Haemorrhoids and varicose veins in pregnancy: steps that relieve and prevent

Talk to a few people and you will notice: haemorrhoids and varicose veins are far from rare in pregnancy, they are just rarely discussed. There is nothing to be embarrassed about. Both come from the natural way your blood vessels respond to pregnancy, and in most cases simple measures can bring relief.

Why do they increase in pregnancy?

• Blood volume rises: The body carries more blood to nourish the baby, so vessels work fuller.
• Hormones relax vessel walls: Progesterone makes veins stretchy and slows the return flow of blood.
• Pressure from the uterus: The growing uterus presses on the veins in the pelvis and legs.
• Constipation: Common in pregnancy, and straining can trigger haemorrhoids.

Haemorrhoids (piles)

These are swollen veins around the back passage. They are more common in the last months and after birth. Signs:

• Pain, burning or itching around the anus
• Bright red blood after a bowel movement (on the paper or in the bowl)
• Swelling or a small lump you can feel around the anus
• Difficulty sitting

Varicose veins

Swollen, bluish, twisting veins in the legs, sometimes around the vulva. You may feel heaviness, pulling, aching, throbbing, or swelling that grows towards evening. The chance is higher if varicose veins run in your family or if you had them in earlier pregnancies. Most improve clearly in the months after birth.

What you can do for haemorrhoids

• Prevent constipation: Fibre-rich foods (vegetables, fruit, whole grains, pulses) and plenty of water.
• Avoid straining: Do not sit on the toilet for long or pass time scrolling your phone.
• Hygiene: Gentle washing, fragrance-free, and warm water instead of wet wipes.
• A cold compress or a warm sitz bath can ease pain and swelling.
• Avoid standing or sitting for long periods; change position.
• Ask your doctor or pharmacist about creams, suppositories and medicines; not every product is suitable in pregnancy.
• Kegel exercises support circulation in the area.

What you can do for varicose veins

• When sitting or lying, raise your legs above heart level, for 10–15 minutes several times a day.
• Do not stand for long periods or cross your legs.
• Suitable compression stockings recommended by your doctor, put on before getting out of bed, can reduce swelling.
• Regular gentle movement such as walking or swimming activates the calf muscle pump.
• Avoid tight clothes; choose comfortable shoes.
• Lying on your left side can reduce pressure on the large veins.
• Try to avoid gaining weight too quickly, but do not blame yourself over your weight.

After birth

Haemorrhoids and varicose veins improve over time in most people after birth. For haemorrhoids, a warm sitz bath, fibre-rich food and plenty of water help in the first days. Even in the tiredness of early parenthood, it matters not to rush or strain on the toilet. Varicose veins clearly shrink within a few months; if they do not, or are painful, ask your doctor about further assessment. Be patient with yourself; your body is recovering.

Talking to your doctor or midwife about these things is an ordinary part of a check-up; they hear it every day. However small the discomfort may seem, it is worth looking for a solution. Holding back only prolongs the problem.

When to contact your doctor

• Heavy or continuous bleeding from the back passage, or dark bloody stools
• Haemorrhoids with severe pain or a hard purple lump
• One-sided swelling, warmth, redness and pain in a leg: this can point to a clot, get seen the same day
• Breathlessness, chest pain or blood in phlegm: call 112 or go to the emergency room
• A sore, skin colour change or marked pain around a varicose vein
• Constipation lasting days without relief
• A large, painful swelling in the vulva

This article is for information only; your doctor's or midwife's advice is what counts for your personal situation.