Regardless of whether you had a vaginal birth or a c-section, being concerned about the discomfort of going to the bathroom may cause some stress and anxiety. If you had a vaginal birth, your concerns may have to do with the tenderness you feel in the perineum. And, if you had a c-section, you may be worried that straining will cause pain or affect your incision. Likewise, it’s not uncommon to experience postpartum diarrhea, constipation, or even hemorrhoids after giving birth. Here’s an overview what’s normal, what’s not, and what you can do about it.
Postpartum Poop Problems Are Normal
Christine Masterson, MD, chief of the women and children’s service line at Summit Medical Group in New Jersey, says that pooping problems are common among postpartum women. So much so, in fact, that it would be strange if you didn’t have any issues at all. Typically, this distress comes in the form of constipation—though diarrhea can rear its ugly head postpartum, too. And, it’s not uncommon for women to experience hemorrhoids or even a short bout of fecal incontinence. “So many things affect postpartum bowel movements, including hormones, what you are eating, and how much you are drinking,” she explains. “Infection, a virus, or a reaction to antibiotics used in the hospital could all affect your bowel movements as well.” Of all the possibilities that can impact women postpartum, constipation is the most common. Typically, women have their first postpartum poop 3 to 5 days after giving birth. But, there are some women who have a bowel movement on the same day that they delivered their baby.
Postpartum constipationPostpartum hemorrhoidsPostpartum diarrhea Postpartum fecal incontinence
It’s normal to experience any of these scenarios, but be sure to communicate with your doctor about what you’re experiencing so that they can provide guidance and treatment. Both situations are normal. If a week has passed and you still haven’t had a bowel movement, call your doctor. Keep in mind, that just as every pregnancy is different, so are postpartum bowel movements. In fact, Dr. Masterson says that “normal” is relative. It helps to know what your bowel movements were like before birth. “What is ‘normal’ can truly vary,” she explains. “Some people have bowel movements three times a day and that is normal for them, while some have bowel movements three times a week and that is normal for them.” If you used to have a bowel movement every day and it’s been 4 or 5 days since you’ve gone, that could be a problem. On the other hand, if you used to only go a few times per week and now you’re running to the bathroom multiple times per day, that could point to an issue as well. If you’re anxious about your first postpartum poop, you are not alone. It’s normal to worry about the potential pain it could cause or to have concerns about how soon you will be able to go. Try not to worry too much and pay attention to your body’s cues. If you do feel the urge to go, try not to hold off, because the longer you wait, the harder it will be to poop without pain. Plus, the sooner you go, the better you will feel.
Why Giving Birth Affects Bowel Movements
Changes in your body, medical interventions, and fear, can all impact your bathroom experiences those first several days after giving birth. Here’s an overview of what contributes to the changes you’re experiencing.
Body Changes
Every new mother experiences changes in her body after giving birth. Here’s how those changes could impact your bowel movements.
Uterine contractions: After you give birth, your uterus begins shrinking back down to its normal size. In order to do so, says Dr. Masterson, it contracts and cramps, which can trigger looser or more frequent stools. Pelvic floor changes: The process of delivering a baby stretches the muscles in your pelvic floor, which can also cause changes in the rectum. More stool may collect in your intestines before it’s finally expelled. Stress hormones: Dr. Masterson says that stress hormone cortisol can cause constipation or diarrhea, depending on the person. Hemorrhoids: Pushing the baby through the birth canal during labor can leave you with hemorrhoids—inflamed and swollen veins in the rectum and anus. They can be very uncomfortable and make you reluctant to have that first postpartum bowel movement, which leads to constipation.
Medical Interventions
When it comes to labor and delivery, both women who gave birth vaginally and those that had a Cesarean section will likely experience some issues with their postpartum bowel movements. For instance, women who give birth vaginally are susceptible to constipation postpartum, thanks to tearing, stitches, and muscle strain that occur commonly during labor. And, women who have had C-sections are at risk for issues because they often receive more medications before and after labor and have restricted movement postpartum. Here’s an overview of how other medical interventions can impact postpartum poop.
Medications given after birth: Dr. Masterson says that Percocet (oxycodone/acetaminophen), an opiod pain reliever, can cause constipation. Antibiotics for postnatal infections may bring on diarrhea. Labor restrictions: If you were in labor for a long time, you may have been told not to consume anything but water, so your stomach could be pretty empty. That can make it hard to have a productive bowel movement. Iron supplements: Many women are prescribed iron supplements to counteract anemia due to blood loss after birth. These are notoriously constipating. Perineal stitches: Whether you elect to have an episiotomy before delivery or experience an unexpected tear during birth, you may wind up with stitches in the area between your vulva and anus (the perineum). The stitches will not only make your perineum sore, they also may cause it to feel excessively tight. It’s common for women to worry that bearing down to have a bowel movement will “pop” their stitches. Most likely, that won’t happen.
Fear and Embarrassment
After you give birth, your vaginal area may feel like a battlefield. Consequently, it’s not uncommon for women to experience some fear when it comes to the first postpartum poop. Even the first postpartum pee can be intimidating and uncomfortable, especially if you had a vaginal delivery. You might also worry about having to poop with an audience if you are still in the hospital and sharing a room with another new mom. Many practitioners will prescribe stool softeners to not only make it easier for you to use the restroom, but to encourage you to go.
