Haemorrhoids During Pregnancy? You Are Not Alone

Motherhood brings unique joys and pains to every mum, and we are better off acknowledging that. In this series called Mum Truths, mums reveal their secret successes, miseries and gripes about parenting in a no-holds-barred first-person recount.

I am mother to two beautiful girls, Lily Indie and Ziggy Kee. Along with them are two haemorrhoids (piles) - Polly and Penny - that decided to set up home at my rear end while I was pregnant.

For the uninitiated, piles or haemorrhoids refer to veins around the anus that become swollen or inflamed. A Google search tells me that the condition affects, shockingly, one in three people in Singapore, more commonly among pregnant women and those above 40 years old. 

While these little bulges are a literal pain in the butt (they can also itch and bleed), piles don’t usually cause major complications.

When I first met Polly the pile, in the eighth month of my first pregnancy, I was thoroughly grossed out. What was this foreign piece of skin? What did Google mean by “gently insert finger and push it in”?  The horror of having to deal with haemorrhoids during pregnancy!

Soon after delivery, as I was scrolling through Instagram, a picture of Kim Kardashian in a thong bathing suit came into view. I shuddered in pain. This after having a fourth-degree tear and an angry inflamed pile. I thought to myself: “Am I the only person who’s gotten haemorrhoids?”

I asked my doctor how soon I could have it removed. “If it’s not causing you any discomfort or bleeding, just leave it, especially if you’re planning to have another child.” What? Another child? Does that mean another pile? True enough, six months into my second pregnancy, Penny made her unwanted appearance. 

Like my pile, you are not alone

After my first birth, my work group chat extended their congratulations, many asking how I was feeling. I replied with two words, “Traumatic. Haemorrhoids.” I received private messages from my mum friends extending their condolences and advice on how they handled it. So it is normal!

Not long after, again while scrolling through Instagram, I stumbled upon Marie Soh, a mother of three, makeup artist and baker, talking about her experience with haemorrhoids caused by pregnancy. Before becoming a makeup artist, she was a trained nurse and learnt all about piles in nursing school.

Similar to me, she experienced piles with each pregnancy as well, the worst being with her third. As she bent over to pick up her child, she strained and it caused her to have a thrombosed pile, whereby a blood clot forms in an external haemorrhoid and causes itching and bleeding. It caused such pain she checked herself into the hospital at once to have it removed.

I gave birth vaginally so it would make sense with all the straining for a haemorrhoid to slip out. However as Marie told me, she had all three kids via caesarean section, so it was the sheer pressure of being pregnant that caused the emergence of piles. 

“The process was simple," she recalls. "I decided at the A&E to have it surgically removed, signed a consent and went into surgery! The full recovery took three weeks. With the help of stool softeners and painkillers it was all pretty manageable, and I could still breastfeed.” 

When to seek help

Unlike Marie, I haven’t gotten around to having my little visitors removed (should I even bother?). I reached out to Dr Tan Wah Siew, a general and colorectal surgeon in private practice for advice.

Why do some haemorrhoids go back in on their own? Are there different types? Apparently the answer is yes! There are four to be exact.

Grade 1: Blood vessels are prominent but haemorrhoids do not protrude

Grade 2: Protruding haemorrhoids that spontaneously reduce

Grade 3: Protruding haemorrhoids that need to be manually reduced

Grade 4: Protruding haemorrhoids that can no longer be manually reduced

Having that in mind I wondered how long one should wait to have their bottom looked at. After all, haemorrhoids and cancerous lumps can cause similar symptoms. Good practice is always having any lump checked out even if there is no pain. “If there are associated symptoms like worsening pain or fever, this will prompt the patient to seek medical attention early. Otherwise, it is not unreasonable to wait a week or so to see if the lump goes away," says Dr Tan.

While speaking with Dr Tan, she made sure to stress that bleeding is not normal even if it is painless. “I’ve had patients who become anaemic because they didn’t realise how much blood they were really losing at each poo.”

Now if you have a low-grade haemorrhoid and surgery isn't for you, there are some over-the-counter creams you can use. Though there is no strong evidence that any one of these products work better than the others, it is useful to note that most contain steroids, and long-term steroid use should be avoided. 

Happy bottom ends

When it comes down to it, there isn’t anything embarrassing about haemorrhoids. I personally have taken it upon myself to tell all my girlfriends about it. In fact, Preparation H, a little ointment to relieve the discomfort of piles has become one of the main stars of my pregnancy kit. That, along with some Epsom salts, and a tub for mummy to do a little sitz bath in. 

Jill Lim is the perpetually exhausted mother of two girls and an adopted dog. Dark humour and cynicism are her love language. Like and subscribe at @killjilllll.