the vagina and is unrelated to bowel movements. If you are unsure of the source, or if you are experiencing vaginal bleeding, contact your midwife or GP promptly. Vaginal bleeding during pregnancy always needs assessment.

What causes hemorrhoids during pregnancy?

Several pregnancy-related factors contribute: increased blood volume causes veins to swell, the growing uterus puts pressure on pelvic veins, progesterone relaxes vein walls, constipation from hormonal changes and iron supplements leads to straining, and reduced physical activity in later pregnancy.

How is rectal bleeding treated during pregnancy?

Treatment focuses on safe measures: stool softening through fibre and hydration, pregnancy-safe stool softeners if needed, sitz baths for comfort, good toilet posture, and avoiding straining. Most prescription topical treatments for hemorrhoids and fissures are used with caution during pregnancy — discuss any treatments with your midwife or GP.

Will rectal bleeding get better after delivery?

For many people, pregnancy-related hemorrhoids and fissures improve after delivery as hormonal changes reverse and pelvic pressure reduces. However, delivery itself — particularly vaginal delivery — can temporarily worsen symptoms. Maintaining good stool management through the postpartum period supports recovery.

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:

  • Heavy rectal bleeding during pregnancy
  • Dark blood or blood mixed through stool
  • Bleeding with abdominal pain or cramping
  • Bleeding with dizziness or faintness
  • Any vaginal bleeding (which is distinct from rectal bleeding and always needs assessment)
  • Any rectal bleeding that concerns you during pregnancy

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.

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  • 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 →

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