Self-Care Struggles
Having and caring for a baby can be overwhelming and all-consuming—so much so that you might neglect taking care of yourself. Though you may not immediately connect the two, this can impact your postpartum bathroom habits:
You become dehydrated: Not drinking enough water can lead to constipation. Breastfeeding mothers—who are losing volumes of fluid due to milk production—are especially prone to dehydration, says Dr. Masterson. You become fatigued and hungry: Lack of sleep, difficulty finding the time to sit down to a healthy meal, and the stress of needing to be “on” 24/7 can all contribute to constipation. You don’t go when you should: It can be hard to answer nature’s call when, say, your baby just had a blow-out or you’re in the middle of nursing.
If your digestive issues are mild, you can try resolving them at home before reaching out to your healthcare provider. If you’re having moderate to severe issues, though, don’t hesitate to call.
Postpartum Diarrhea
If you’re struggling with postpartum diarrhea, you might want to monitor your caffeine intake. Dr. Masterson says that caffeine can trigger bowel movements, so you may need to cut back. The same goes for artificial sweeteners and, for some people, dairy. It’s also helpful to start working on those kegel exercises. Some women have postpartum diarrhea because their rectal muscles are stretched or torn. Rehabilitating your pelvic floor can help return your bowel movements to their usual regularity. Also think about working in more “binding” foods, like bananas and rice. When in doubt, follow the BRAT diet consisting of bananas, rice, applesauce, and toast. Try it for 48 hours and call your healthcare provider if your diarrhea hasn’t resolved. (Staying on this diet for too long is not advised as it is lacking in important nutrients.)
Postpartum Constipation
Constipation can sometimes feel like it will never improve. You may be surprised by how quickly some of these strategies can help.
Drink up: Make sure you’re drinking plenty of water. Dr. Masterson says that breastfeeding moms should aim for 80 to 100 ounces per day. Review your diet: Oily, greasy, or fatty foods—especially without a balance of fruits, veggies, and other fiber sources—can lead to constipation. That doesn’t mean you can’t indulge postpartum cravings or that you need to adhere to a strict diet, but it is helpful to make healthy foods your go-tos. Try eating more prunes, oatmeal, apples, peas, leafy greens, bran, melon, dried fruit, and nuts. Move your body: Exercise is another way to get things moving, if you are not restricted due to a C-section. Be realistic about what you can do right now and aim small in the beginning. For instance, take a walk around the block, or try walking around the house or dancing while wearing your baby. Try a stool softener: Stool softeners are generally considered safe to use while breastfeeding. Colace is a popular brand often recommended by healthcare professionals. Use perineal massage: Performing some self-massage on the perineum may also help. A 2015 study published in the Journal of General Internal Medicine showed that constipated adults who performed perineal massage on themselves for 4 weeks—reported better quality of life and improved bowel function than the control group. Wean off any medications or supplements: With the supervision of your doctor, try to wean yourself off of any supplements you’re taking. For iron supplements, start incorporating natural sources like spinach, beef, and beans. If you’re on an opioid pain reliever, ask if you can take ibuprofen or acetaminophen instead.
Postpartum Hemorrhoids
If you are struggling with hemorrhoids postpartum, try using a sitz bath or donut pillow to help heal hemorrhoids. Although these aids won’t help you poop, they can help reduce your discomfort and anxiety about using the bathroom. You also can try regularly applying witch hazel pads. For extra relief, try chilling them in the refrigerator. Applying a covered ice pack or a cold compress may also be soothing. And when using the restroom, opt for cleaning with wipes instead of regular toilet paper, which are much less irritating. Just be sure to opt for a flushable, fragrance-free version. Perfumes and fragrances can cause irritation to an already-sensitive area. Finally, to allow yourself time to heal, try to avoid bearing down or straining when using the restroom.
When to Get Help
Aside from noticing changes in your personal bowel movements, keep an eye out for the following, which can indicate more serious problems. Call your doctor right away if any of these occur:
Very loose, unformed stools (e.g., explosive postpartum diarrhea)More than five bowel movements per dayFever: A temperature of more than 100.4 F could signal an infection in the uterus, vagina, or urinary tract, or an infection at the site of Cesarean incisions or perineal tears.Signs of a tear (fissure) in the lining of the anus, including blood in your stool, changes in stool color, and unusually painful bowel movements
Anal fissures are typically caused by straining during bowel movements or during labor and delivery. They are treated much the same as hemorrhoids, though some severe cases may require surgery. According to one study, both hemorrhoids and fissures are common during the last trimester of pregnancy and after birth. Of the 280 women studied, nearly half experienced perianal disease, with 34% of those women reporting either hemorrhoids and/or anal fissures after delivery.
A Word From Verywell
Postpartum poop problems are more common than you may realize. But that doesn’t make them any easier. Don’t hesitate to reach out to your doctor if you’ve been home for a few days and haven’t had a bowel movement yet. Complications are rare, though, so try not to worry too much. Most likely, you’ll be able to resolve your bowel movement issues with patience and some basic home remedies.
