A Pelvic Floor Therapist’s Perspective
Bringing a baby into the world is an extraordinary experience — but it can also bring physical changes that many new mothers aren’t expecting. One of the most common postpartum concerns we see in our pelvic health clinic is hemorrhoids.
If you’re experiencing discomfort, itching, or pain after childbirth, know that you’re not alone — and that help is available. In this post, we’ll explain why hemorrhoids occur after pregnancy and delivery, and how pelvic floor therapy can support your recovery.
What Exactly Are Hemorrhoids?
Hemorrhoids are swollen veins in the lower rectum or around the anus, caused by increased pressure in the pelvic region.
Common symptoms include:
- Pain or burning during bowel movements
- Itching or irritation around the anus
- A small lump or swelling
- Bright red bleeding on toilet paper
While they can occur at any time, hemorrhoids are especially common during pregnancy and after childbirth due to hormonal, mechanical, and lifestyle factors.
Why Do Hemorrhoids Develop After Childbirth?
1. Increased Pelvic Pressure During Pregnancy
As your uterus grows, it puts pressure on the veins in your pelvis and lower body. This makes it harder for blood to return to the heart, which can lead to vein swelling and congestion around the rectum.
2. Hormonal Changes
The hormone progesterone, which helps your body prepare for pregnancy, also relaxes the walls of blood vessels and slows bowel motility. This combination increases the likelihood of developing hemorrhoids.
3. Constipation and Straining
Constipation is common in pregnancy and postpartum — often due to hormones, iron supplements, pain medications, and dehydration. Straining during bowel movements raises pressure in the rectal veins, worsening hemorrhoids.
4. The Pressure of Pushing
During vaginal delivery, the act of pushing creates intense intra-abdominal pressure. This can lead to immediate hemorrhoid flare-ups, especially after prolonged labor.
5. Postpartum Recovery Habits
After giving birth, new mothers often sit for long periods while feeding or resting. Combined with fatigue and limited mobility, this can impair circulation and delay healing of rectal tissues.
The Pelvic Floor Connection
Your pelvic floor muscles play an important role in bowel function and pressure management. After childbirth, these muscles may be weak, tight, or poorly coordinated, making it harder to fully relax during bowel movements — which can worsen hemorrhoids.
As pelvic floor therapists, we assess:
- Muscle tone and coordination
- Breathing and pressure management
- Bowel habits and toileting posture
Correcting these patterns can make a significant difference in both comfort and long-term recovery.
How to Manage and Heal Postpartum Hemorrhoids
1. Support Healthy Bowel Habits
- Stay hydrated (aim for 2–3 liters of water daily)
- Eat a fiber-rich diet: fruits, vegetables, whole grains, and legumes
- Avoid holding in bowel movements or prolonged straining
- Consider stool softeners if recommended by your provider
2. Soothe the Area
- Take warm sitz baths for 10–15 minutes, several times a day
- Use witch hazel pads or cold compresses to reduce swelling
- Ask your provider about safe topical creams or ointments if breastfeeding
3. Optimize Pelvic Floor Function
Working with a pelvic floor physical therapist can help you:
- Coordinate breathing and abdominal pressure
- Learn the “exhale to empty” technique for bowel movements
- Practice gentle movement to improve pelvic circulation
- Adopt proper toileting posture (knees elevated, leaning forward slightly)
4. Seek Medical Care When Needed
If your hemorrhoids are extremely painful, bleeding heavily, or not improving within a few weeks, consult your healthcare provider. In some cases, medical procedures may be necessary.
Healing Is Possible
Postpartum hemorrhoids are a common and treatable part of recovery. They’re a sign of the incredible changes your body undergoes to grow and deliver your baby — and with the right care, they can heal completely.
If you’re experiencing hemorrhoid discomfort or other pelvic floor concerns, our team can help, at Pelvic Health Center, we specialize in postpartum pelvic health — offering personalized therapy to restore comfort, confidence, and function.
Reach out to us at 908-443-9880 or email us at [email protected] to book a pelvic floor assessment today and take the next step in your postpartum healing journey.