• The uterus puts pressure on the veins that bring blood back from the lower body to the heart, at the same time as the pregnancy hormone progesterone relaxes the walls of the veins. This combination causes the veins in the lower half of the body to swell. Gravity adds to this effect if you stand or sit for long periods of time.


• Increased abdominal pressure, like pushing out a hard bowel movement (or a baby) can also inflate these veins.

• Prevention: Avoid constipation, and try not to push or strain when you are having a bowel movement.


• Treatment:


• Treat constipation before it gets severe.


• Topical therapy of hemorrhoids can give relief of symptoms


• Over-the-counter creams, ointments and suppositories that contain hydrocortisone soothe the inflammation


• Sitz baths: Sitting in warm water in your bathtub or in a plastic sitz-bath tub which fits into your toilet and can be purchased over-the-counter from your drugstore, is soothing and can help clean the area if it is too painful to wipe.


• Pads containing witch hazel, an astringent solution (under the brand name Tucks™) can be purchased over-the-counter. These are used for cleansing and soothing the hemorrhoid area.


• On rare occasions, if a large clot forms in the dilated vein, surgery is done during pregnancy. These clots are very painful, but the surgical procedure to remove them is relatively minor. The procedure is done with local anesthesia in the office or hospital.

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