Everything You Need to Know About Postpartum Poop

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Everything changes after you have a baby including your digestive system. 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

Everyone has trouble from time to time staying regular, but throw in the life-changing event of giving birth and it’s no surprise that postpartum women often struggle with stomach distress. Typically, this distress comes in the form of constipation—though diarrhea can rear its ugly head postpartum, too. Dr. Christine Masterson, 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 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. So, 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 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

After giving birth, your body is going through a number of changes, all of which impact your postpartum poop. 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 and a reluctance 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, an opiod pain reliever, can cause constipation, while 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 eat or drink anything but water, so your stomach could be pretty empty. That fact 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, but 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, called your 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” your stitches. But most likely, that won't happen.

Fear and Embarrassment

After you give birth, your vaginal region 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 is intimidating and often uncomfortable, especially if you had a vaginal delivery.

Likewise, sharing a room at the hospital with another new mom, can cause you to feel uncomfortable about using the restroom. Here's a closer look at how these factors can contribute to postpartum poop issues.

  • You're sore: The thought of bearing down yet again so soon after labor and delivery is enough to make anyone afraid of going to the bathroom. For this reason, many practitioners will prescribe stool softeners to not only make it easier to use the restroom but also to encourage you to go.
  • You’re embarrassed: Nobody likes pooping with an audience, so a lot of women are nervous about how long it will take to successfully manage a postpartum poop with others right outside the door. To make matters worse, putting pressure on yourself to have a bowel movement right now basically ensures you won’t be able to have one.

Self-Care Struggles

Having a baby can be overwhelming so much so that you can neglect taking care of yourself as you are focusing on your baby. But doing so can impact your postpartum bathroom habits. Here are some of the most common ways that neglecting to care for yourself can impact your postpartum poop.

  • Becoming dehydrated: Not drinking enough water can lead to constipation, and breastfeeding mothers—who are losing volumes of fluid due to milk production—are especially prone to dehydration, says Dr. Masterson.
  • Experiencing fatigue and hunger: When you’re a new mom, you’re often so busy taking care of your baby, and possibly other children as well, that it’s easy to forget to take care of yourself by getting enough rest and eating healthfully. A disruption in sleep and diet can contribute to constipation.

Obviously, there’s no shortage of reasons why your poop is all kinds of messed up after giving birth. In fact, it would be sort of strange if you weren’t having any trouble at all. Thankfully, though, there are ways to bring yourself some relief.

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 your doctor. Here's a few at-home treatments you can try if you're having mild bathroom issues.

Constipation

When it comes to constipation, make sure you’re drinking plenty of water. Dr. Masterson says that breastfeeding moms should aim for 80-100 ounces per day. You also should consider what you’ve been eating.

Oily, greasy, or fatty foods—especially without a balance of fruits, veggies, and fiber—can lead to constipation. That doesn’t mean you can’t indulge those postpartum cravings or that you should be sticking to a strict diet; but try to work in some healthy foods, too, if only for the sake of your colon.

Try eating more prunes, oatmeal, apples or peas, leafy greens, bran, melon, dried fruit, and nuts.

Exercise is another way to get things moving, if you are not restricted due to a c-section. With a new baby in the house, it can be challenging to make time to move, so 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. The key is that you get your body moving. Here are some other things you can experiment with.

  • Try a stool softener. Stool softeners are generally considered safe to use while breastfeeding. Colace is a popular brand often recommended by health care professionals. Your doctor may have even recommended you start taking them right away, to make that first postpartum poop go smoothly.
  • Use perineal massage. Performing some “self-acupuncture” on the perineum can get things moving again. A 2015 study published in the Journal of General Internal Medicine showed that constipated adults in a treatment group—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, see 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 will reduce your discomfort as well as reduce anxiety about using the bathroom while dealing with hemorrhoids.

You also can try regularly applying witch hazel pads. You can even keep them chilled in the fridge for extra relief or simply try using an ice pack or a cold compress.

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. 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. Same goes for artificial sweeteners and, for some people, dairy.


You also should 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 then call your doctor if your diarrhea hasn’t resolved. You can’t stay on the BRAT diet for too long, because it’s 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 on a number of red flags that could signal more serious problems. Dr. Masterson says that very loose, unformed stool—like explosive diarrhea—should be reported to your doctor, as should having more than five bowel movements per day. 

You also should call your doctor as soon as possible if you notice blood in your stool, changes in color, or unusually painful bowel movements. These could be signs of an anal fissure.

Anal fissures are small tears in the skin around your anus, 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 to repair. 

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 peri-anal disease, with 34% of those women reporting either hemorrhoids and/or anal fissures after delivery.

Finally, a fever postpartum should always be reported to your doctor. A temperature of more than 100.4 degrees could signal a serious postpartum complication that shouldn’t be ignored. You could have an infection in the uterus, vagina, or urinary tract, or an infection at the site of cesarean incisions or perineal tears.

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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