Relief.
Managing Haemorrhoids After Birth: A Physiotherapist’s Guide to Hormones, Bowels, and Recovery.
Haemorrhoids are a very common post-partum issue, yet they’re rarely talked about or brought up in clinic by clients. Symptoms can include; discomfort during bowel movements, itching, heavy feeling or pressure, and pain can add another layer of challenge during an already demanding recovery period.
As physiotherapists, particularly those working in pelvic health, we see haemorrhoids not just as a local problem, but they generally occur as part of a bigger picture involving hormones, bowel function, pelvic floor mechanics, and birth recovery. Understanding how these factors interact can make management far more effective.
For many people, symptoms improve naturally over time, but targeted management can significantly reduce discomfort and speed up recovery. If you are experiencing any of the above symptoms it is important to see a healthcare professional, likely your GP, for further assessment and guidance as the initial step…
Why are Haemorrhoids so common?
Haemorrhoids are swollen blood vessels in and around the anus and rectum. During pregnancy and after birth, several factors increase the likelihood of developing them:
Increased pressure from the growing uterus during pregnancy
Straining during bowel movements or during the pushing stage of labour
Reduced circulation and venous congestion in the pelvic area - may occur with more sedentary time post partum or when recovering from surgery.
Changes in bowel habits, including constipation which can be influenced by hormones but also hydration (see our other blog about hydration specficially!)
Weakened or poorly coordinated pelvic floor muscles
The Role of Hormones in Your Digestive System.
During pregnancy, progesterone levels are high. Progesterone relaxes smooth muscle including the muscles of the digestive tract. While this is essential for maintaining pregnancy, it also slows your gut motility, meaning food moves more slowly through the intestines. The result is often constipation and harder stools, which increase strain on soft tissues which may already be feeling the strain!
After birth, hormone levels change rapidly. Combined with:
Reduced physical activity
Dehydration (especially if breastfeeding)
Pain or fear around bowel movements
Perineal trauma or stitches
…the digestive system can remain sluggish for weeks or months after your baby.
Practical Tips you can start today.
Aim for regular, gentle movement such as walking. If you have had a c-section ‘potter’ around the house as you are able during the initial weeks.
Avoid delaying bowel movements when you feel the urge, use breathwork to relax if you are feeling anxious after any birth trauma.
Use a footstool on the toilet to optimise your position.
See your GP to check they are haemorrhoids and know all of your options for treatment - medical and conservative management methods.
Consider seeing a Pelvic Health Physiotherapist - either via your Local NHS service or a Mummy MOT Practitioner, Suzy Shutt @TheMWordPhysio.
Written by Suzy Shutt | Owner and Founder The M Word Physio
Specialist Physiotherapist Women’s Health | Musculoskeletal
Fellow of Higher Education | University Lecturer