Piles in pregnancy: what they are, why they happen, and why it gets better

It starts as a little itch. Then a lump you can feel when you wipe. Then sitting down becomes a planning exercise. And you tell no one, because it feels too awkward.

What piles are

Piles, also called haemorrhoids, are swollen veins in and around your bottom. Everyone has these veins. They only become a problem when extra pressure makes them stretch and swell.

Some piles stay inside and you may not even know they are there, until you see a little bright red blood on the tissue. Others sit just outside and feel like a soft lump. They can itch, ache, burn, or sting when you pass stool. They often flare up after a hard motion.

Why pregnancy brings them on

Pregnancy puts pressure on these veins from almost every side.

The biggest reason is constipation. Pregnancy hormones slow your digestion down, so stool stays longer in your gut and turns hard. Iron tablets, which almost every pregnant woman in India takes, make it harder still. Then you strain, and straining pushes hard on the veins down there.

Your body is changing too. As your baby grows, your uterus presses down on the veins in your pelvis, so blood doesn't flow back up as easily. Your blood volume goes up a lot to support your baby, which means more pressure inside every vein. And progesterone, the hormone that keeps your pregnancy safe, also relaxes the walls of your veins, so they swell more easily.

Daily life adds to it. Long hours at a desk, on the sofa, or standing in the kitchen all put weight on that area. And some women get piles for the first time after a normal delivery, from all the pushing during labour.

How common they are, and the good news

If this is happening to you, you are far from alone. About 3 to 4 in every 10 pregnant women get piles. They are most common in the third trimester, when your baby is heaviest. You rarely hear about them only because nobody wants to bring them up.

The good news is that piles don't harm your baby. For most women, they settle down within a few weeks of giving birth.

Until then, small changes help a lot. Drink plenty of water. Add fibre through fruits, vegetables, dal and soaked figs or raisins. Walk every day, go to the toilet when you feel the urge, and don't strain or sit there scrolling for long. A warm sitz bath for 10 to 15 minutes can bring real relief. If iron is making you constipated, tell your doctor instead of stopping it yourself. And ask her before using any cream or syrup, since not everything is safe in pregnancy.

Tell her straight away if you see any bleeding or the pain doesn't get better. She has heard this hundreds of times. A two-minute conversation could make the rest of your pregnancy a lot more comfortable.