Sometimes, motherhood can be a real pain in the butt.
Yep, we're talking about postpartum hemorrhoids, people. Not the most glamorous subject, but it's a conversation worth sitting down for.
Okay, I'll stop with the puns.
Hemorrhoids after childbirth are a common problem. One that nurse midwife Blanche Skubic, of Sutter Davis Hospital in Northern California, realized during our conversation that medical professionals probably don't do enough to warn women about during pregnancy.
Why is that?
For the women that have hemorrhoids before the baby, we'll tell them that the hemorrhoids aren't going to get better until after the baby. But if you don't have them before the baby, I don't think we'd say anything about it.
If you were to prepare women better for what to expect postpartum, what would you tell them?
I would tell them that just having a baby in your uterus, down in your pelvis, makes you more prone to hemorrhoids, because the blood flow doesn't get back up where it's supposed to be. It's kind of like varicose veins in your bottom instead of your legs. It's not unusual to have hemorrhoids. Then you push a baby out, that pressure increases, and you're more likely to get hemorrhoids.
What can you do about it?
There's not a whole lot you can do about it, except comfort care. I recommend to women, especially immediately postpartum, ice is your best friend. Especially there; it helps shrink them. You can also use "Tucks", or a generic form of little cotton pads that are saturated with witch hazel, to help shrink and soothe the hemorrhoids.
The other thing that works is Preparation H or anything with a steroid in it. If you're going to use a steroid cream, you don't want to use it for more than two weeks.
So there's nothing really to make them go away?
Not really, but most of the time, the hemorrhoids will shrink when the baby's born, so that you're not bothered by them.
If they're not, or if they get excruciatingly tender, they can get something called "thrombosed," where you get a blood clot in them. Those have to be lanced. The only way to get rid of a hemorrhoid, is to have a hemorrhoidectomy, which is not a small little surgery. And probably not something that you want to do until you're done with your childbearing years. Because anything that puts pressure on the veins down there is gonna make them pop out again.
Speaking of pressure, the first postpartum bowel movement is scary enough. What happens when you also have hemorrhoids?
If you have a big tear down there, that's what is the most scary. So you're really afraid to poop. Another thing that happens a lot in postpartum, especially if you're breastfeeding, is you get pretty constipated. So the key to all this is lots of fiber, lots of fluid, a stool softener if you need it, and even the old time Milk of Magnesia works a little bit after the baby's born. The key is to keep things soft and moving down there.
Skubic also adds that it’s normal for hemorrhoids to hurt, but if you are having excruciating pain, an intense burning sensation, or bright red blood in your stool, you should see your provider to make sure you don't have a rectal tear.