I'm 37+ with my 2nd.
In the last week my piles have become pretty sore and uncomfortable in any position, sitting/standing.
I'm conscious of how much worse they will get during childbirth/pushing and hence how horrific and annoying they will be in the days/weeks following when I will be feeling pretty tender anyway.
I'm thinking that it would help if I could get the midwife to hold a cold compress against my anus during the pushing stage but I'm not sure if this is asking too much especially with the likelihood of pooing. 
Does anyone have any experience/ tips?