Postpartum hemorrhoids are extremely common, and most respond well to simple home treatments within the first few weeks after delivery. Up to 85% of pregnant people experience hemorrhoid symptoms, and in one study of 280 women who gave birth, 43% had hemorrhoids afterward. The good news: a combination of warm soaks, topical relief, and dietary changes can significantly reduce pain and swelling while your body heals.
Why Hemorrhoids Happen After Birth
During pregnancy, your growing uterus puts increasing pressure on the veins in your pelvis, making it harder for blood to flow back toward your heart. Blood pools in those veins, causing them to swell, much like varicose veins. This typically worsens in the third trimester as the baby’s weight increases. Then, during delivery, the intense pushing compounds the problem. Women who pushed for more than 20 minutes during delivery were more likely to develop hemorrhoids in the study mentioned above.
Postpartum constipation, which is nearly universal in the days after birth, makes things worse. Straining on the toilet puts direct pressure on already swollen veins, so preventing constipation is just as important as treating the hemorrhoids themselves.
Sitz Baths: The Single Best Relief
A sitz bath is the most consistently recommended treatment for postpartum hemorrhoids. Fill your bathtub or a shallow plastic basin (sold at most pharmacies) with 3 to 4 inches of warm water, around 104°F (40°C). Soak for 15 to 20 minutes, letting the warmth increase blood flow to the area and relax the swollen tissue. Three to four sitz baths a day is a reasonable frequency when symptoms are at their worst.
Pat the area completely dry afterward with a soft cloth rather than rubbing. Many people find that doing a sitz bath right after a bowel movement offers the most relief, since that’s when irritation peaks.
Topical Treatments That Help
Witch hazel pads (often sold as Tucks pads) reduce swelling, pain, and itching when applied directly to the hemorrhoid. Look for alcohol-free formulations, which are gentler on already sensitive tissue. You can tuck a pad against the hemorrhoid inside your underwear and leave it in place for ongoing relief. Some people make “padsicles” by spreading aloe vera and alcohol-free witch hazel on a maxi pad, then freezing it. The cold adds another layer of relief on top of the witch hazel’s anti-inflammatory effect.
Over-the-counter hydrocortisone cream can also reduce inflammation. If you’re breastfeeding, rectal application of hydrocortisone cream or suppositories poses little to no risk to your baby. The amount absorbed systemically is minimal. That said, hydrocortisone is best used for short stretches rather than continuously, as prolonged use can thin the skin in that area.
Plain ice packs wrapped in a cloth and held against the area for 10 to 15 minutes at a time can numb pain and reduce swelling, especially in the first few days postpartum.
Preventing Constipation and Straining
Nothing will undo your progress faster than straining on the toilet. Keeping stools soft is essential to letting hemorrhoids heal. Aim for about 29 grams of fiber per day from fruits, vegetables, whole grains, and legumes. If you’re not used to eating much fiber, increase gradually to avoid bloating and gas. Pair that with plenty of water: about 12 cups (3.1 liters) daily, which also supports milk production if you’re breastfeeding.
A stool softener containing docusate sodium is commonly given in the hospital after delivery and is considered compatible with breastfeeding. It works by drawing water into the stool so it passes more easily. If you need something beyond a stool softener, options like psyllium fiber supplements, magnesium hydroxide, or senna are also considered safe alternatives during breastfeeding. The goal is to never sit on the toilet straining. If a bowel movement isn’t happening easily, stand up and try again later.
Sitting and Positioning Tips
You might assume a donut-shaped pillow would help, but colorectal specialists actually advise against them. The ring shape fails to properly support the tissue around the hemorrhoid and can increase pressure on the swollen veins, potentially making things worse. A regular soft cushion or pillow provides better, more even support when you need to sit.
More importantly, avoid prolonged sitting whenever possible. Lying on your side takes all pressure off the rectal area and is the most comfortable position for many people in the first week postpartum. When you do sit, shift your weight periodically and take standing breaks. This is especially worth remembering during long breastfeeding sessions: side-lying nursing can give both you and the baby a comfortable position while keeping pressure off your hemorrhoids.
What the Healing Timeline Looks Like
Most postpartum hemorrhoids begin to shrink noticeably within the first one to two weeks as the swelling from delivery subsides. Mild hemorrhoids often resolve on their own within a few weeks with consistent home care. Larger or more persistent ones can take several weeks to fully settle, and some degree of skin tags or tissue changes may remain even after symptoms are gone.
The factors that slow healing are the same ones that caused the problem: constipation, straining, and prolonged sitting. If you stay on top of fiber, hydration, and sitz baths, you give your body the best chance to recover without intervention.
Signs That Need Medical Attention
A thrombosed hemorrhoid, where a blood clot forms inside the swollen vein, looks like a blue or purple lump near the anus and causes intense, constant pain rather than the intermittent aching of a typical hemorrhoid. This type of hemorrhoid sometimes improves on its own over several days, but if the pain remains severe, a provider can perform a quick in-office procedure to remove the clot.
Bleeding that soaks through a pad, pain that worsens rather than improves after the first week, or any signs of infection like fever or chills are reasons to contact your provider. Postpartum bleeding from the uterus is expected, but bright red blood specifically from the rectal area that’s heavy or persistent is worth having evaluated to rule out other issues like an anal fissure, which can develop alongside hemorrhoids and requires its own treatment approach.