In the clinic, we often encounter women with mixed hemorrhoids who are preparing to become pregnant and ask if they need to undergo hemorrhoidectomy to prevent hemorrhoid flare-ups during pregnancy. To date, there are no guidelines or evidence to support or oppose hemorrhoidectomy for pregnancy. The fundamental purpose of hemorrhoid surgery is to address the symptoms of bleeding and prolapse due to hemorrhoids, and this principle should be largely followed for hemorrhoid treatment in people who are preparing for pregnancy. Therefore, for stage one hemorrhoids, which are mainly bleeding, you can take some medications such as abortifacient and mai zhi ling, take a sitz bath, use hemorrhoid suppositories and keep your bowels open; for stage two hemorrhoids, in addition to bleeding, prolapse symptoms also appear, but the prolapsed hemorrhoid nucleus can be returned on its own, generally in clinical practice, stage two hemorrhoids are not treated surgically, but only conservative treatment is needed, but for expectant mothers who are preparing for pregnancy, if prolapse every time they have a bowel movement, these people have a higher probability of thrombosed hemorrhoids and hemorrhoidal edema as the fetus increases in size and pelvic pressure during pregnancy, and it is recommended that surgery be considered! For stage 3 hemorrhoids, those who exhibit hemorrhoid prolapse that cannot be returned, surgery is recommended, otherwise there is a high risk of hemorrhoid flare-ups during pregnancy. Which is the appropriate procedure to choose for hemorrhoid surgery? At present, many hospitals may promote the so-called “minimally invasive surgery” such as PPH and internal hemorrhoid ligation, but long term studies and meta-analyses have determined that these procedures have poor long term efficacy, high cost and high chance of serious complications. For pregnant mothers-to-be, conventional external and internal dissection is the most effective procedure.