Nursing Component Task
Nursing procedures & clinical learning

Midwifery (RM)

Education on Minor Disorders of Pregnancy: Haemorrhoids

Haemorrhoids are swollen rectal veins that may cause discomfort, itching, or bright red bleeding in pregnancy. Advice promotes bowel regularity, comfort, safe hygiene, and review of bleeding or severe pain.

Purpose

  • Relieve discomfort and prevent worsening
  • Promote soft regular stools and safe perineal care
  • Identify bleeding or symptoms needing assessment

Indications

  • Pregnancy-related rectal discomfort, itching, swelling, or blood on wiping
  • Constipation or straining
  • Persistent, severe, or atypical anorectal symptoms

Equipment

  • Private assessment space
  • Approved education materials
  • Antenatal record
  • Weight, vital-sign, and examination resources when indicated
  • Referral information

Preparation

  • Assess bowel pattern, diet, medicines, and pregnancy risk.
  • Arrange clinical examination or referral for atypical symptoms.

Procedure steps

  • Ask about pain, itching, swelling, bleeding amount and colour, constipation, straining, diet, medicines, and previous bowel disease.
  • Explain haemorrhoids and distinguish minor symptoms from concerning bleeding or severe pain.
  • Encourage fibre-rich foods, safe fluids, activity, avoidance of straining, and prompt response to the urge to defecate.
  • Discuss gentle cleansing, patting dry, and cool or warm comfort measures according to policy.
  • Review medicines that may worsen constipation and use stool softener or topical treatment only when prescribed or approved.
  • Assess for anaemia, heavy bleeding, thrombosis, severe pain, fever, or prolapse.
  • Use privacy and a chaperone if examination is required.
  • Refer persistent, heavy, dark, unexplained, or painful bleeding and symptoms suggesting another condition.
  • Provide follow-up and warning signs.
  • Document assessment, education, treatment, referral, and response.

Precautions

  • Do not assume all rectal bleeding is haemorrhoids.
  • Escalate heavy or dark bleeding, severe pain, fever, anaemia, or an irreducible prolapse.
  • Avoid unapproved topical or herbal products.
  • Respect privacy and avoid unnecessary examination.

Aftercare

  • Review bowel function and symptoms.
  • Coordinate medical or dietary care if constipation or anaemia persists.

Nursing considerations

  • Use non-judgmental language for bowel and rectal symptoms.
  • Assess maternal wellbeing and anaemia risk.

Patient education

  • Eat fibre, drink safe fluids, stay active, avoid straining, and use only approved treatments.
  • Seek care for heavy or dark bleeding, severe pain, fever, or worsening swelling.

Documentation

  • Record symptoms, bleeding, bowel pattern, advice, medicines, examination, referral, and follow-up.
  • Document red flags.

References and further reading

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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