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Answer
Hemorrhoids are basically varicose veins surrounding the rectal area. The
hormones of pregnancy cause a relaxation of all smooth muscle. The veins
are smooth muscles. This relaxation in combination with the increased blood
volume and pressure that occurs during pregnancy makes a pregnant woman
more prone to hemorroids. Keeping the stool soft by have a diet high in
fluids and fiber should help to prevent worsening of hemorroids. Wearing
support panty hose can also help. Remember to put panty hose on before you
stand up in the morning or lie down for 5 minutes with your feet higher
than your head and then put on your pantyhose.
To decrease worsening at the time of delivery, I would recommend not
pushing until the baby has descended spontaneously into the vagina.
This means waiting until the urge to push is uncontrollable. When you
begin to push I recommend using an open glottis pushing. This means you
do not hold your breath and push but allow a small steady amount of air
to be released continuously while pushing. Usually you will be able to
hear the air being released while pushing. The push will not be silent
but wll sound more like a prolonged "AHHHHHHHHHHH".
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