Pregnancy and childbirth are usually framed as stories of joy, strength, and fresh beginnings. What often goes unspoken are the lingering physical struggles many women continue to carry well after delivery. One such issue – frequently dismissed as “normal” or temporary – is piles. Pain, bleeding, or swelling during bowel movements are quietly endured by countless new mothers, with many assuming it is simply part of the postpartum phase, unaware that these symptoms are neither inevitable nor something to be ignored without medical care.
HT Lifestyle reached out to Dr Pankaj Sharma – director of the department of robotic, bariatric, laparoscopic and general surgery at Fortis Hospital, Shalimar Bagh and founder of Shalya Clinic in Rohini, New Delhi – to gain expert insights into the issue.
He highlights, “In clinical practice, it is common to see women months – or even years – after childbirth, hesitantly admitting they have been living with discomfort since pregnancy. Piles during and after pregnancy are far more common than most women realise, yet stigma and lack of awareness keep many from seeking help early.”
What are the factors responsible?
Pregnancy brings about extraordinary changes in a woman’s body, and the digestive system is no exception. Dr Sharma outlines the biggest contributors to piles during pregnancy as follows:
Hormonal fluctuations
Pregnancy brings with it intense hormonal fluctuations, particularly a rise in progesterone, which relaxes intestinal muscles and slows bowel movements – a key reason many women experience constipation during this period.
Dr Sharma explains, “This hormone relaxes smooth muscles throughout the body, including the intestines. While this supports pregnancy, it also slows bowel movements, leading to constipation – one of the strongest triggers for piles.”
Increased pressure on pelvic muscles
During pregnancy, the growing uterus places increasing pressure on the pelvic muscles while compressing veins in the lower abdomen and rectal region, impairing blood flow and contributing to discomfort.
The surgeon highlights, “As the uterus enlarges, it compresses veins in the lower abdomen and rectal area. This slows blood circulation, causing veins around the anus to swell and enlarge. Over time, these engorged veins develop into piles, which may become painful or start bleeding.”
Childbirth increases risk
Childbirth – particularly normal vaginal delivery – places immense strain on the rectal veins, often causing them to swell and resulting in significant pelvic discomfort during the postpartum period.
Dr Sharma states, “Childbirth itself further increases the risk. During normal vaginal delivery, intense straining while pushing the baby puts sudden pressure on the rectal veins.”
Postpartum lifestyle changes
The struggles of pregnancy do not end with childbirth. The arrival of a new baby brings intense lifestyle changes, where a mother’s focus often shifts entirely to the baby’s needs – frequently at the cost of her own nutrition, sleep, and overall wellbeing.
The surgeon explains, “The post-delivery phase also brings lifestyle challenges. Irregular meals, dehydration, lack of sleep, and fear of painful bowel movements contribute to constipation. Many women suppress the urge to pass stools, worsening strain and creating a cycle where constipation aggravates piles and piles make bowel movements more difficult.”
Ignoring symptoms during pregnancy often makes it worse after delivery. Dr Sharma highlights, “Piles that were mild or unnoticed during pregnancy often worsen after delivery. New mothers, focused on recovery and caring for their newborn, frequently ignore symptoms, assuming they will resolve naturally.”
Risks
The surgeon highlights that a major concern is the delay in seeking medical care. Bleeding during bowel movements is often brushed off as a post-pregnancy issue, but it should never be considered normal or ignored.
He stresses, “When addressed early, piles can usually be managed with dietary changes, hydration, stool softeners, and medication. Delayed treatment, however, can lead to chronic piles that may require surgical intervention.”
Treatment
Fortunately, the surgeon reassures that advances in minimally invasive and laser-based treatments now offer effective relief with minimal pain and faster recovery. That said, early diagnosis remains crucial to preventing prolonged discomfort and the need for more complex interventions later on.
Pregnancy and motherhood demand strength, but silent suffering should not be part of the journey. Dr Sharma emphasises the importance of open conversations, awareness, and timely medical guidance can make a significant difference in a woman’s quality of life.
The surgeon concludes, “Piles during pregnancy and after childbirth are common, but they should never be accepted as normal. With early awareness and appropriate treatment, women can recover comfortably and focus on motherhood without ongoing pain.”
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
