When you're pregnant, you'll hear plenty about the common discomforts of pregnancy like nausea, fatigue, and heartburn. You'll be reassured that it's OK to be scared about labor and delivery because everything will be fine. One thing you won't hear about? Hemorrhoids, also known as a Pain Worse Than Death. (Dramatic? Me?) Maybe it's because most people are too prim and proper to talk about buttholes. Fortunately for you (arguably), I'm not most people. I'm here to tell you all the things no one tells you about pregnancy hemorrhoids. You're welcome.
For the blessedly uninformed, hemorrhoids are swollen and inflamed veins in the rectum or anus that can cause discomfort, pain, itching, and bleeding. They're also called piles, because apparently we needed a heaping side of heinous mental images in order to completely understand the situation. A case of the "hemmies" is quite common during pregnancy, especially during the third trimester. Think about it: there's pressure from your growing uterus, increased blood flow to the area, and constipation (also typical when you're expecting). It's a recipe for an angry rectum. (Angry Rectum, by the way, would be a wonderful band name, in case you're looking.)
If you've had hemorrhoids before, you're more likely to get them during pregnancy, too. I had my first bout right after I moved home from living abroad and started a new job. I thought that was bad, but I had no idea of the fresh hell that was awaiting me two years later. On my final day of work before maternity leave, I felt a familiar, unwelcome itching in the backdoor of my nether regions. By the next day, the biggest one was dark purple and the size of a newborn's fist. Within 24 hours, I was in urgent care getting the things surgically excised (that's about as fun as it sounds). Unfortunately, that didn't fix it, and I found myself in general surgery again three days later. I went into labor that weekend. You know what feels awesome? Pushing out a baby over a surgical site.
I had nausea for 20 weeks, vomited my entire pregnancy, and was in labor for 29 hours. However, out of everything pregnancy so lovingly provided, hemorrhoids were the absolute worst. You better believe that if I do form that marvelous band, Angry Rectum, there will be songs about it.
Do. Not. Google. Hemorrhoids. Trust me when I say they are essentially anal tortellini. Here's a helpful emoticon: ( @ ) *trademark pending.
If you're brave, you might take a hand mirror down there, but be warned that you can't un-see that sh*t. It's also quite effective to sit on your iPhone so you can send an "I need sympathy" picture to your sister. (What? Normal people don't do that? Whatever. We literally have no boundaries. You're talking to the women who played "How Bouncy Is Your Eyeball Meat?" for funsies.)
There are four types of hemorrhoids: internal, external, prolapsed, and thrombosed. I had thrombosis, so my hemorrhoids protruded from my body (you could actually see the f*cker from between my cheeks) and had formed a blood clot. It was so big I was worried my baby would come out and think it was her mommy. When something's that significant, it deserves a name. My sister dubbed it Eloise. (I told you we were weirdos.)
If your case isn't that severe, you can use home remedies like creams, witch hazel, petroleum, or a cold pack to soothe pain and relieve itching. However, if they don't get better or you have an acute case, you're looking at the following delightful options:
1) Injection to close off an internal hemorrhoid. Nothing like a shot to the anus, Amirite?
2) Rubber band ligation to cut off blood supply. Kind of like castrating a sheep.
3) Cauterizing. Mom says if a doctor says this word, you should run the other way.
4) Surgery. A hemhorroidectomy! Whee!
Friend #1: Glycerine suppositories. I used to be grossed out by the mere concept of suppositories. I got over it because damned if they don't provide a ton of relief.
Friend #2: Stool softeners. I know they say "geriatric" on them, but it's a small price to pay if it gets you going.
Friend #3: Prunes. They're a natural laxative, and they're not so bad if you get them individually wrapped.
Friend #4: Doughnut-shaped pillow. I have no shame and carried mine everywhere. Anything to take some pressure off my poor, long-suffering bumbum.
Friend #5: Sitz bath. It takes a hot minute to figure out, but the warm water is both soothing and cleansing. You'll want one postpartum anyway.
My husband is of the opinion that I am a "delicate snowflake" who exaggerates her symptoms, so I made him look at my hemorrhoids. That was nothing. After my surgery, I peed all over my dressings. My partner had to fashion me a sumo diaper as I lay spread-eagle on our marriage bed.
In other words, your body may be changed permanently. After the excision, I was left with skin tags. Skin tags, you guys. On the bright side, the hubs has seen me at my absolute worst, and he's still here.
Rectal bleeding is a common symptom of hemorrhoids. Even when you know that, it's disconcerting to wipe away bright red blood. No one told me that I could also develop anal fissures. These are tears along the rectum, and they sting like a bitch when you poop. When I hear "fissures," I think about a crevasse or a chasm but you know, in my butt.
I'm willing to bet there was a time in your life when there was nothing quite so satisfying as a good, old-fashioned bowel movement to start your day off right. Those days are gone, dear reader. I swear to God, sometimes it feels like I am trying to pass an everlasting gobstopper. When you know you're going to get internally shredded, you'll avoid the bathroom at all costs (which doesn't help your situation in the least).
Let's add a big old "in my opinion" caveat to that. Granted, I had a medicated birth, but I still felt it. I would give birth ten times in exchange for never experiencing hemorrhoids again. At least when you're in labor, you know it's going to be over in a matter of hours. Hemorrhoids, on the other hand...
The books assured me that my hemorrhoids would likely go away postpartum, although they might be exacerbated by the birthing process itself. (Makes sense. Pushing out a baby is a lot like straining during a BM.) Well, my kid is a year and a half old, and I still have them. That's right, Eloise may be a shadow of her former self, but her legacy lives on through her illegitimate progeny, Francois and Jean-Raphael.
I want nothing more than to have another baby, but I am terrified for what another pregnancy might mean for my rear end. I'm not trying to scare you, although I realize I may have that effect. In fact, my doctor has assured me that we will get my "situation" taken care of before I conceive again. I just want you to be prepared. As the saying goes, an ounce of prevention is worth a pound of cure.
Now, if you'll excuse me, I have to go eat some prunes.