Day 148 of 280 · 21 weeks + 1 day
Piles
Last reviewed · 3 min read · 5 sources · Plain-text version
Twenty-one weeks and one day. Up to half of pregnant women get hemorrhoids. Today you put together a small kit, and learn when blood means a call.
- Size this week
- about the size of a carrot
- Length this week
- around 26.7 cm from head to toe

Twenty-one weeks and one day. Today's note is about a part of pregnancy nobody puts in the announcement. It's common, it's treatable, and a few cheap things make it much better.
Your baby

Your body
Piles are on the NHS's list of symptoms for this week (NHS). Up to 50 percent of pregnant women develop hemorrhoids, and they tend to get better after delivery (OWH). Pressure on the anus during pregnancy can make the veins and tissue there swell (MedlinePlus).
They're usually not painful; painless bright red blood when you wipe is a common sign, and a clot inside one can make it very sore (MedlinePlus). Prevention is mostly about not straining: plenty of fluids, a high-fiber diet, and, if your provider agrees, a fiber supplement or stool softener (MedlinePlus).
Try today
The hemorrhoid kit
Time: 15 minutes
Fill a water bottle and keep it where you sit most. Fluids are the first line of prevention (MedlinePlus).
Put high-fiber food on the shopping list: fruit, vegetables, whole grains, beans.
Buy witch hazel pads and plain baby wipes to use instead of scented tissue, and wear cotton underwear; all three ease the itch (MedlinePlus).
Plan a sitz bath: 10 to 15 minutes sitting in warm water when it flares (MedlinePlus).
Ask your provider before buying a stool softener or any cream.
Make it work:Don't scratch, however much it itches; MedlinePlus lists that too (MedlinePlus).
Watch for
Normal
a little bright red blood on the paper, without pain (MedlinePlus).
Call your provider
about rectal bleeding; MedlinePlus lists it as a reason to get in touch (MedlinePlus).
Normal
itching and soreness that ease with a sitz bath.
Call your provider
if home treatment doesn't help (MedlinePlus).
Normal
piles that don't hurt at all; most don't (MedlinePlus).
Seek care immediately
for a lot of rectal bleeding, or bleeding with dizziness or faintness (MedlinePlus).
Normal
not always being sure which way blood is coming from.
Call your provider
for any vaginal bleeding; in months 4 to 9 it can signal a problem with the placenta, and MedlinePlus says to treat it as a potential emergency (MedlinePlus).
For you
Nobody enjoys this page. But piles are on the NHS's ordinary list for this week, alongside backache and heartburn (NHS), and saying the word out loud at your next visit is easier than putting up with it for nineteen more weeks. If it's sore, say so.
They also tend to show up again later: the OWH lists hemorrhoids among the common third-trimester discomforts (OWH). The habits in the kit, water and fiber, are worth keeping going.
If you're the partner: buy the kit without being asked, and don't make a joke of it.
Sources
- NHS. "Week 21." Week-by-week guide to pregnancy, Best Start in Life. https://www.nhs.uk/best-start-in-life/pregnancy/week-by-week-guide-to-pregnancy/2nd-trimester/week-21/
- Office on Women's Health. "Body changes and discomforts." U.S. Department of Health and Human Services. https://womenshealth.gov/pregnancy/youre-pregnant-now-what/body-changes-and-discomforts
- MedlinePlus. "Hemorrhoids." Medical Encyclopedia, National Library of Medicine. https://medlineplus.gov/ency/article/000292.htm
- MedlinePlus. "Vaginal bleeding in pregnancy." Medical Encyclopedia, National Library of Medicine. https://medlineplus.gov/ency/article/003264.htm
- Office on Women's Health. "Stages of pregnancy." U.S. Department of Health and Human Services. https://womenshealth.gov/pregnancy/youre-pregnant-now-what/stages-pregnancy
This guide is general education that summarizes published research and guidance from groups like the American Academy of Pediatrics, the CDC, and the WHO. It isn’t medical advice, and every child develops on their own timeline. Your pediatrician knows your child; if something feels wrong, call them. In an emergency, call 911.
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