This past Christmas, my pregnant niece's husband confided in me, "Elizabeth* has like 1,000 hemorrhoids."
He did look over his shoulder and around the room as he told me this news in a hushed tone. Apparently, he knew it wasn't exactly the type of stuff you normally share about your spouse with another family member.
So, why would he put his confidence in me and risk the wrath of his wife if she found out he was talking about her nether regions? Because I have never made it a secret that when it comes to butt issues, I've pretty much been there done that. The horrors of pregnancy butt are no exception.
I was not at all surprised, taken aback, or disturbed by what my nephew-in-law shared with me. On the contrary, our hush-hush conversation about his wife's problem brought back a lot of painful memories of my own butt trials and tribulations during and after pregnancy. It also sparked a desire to try to explain the reality of the hazards of pregnancy bum.
Before going on, though, I want to make sure there's no confusion about what I'm talking about when I say "pregnancy bum". I am definitely NOT talking about the aesthetic butt issues that us mums tend to have pre- and postpartum. I acknowledge that cheek expansion, sagging, and flattening are not very fitting rewards for the 40+/- long-ass weeks that we drag around another human being in our bodies. But at least there's some hope with these issues that we can reverse them, even if it takes a few million squats, lunges, and glute bridges.
Rather, what I am talking about, is the internal trauma that carrying and pushing out something roughly the size of a watermelon through our lower (and, generally, tiniest) parts may cause.
You may think that the biggest threat of injury during the pregnancy process is to the vajajay. But from my experience--and probably millions of other women who've had babies can tell you--your rectal area is not at all safe during the pregnancy and birth process. In fact, it's in danger, girl!
I certainly do not want to scare anyone off from getting pregnant. And, of course, I don't want to add to the fear and stress an expectant mother might already be feeling. So, if you'd rather not know what could happen or why something is happening, by all means, please feel free to move on from this post.
However, I personally wish there had been a whole chapter dedicated to butt issues in the books like What To Expect When You're Expecting. Honestly, I could have done with far less information about what nut, vegetable, or fruit the growing human in my belly resembled week-by-week and much more on what the hell was forming between my cheeks that was so painful!
So, let's dig in to the burning questions moms-to-be and many moms-that-have-been may have about the pain in their butt.
Why do you get hemorrhoids during pregnancy?
When you're pregnant, blood flow increases to the pelvic area and, together with your enlarging uterus and growing baby inside, puts an enormous amount of pressure on the veins that run through the anus, which often results in those swollen 'rhoids. Pregnancy also slows down your bowels, which may mess with your bathroom behaviors, result in harder stools, and, ultimately, lead to some serious constipation. The resulting effort you might make to try to release the hounds, so to speak, could put even more pressure on the veins in your rectal area, causing them to become inflamed and bulge. As if that weren't enough crap working against you and your butt health when you're pregnant, your higher progesterone levels can cause the walls of the veins to relax, allowing them to swell more easily.
If I've had hemorrhoids before, am I definitely going to get them during pregnancy?
You know the saying: Nothing in life is certain, except for death and taxes. I feel that getting a raging case of hemorrhoids as a result of pregnancy is in the running to be added to that list. Especially if you were prone to getting them before--like me. Going into my pregnancy, the chance of a recurring episode of hemorrhoids (and possibly worse) was forefront in my mind. While I was worried about a lot of things when I was with child, like finding a new place to live, changing jobs, securing affordable child care, and much more, nothing kept me up at night more than the thought of what was going to happen to my butt during the whole pregnancy situation. I did what I could to avoid the worst and took loving care of my tush. I kept to my daily baths; I always had my butt pillow with me in the car and at the office; I did not go off the rails with my food; and I continued to move, whether it was moderate weight training, walking, yoga, etc. All of this routine helped me stay fairly regular on the potty, as well. Did I make it through pregnancy hemorrhoid-free? Only in my sweetest dreams. But if I hadn't given my bum all this love and attention, I can only imagine how much angrier it would have become as my pregnancy progressed.
Will delivery make the hemorrhoids worse?
Ummmm, let me think on this....HELLZ YES! Think about the birthing process--it's all about the pushing and straining to squeeze this watermelon out. I'm actually shocked that things don't simply explode down there from the pressure. If you have hemorrhoids going into that "magical" day, I am so sorry. Now, remember, this is my highly non-medical opinion, but....there is no way to avoid aggravating your 'rhoids further in the process of giving birth. This is why you should tell your OB early on if you have a history of hemorrhoids or alert them if you get them during pregnancy. I worked up the courage to bring up my concerns with my Doc. I really needed to make sure she understood the extent of trauma my butt had been through in the past few decades. While I wasn't campaigning for a c-section, I was doing a pretty good job--and admittedly a very passive-aggessive one--of building an argument for it. Not that recovering from a c-section is a piece of cake, and it can certainly come with its own mess of digestive and excretory issues. But if I had to put all my money on the birth option that would give me the best chance of avoiding a butt-astrophe, I'd pick the one where the baby comes out of my belly. However, my doctor did not see it that way and was, I felt, a little bit dismissive of my concerns. Vaginal birth it was going to be. Now, comes the part where I am supposed to let you know that in the end Doc was correct; there was nothing to worry about. Unfortunately, this is not one of those butt stories with a happy ending. I knew I was in trouble when the nursing staff was giving my bum a first look after birth. There was an audible gasp from the ladies poking around my behind. One well-meaning nurse gave me her idea of a pep talk: "Oh dear, I am so, so sorry." I don't know exactly what they saw back there, but it clearly was as horrendous looking as it felt.
What can you do to stop the hemorrhoid madness?
I'm not going to sugarcoat it--you'd be disappointed if I did--when I brought baby home, I was in a LOT of pain. I cursed the three flights of stairs in our new apartment. I despised being hungry and having to eat because that meant I was going to have to poop it out eventually, which hurt like hell. And I was closed for business to my husband for nearly a year--there would be no Irish twins for us. Thank goodness he has blocked that time in our marriage and life out of his head or he would have constant PSTD, I'm sure. But I will never forget; my bum felt that bad. For the three months I was on maternity leave, I was trying so hard to bask in the joy of motherhood but was consumed with the pain in my ass.
But it did get better. I eventually cooled my fiery butt with ice packs and Sitz baths, and I took my sorry ass to a colon-rectal specialist for advice on what ended up not just being hemorrhoids, but also a **bonus** anal fissure. I wish I could say I'd figured out a foolproof method to avoid hemorrhoids (and other butt issues) during pregnancy and postpartum. I believe I did all the right things leading up to the day my daughter was born, and I still ended up with a butt that looked like Frankenstein's face. However, even if hemorrhoids are inevitable, I cannot emphasize enough that you shouldn't just throw caution to the wind and ignore your butt--it will not like that. Most importantly, discuss any issues with your doctor and, for good measure, treat your pregnancy butt like a newborn baby's bottom--give it lots of TLC.
*Names have been changed to protect the innocent and their butts.