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Hemorrhoids during pregnancy: what's safe, what works, and when to call your OB

The Tushlab guide · Updated July 2026

If you're pregnant and dealing with hemorrhoids, two things are true at once: it feels miserable, and it is extremely normal. Published estimates suggest up to 40% of pregnant women experience hemorrhoids, most often in the third trimester, when a growing uterus puts pressure on the veins that drain the lower body and progesterone relaxes vein walls. Constipation, common in pregnancy, adds to the strain.

Why pregnancy causes hemorrhoids

Three forces stack up: pressure from the uterus on pelvic veins, pregnancy hormones that make vein walls more elastic, and slower digestion that leads to constipation and straining. None of this is something you did wrong, and for most women it improves substantially after delivery.

What's generally considered safe during pregnancy

• Warm sitz baths. Ten minutes in a few inches of warm water, once or twice a day, increases blood flow and relaxes the area. This is the same protocol hospitals use in postpartum care. Plain warm water works; epsom salt soaks are a common, gentle addition.
• Witch hazel. A plant-based astringent used for decades on irritated perianal skin, including in medicated pads and cloths. Drug-free witch hazel cloths can replace dry toilet paper, which often makes things worse.
• Easier bathroom habits. More water, more fiber (food first, or a fiber supplement your OB approves), don't delay the urge, don't strain, and keep feet on a low stool so you're in more of a squat.
• Cold compresses for swelling, and lying on your left side to take pressure off the pelvic veins.

What to ask your OB about first

Medicated options exist over the counter, but during pregnancy the rule is simple: ask before you use them.

• Topical anesthetics such as lidocaine creams numb pain quickly. Many providers are comfortable with short-term external use in pregnancy, but this is exactly the conversation to have with yours.
• Vasoconstrictors (like phenylephrine, found in some classic hemorrhoid creams) are commonly advised against during pregnancy. Check the active ingredients on any product you already own.
• Steroid creams (hydrocortisone) are usually a short-course, ask-first option.

When to call your provider promptly

• Any rectal bleeding (usually harmless in this context, but it should always be confirmed by a professional)
• Severe pain, or a hard, very painful lump (possible thrombosed hemorrhoid, which has quick in-office treatments)
• Symptoms that don't improve after about a week of consistent self-care

After delivery

Postpartum is the other peak moment for hemorrhoids, especially after a long second stage of labor. The same gentle toolkit applies and matters even more; we've written a separate guide: Postpartum hemorrhoid care, a gentle recovery guide.

This guide is general information, not medical advice, and doesn't replace a conversation with your OB, midwife, or doctor. Prevalence estimates per the National Institute of Diabetes and Digestive and Kidney Diseases and published obstetric literature.

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