Postpartum Constipation: Causes and Treatment

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Constipation is common after giving birth. Many people who have just had a baby find that postpartum constipation is par for the course during recovery. People who did not have an issue with constipation during their pregnancy might be surprised to develop it after. On the other hand, for someone who has had bowel woes in the past or dealt with them while they were pregnant, constipation after giving birth will be nothing new.

Whether the experience is new to you or not, constipation is uncomfortable—especially when your body is still trying to heal from labor and delivery. Postpartum constipation can happen for several reasons. Understanding them can help you find the best treatment and get relief.

Causes of Constipation After Childbirth

Constipation is often a normal, yet annoying, discomfort that can be caused by several factors related to what's happening to your body before, during, and after you give birth.

Common causes of constipation after childbirth include:

  • Damage to the anal sphincter or pelvic floor muscles (which can occur during labor and delivery)
  • Dehydration or lack of fluids (which might happen if you were vomiting or experienced blood loss)
  • Hormonal changes (which begin while you are pregnant and can slow bowel function)
  • Iron supplementation (which might be given if you are anemic)

Certain things that may have taken place while you were in labor can also contribute to you developing constipation after you give birth. See if any of these descriptions sound familiar in terms of what you experienced during delivery.

  1. I had a long labor with little food
  2. I had a bowel movement or enema during labor.
  3. I had a C-section.
    1. It can take up to 3 to 4 days for your digestive system to start working normally again following major surgery—which a C-section is!
  4. I used pain relievers during delivery or I am currently using them for postpartum pain relief.
    1. Particularly systemic narcotics, which are known to slow down the digestive tract.
  5. I have pain in my perineum (for example, after getting an episiotomy or because of postpartum hemorrhoids).
    1. In this case, constipation might not be as much a physical problem as a mental one. If you are afraid of tearing your stitches or having more pain, the fear will cause you to retain stool.

Hemorrhoids

Constipation and hemorrhoids often go hand-in-hand. If you had a vaginal delivery, you might be more likely to develop hemorrhoids. Straining to pass a bowel movement and having hard stool can make hemorrhoids worse.

While they are not usually severe and often get better after a couple of weeks, hemorrhoids can be very uncomfortable. Fortunately, they can be treated.

Treating Postpartum Constipation

Depending on the cause and the steps you take to treat it, constipation is likely to resolve within a few days of giving birth. The best thing you can do is be proactive about prevention and treatment.

In most cases, you can successfully treat postpartum constipation at home. Here are some simple tips that can help.

  • Eat well. High fiber foods can be your best defense. Foods such as whole-grain cereals and whole-grain bread, brown rice, beans, and fresh fruits and veggies are excellent fiber-rich foods.
  • Drink plenty of water. Try to drink 8 to 10 glasses a day. Warm liquids such as herbal tea might be helpful as well. The fiber-filled foods you add to your diet will absorb the water you drink. This makes your stools softer and easier to pass.
  • Don't ignore the urge. As much as you might fear more pain, holding on to a bowel movement will only make the stool harder. Try to go when you sense you need to.
  • Take a stroll. It might seem intimidating—particularly if you are recovering from a C-section—but a little bit of walking (at a slow pace) can help move your bowels.
    • If you had a C-section, you'll need to get medical clearance from your doctor before resuming any form of exercise.
  • Ask about stool softeners. Talk to your doctor or midwife about taking a stool softener. If you've had a severe tear (third or fourth degree), you might be taking one already. A softener might also be recommended if you have hemorrhoids, are taking iron supplements for anemia, or are on narcotic pain medicine.
    • A mild laxative or fiber supplement might be necessary if other measures don't work. Reach out to your health provider for personalized recommendations.

When to Call Your Doctor

While it is not common, constipation during the postpartum period can sometimes be a sign of a bigger problem. There several "red flag" symptoms that you should be on the lookout for.

Call your doctor if you are constipated and have other symptoms, including:

  • Constipation alternating with diarrhea
  • Blood or mucus in your stool
  • Excessive rectal bleeding
  • Severe rectal pain
  • Severe stomach pain
  • Severe, painful bulging in the vagina, vulva, and/or perineum
  • You do not have a bowel movement by the 3rd day after having your baby
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  1. Verghese TS, Futaba K, Latthe P. Constipation in pregnancyObstet Gynecol. 2015;17(2):111-115. doi:10.1111/tog.12179

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