Everything You Need to Know About Postpartum Poop

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Everything changes after you have a baby. Organs are shifting around, hormones are fluctuating, and your uterus is shrinking back to its normal size. All of these factors can throw your bowel movements completely out of whack.

And, let’s be honest, after what you just went through giving birth, you’re a little nervous about enduring any more trauma down there. So, going to the bathroom may cause some anxiety as well as some other bathroom issues.

Here's an overview what's normal, what's not, and what you can do about it.

Postpartum Poop Problems Are Normal

Christine Masterson, M.D., 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.

“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.”

Dr. Masterson also 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.”

Instead of focusing on an objective “normal,” pay attention to changes in what used to be normal for you, personally.

If you used to have a bowel movement every day and it’s been four or five 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.

The First Postpartum Poop

When it comes to the first postpartum poop, it can take two to three days after you give birth for you to go, though some women have one sooner.

If you’re anxious about your first postpartum poop, you are not alone. But remember, you will have to go eventually, and the longer you hold off, the harder it will be to poop without pain.

If you’ve been using stool softeners and drinking water and you have the urge to go don't put it off. The sooner you go, the better you will feel. If it’s been more than four days since you left the hospital and you still haven't gone, you should call your doctor for further advice and treatment.

Why Giving Birth Affects Bowel Movements

There are physiological, environmental, and psychological reasons why the first several days after giving birth are a gastrointestinal minefield. Here's an overview of how these factors contribute to changes in your bowel habits postpartum.

Body Changes

Here is a closer look at the typical changes a new mother experiences and how they impact 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.

Treat Postpartum Poop Problems at Home

If your digestive issues are mild, you can try resolving them at home before reaching out to your doctor. If you're having moderate to severe issues, though, don’t hesitate to call.

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-acupuncture 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 four 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 opiod pain reliever, ask if you can take ibuprofen or acetaminophen instead.

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.

Diarrhea

If you're struggling with diarrhea, you might want to check how much caffeine you’re having per day. 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.

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 doctor if your diarrhea hasn’t resolved. (Staying on this diet for too long is not advised as it is lacking in important nutrients.)

It's also helpful to start working on those kegel exercises. Some women have diarrhea postpartum because their rectal muscles are stretched or torn, so rehabilitating your pelvic floor can help return your bowel movements to their usual regularity.

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 diarrhea)
  • More than five bowel movements per day
  • Fever: 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.

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Article Sources
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