Hi, Pregnancy usually aggravates hemoorhoids as it causes pelvic congestion. Constipation may be avoided by increasing the intake of whole fruits, fresh greens vegetables and slight mobility. Maintain adequate intake of water. The cause of the spotting is more likely to be the hemorrhoids if it is painless and a suspected fissure if it is associated with pain. You should ask to see a surgeon who is in consultation with your obstetrician for a proper advice. You may need xylocaine jelly application as well as a mild laxative to relieve constipation. Hope this helps. Wish you safe motherhood.