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Frequently Asked Questions


Why do women get hemorrhoids during labor and delivery?

Hemorrhoids are very common, especially during childbirth. During pregnancy your blood volume increases. During labor, the pressure inside the veins of the anus is increased by pushing and the passage of the baby through the birth canal. It is this increased venous pressure and over-extension of the anus that is typically responsible for developing painful, external hemorrhoids during childbirth.

How often do external hemorrhoids occur as a result of childbirth?

Published studies acknowledge hemorrhoidal incidence rates during childbirth of 24% to 30% [1],[2],. There were approximately 3.3M vaginal births in the United States in 2008. Based upon the reported incidence rates up to 825,000 U.S. women had delivery-induced hemorrhoids in 2009. In the Hem-Avert® device clinical study verified these published incidence rates. Fully 25% of the control patients who did not have hemorrhoids upon admission developed hems during childbirth. An additional 10% of patients had existing hemorrhoids upon admission.

After delivery, why are external hemorrhoids more common then internal hemorrhoids?

If a woman gets hemorrhoids during childbirth, they are always external hemorrhoids, not internal hemorrhoids. Also, delivery-induced hemorrhoids most frequently occur as the head and shoulders breach the birth canal, and almost always within 24 hours post-partum.

Why should I be concerned?

Although hemorrhoids aren't a dangerous condition, they are a very uncomfortable one. Your general well-being after childbirth is important to both you and your baby.

What are hemorrhoids?

Hemorrhoids are vascular structures in the anal canal. For a variety of reasons they can become swollen or inflamed and bleed or thrombose. This progression of symptoms is common of external hemorrhoids and can lead to uncomfortable levels of pain and itching.

What's the difference between external and internal hemorrhoids?

The pectinate line (dentate line) is a line which divides the upper 2/3rds and lower 1/3rd of the anal canal. External hemorrhoids originate below this line. Internal hemorrhoids originate above this line and can protrude down below the line.

What causes external or prolapsed hemorrhoids?

Both internal and external hemorrhoids can be caused by a variety of common situations: constipation, diarrhea, low-fiber diet, straining, genetics, obesity, aging, prolonged sitting and pregnancy.

How are external hemorrhoids treated once they occur?

As with many benign medical conditions, hemorrhoids are initially treated with conservative measures like rest, sitz baths, increasing fiber and water intake, topical creams and anti-inflammatory and stool softening medications.

How long after labor and delivery can external hemorrhoids last?

Pregnancy and labor induced hemorrhoids can resolve themselves within a few weeks or months of delivery. However, some excessively prolapsed or thrombosed hemorrhoids may need to be resolved with surgical procedures.

What can I do to prevent hemorrhoids during my delivery?

Plexus Biomedical, Inc. spent 4 years developing the Hem-Avert. A clinical study reviewed by the Food and Drug Administration (FDA) showed the Hem-Avert was 99.8% effective in preventing external hemorrhoids during vaginal childbirth. The Hem-Avert is completely external and is not inserted into the anus or rectum. Your caregiver can help you avoid hemorrhoids during childbirth by prescribing the only product that is clinically proven to prevent this problem.

Who applies the Hem-Avert device?

Federal Law restricts the device to the sale by or on the order of a physician or a practitioner trained in its use. The device may be used by doctors, midwives or labor and delivery nurses that have been through in-service training.

When is the Hem-Avert device applied?

Just prior to pushing—8 to 10 cm of cervical dilation.

How long does it take to apply it?

A trained doctors, midwives or labor and delivery nurse can apply the device in minutes.

Where is the Hem-Avert device applied?

The device is actually seated directly on top of the anus. However, due to anatomical movement during childbirth a small amount of perineal contact is normal and doesn't interfere with the childbirth process.

Is the product invasive or inserted into the anus?

No, the product is completely external and is seated against the anus.

How long is the Hem-Avert device left on?

The device is left on through the end of the second stage of labor, childbirth.

How fast can the product be removed?

Because the straps use hook and loop fasteners, the product can be removed in a couple of seconds if needed.

What is the Hem-Avert device made of?

The base is made of medical grade polycarbonate, the same material eyeglass lenses are made from. It's extremely strong and flexible. The hook & loop material is a short weave composite that's very smooth and is latex free. Biocompatibility testing was conducted on each component of the product. When removed, it doesn't leave a residue.

What if I already have hemorrhoids before going into labor?

You can use the Hem-Avert device even if you already have hemorrhoids prior to delivery.

Is there a difference in the incidence of hemorrhoids from vaginal childbirth and c-sections?

Delivery via vaginal childbirth is more likely to cause hemorrhoids to become symptomatic. With a cesarean section, it depends on how much time the woman is in labor and how much pushing she does prior to the decision to perform surgery.

Does birthing position effect the use of the Hem-Avert device?

During childbirth, some facilities leave the patient's legs in the stirrups while at other hospitals the patient's legs are periodically moved to the chest in hopes of expediting labor—either is acceptable. The device can loosen from excessive leg movement however it can be easily reapplied with the hook and loop fasteners.

[1] Brown S, Lumley J. Maternal health after childbirth, results of an Australian population based survey. British Journal Obstetrics and Gynaecology. 1998 Feb; 105(2): 156-161.

[2] Schytt E, Lindmark G, Waldenstrom U. Physical symptoms after childbirth: prevalence and associations with self-related health. British Journal of Obstetrics and Gynaecology. 2005 Feb; 112: 210-217.