As pregnancy advances, the veins at the rectal opening become enlarged by the gradually increasing pressure within the venous system of the lower half of the body. Hard bowel movements and straining at stool have a tendency to cause these veins to protrude through the rectal opening and to cause local pain, bleeding, and itching. If there is slight rectal bleeding without pain or a bulging lump, it is usually sufficient to apply carbolated Vaseline to the anus with the finger on arising, before bedtime, and after each defecation. If this does not cause the rectal bleeding to stop within forty-eight hours, notify your doctor.
If there is a tender, swollen mass protruding through the anus, you should attempt to reduce it with a well-lubricated finger after sitting for several minutes in a tub of comfortably warm water. When this is unsuccessful, lie on your back with the hips slightly elevated and apply to the rectal region a washcloth or pieces of cotton which have been soaked in iced water—or, better yet, iced witch hazel. Change the dressing frequently so that it remains moist and cold. This may shrink the hemorrhoidal mass sufficiently to permit its reposition. If the pain does not subside with this regimen, an anesthetic ointment such as Nupercainal can be applied to the area, or medicated suppositories such as Anusol may be inserted. It is inadvisable to remove hemorrhoids surgically either during pregnancy or at the time of delivery, since even the severe ones may utterly disappear soon after labor.