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Can Hemorrhoids Impair Delivery?

QUESTION

Dear Midwife,
I am 5 months pregnant and its my first baby at age 42. However, I have hemorrhoids even before I got pregnant. My hemorrhoids are really big, both internal and external. One doctor described it as thrombosed and measures more than 2 cm each. I think they are more than one. Even if they are big, they dont hurt as long as I have a soft bowel movement.

My question is (which is also my fear) will this add to the difficulty in giving birth. What if I need an episiostomy? How can they make that if I have these large hemorrhoids? Have you delivered someone with this kind of case? How did it go? I don't want a c-section if possible but am concerned on the effect of my hemorrhoids during childbirth.

I hope I can get a reply and an advice. Thank you so much.

ANSWER

Hi,
Yes, I have had such a case. There are several things you can do to help yourself:

  • Eating a really good diet with plenty of protein, so your tissues will stretch well when the time comes
  • Taking extra Vitamin C to strengthen your veins
  • Using a provider who rarely cuts episiotomies (Have you considered a nurse-midwife?)
  • Having a baby on the small side of normal (Watch that weight gain!)

This may be one of those rare times when an epidural is a good idea, at least for the pushing stage. That way, you can let your uterus do most of the work without you having that overwhelming urge to push. When the baby is basically out, you can give a couple of little pushes right at the end. These are all just suggestions, things you might want to talk to your provider about. Good luck!

-- Cynthia, CNM

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.