First Post Labor Poop: Why Does Giving Birth Affect Bowel Movement & Tips for a Smooth Postpartum Bowel Movement

Every woman who has given birth knows that it is no joke to bring another life into this world. The body goes through many changes after giving birth. Apart from the main fact that breast milk starts coming in and the hormones continue to fluctuate wildly, one topic that is very rarely talked about is your first bowel movement after giving birth.

After you have given birth, you may have stitches, or you have had surgery during the C-section, one thing that is guaranteed is that you have a weakened pelvic floor that has gone through unimaginable stress and perineum that has been stretched to its limit. Under such circumstances, having your first bowel movement can be worrying. Read on to find out everything you need to know about your first post-labor poop.

Having Postpartum Bowel Problems are Normal

Having problems with your first bowel movement after giving birth is normal. The problem typically comes in the form of constipation, though some women can even experience diarrhea.(1, 2) It’s also normal for women to experience hemorrhoids or a temporary issue with fecal incontinence.(3, 4)

There are many things that affect postpartum bowel movements. This includes:

  • Fluctuating hormones after delivery(5, 6)
  • What you are eating
  • How much fluid intake you have

Furthermore, having an infection or a reaction to the antibiotics being used in the hospital could also affect the bowel movements after delivery.(7)

Here are some of the most common problems women deal with when it comes to postpartum bowel movement:

  • Postpartum hemorrhoids
  • Postpartum constipation
  • Postpartum diarrhea
  • Postpartum fecal incontinence

It is normal for any postpartum woman to experience any of these conditions, but it is also necessary that you let your doctor know about what you are experiencing so that the correct guidance and treatment can be started at the earliest.(8, 9)

Of all the bowel-related conditions that affect women after delivery, constipation is the most common. It is observed that women have their first postpartum bowel movement three to five days after giving birth. However, there are some women who experience a bowel movement on the same day that they deliver the baby. Either situation is totally normal. However, if a week goes by and you still do not have a bowel movement, you should inform your doctor about the same.

It is important to keep in mind that just as every pregnancy is different, so will be the postpartum bowel movements. It will help to know what your bowel movements were like before you gave birth so that you have a good idea of what to expect. For example, if you used to have a bowel movement daily, and it has already been four to five days after delivery since you have had a bowel movement, then this could be an indication that you are constipated. On the other hand, if you used to only go a couple of times per week and now you have to go multiple times in a day, this could also point to an issue.(10)

If you are anxious about your first bowel movement after giving birth, rest assured that you are not alone. It is normal for every woman to worry about the potential pain that a postpartum bowel movement could cause to have concerns about how soon you will be able to poop after delivering your baby.

Why Does Giving Birth Affect Bowel Movement?

There can be many reasons why giving birth impacts bowel movement. Changes in the body, fear and medical interventions can all have an effect on your bowel movement, and this can even continue for the first couple of days after giving birth. Here are some of the reasons why giving birth affects bowel movements:

  1. Body Changes

    Every woman who gives birth experiences changes in the body right from the start of the pregnancy to after giving birth. Here’s how some of these changes can affect your bowel movements.

    • Changes In The Pelvic Floor: The process of delivering a baby can stretch the muscles of the pelvic floor, which in turn causes changes in the rectum. Due to this, more stool can begin to accumulate in the intestines before it finally gets expelled. (11, 12)
    • Uterine Contractions: After the process of delivery, the uterus starts to shrink back down to its normal size. However, in order for the uterus to shrink back down, it cramps and contracts. This can trigger more frequent or looser stools.(13)
    • Hemorrhoids: When you push the baby through the birth canal during labor, it can cause hemorrhoids. These are inflamed and swollen veins in the anus and rectum. This can be an uncomfortable condition that will make you further reluctant to have your first postpartum bowel movement, leading to constipation.
    • Stress Hormones: The primary stress hormone cortisol can also be a cause of diarrhea or constipation, depending on the person.
  2. Medical Interventions

    Women who give birth vaginally or have a Caesarean section surgery are equally likely to experience some issues with postpartum bowel movements. For example, women who have given birth vaginally are more susceptible to postpartum constipation. This happens due to stitches, tearing, and muscle strain that is commonly experienced during the labor process.

    Women who have had C-sections are at a greater risk for issues with postpartum bowel movements because they usually receive more medications before and after their labor. They also have restricted movement after delivery.(14)

    Here’s how some medical interventions can affect postpartum bowel movement:

    • Labor Restrictions: If you experienced long labor, you might have been told n t to consume anything other than water to ensure that your stomach remains empty. This can make it challenging to have a good bowel movement.
    • Medications Administered After Birth: Acetaminophen or oxycodone, an opioid pain reliever, is often administered after delivery. This can cause constipation. Antibiotics given to prevent postnatal infections can cause diarrhea in some women.(15)
    • Perineal Stitches: Regardless of whether you decide to have an episiotomy before delivery or there is an unexpected tear during delivery, you may need stitches in the area between the anus (the perineum) and vulva. These stitches will make the perineum area sore, and they may also cause it to feel very tight. It is common for all women to worry about tearing their stitches if they push too hard to have a bowel movement. However, it is usually quite unlikely that such a thing will happen.(16)
    • Iron Supplements: Many women are commonly prescribed iron supplements to counteract any anemia that may set in due to the blood loss that happens during or after childbirth. These supplements are known to cause constipation.(17)
  3. Embarrassment and Fear

    After delivery, the vaginal area is not going to feel very comfortable. At the same time, it is also not uncommon for women to experience embarrassment and fear when it comes to discussing their first postpartum bowel movement. Even the first postpartum urine can be uncomfortable and intimidating, especially if you have had a vaginal delivery.

    You are also likely to worry about having to have a bowel movement with several people present if you are still in the hospital, especially if you are sharing a room with another new mom.

    Many doctors prescribe stool softeners to make it easier for new mothers to have a bowel movement.

Tips for a Smooth Postpartum Bowel Movement

Here are some tips to help you overcome the fear of having your first bowel movement after birth.

  • Use a Stool Softener: Your doctor is most likely to prescribe a stool softener after your delivery. This prescribed stool softener will be safe to take in the recommended doses, especially for those who are breastfeeding. Stool softeners add moisture to the stool to make it soft and easier to pass.
  • Stay Hydrated: It is essential to remain well hydrated after you go through labor and delivery. Being hydrated is also important for having healthy bowel movements. As food passes through the large intestine, it soaks up the water as it digests and absorbs nutrients. The large intestine needs a lot of water to facilitate this absorption process. This is why it is essential to ensure that there’s a lot of water to hydrate the intestinal tracts. If your stool looks like a bunch of small pebbles, it is a sign of dehydration. You should not only drink plenty of water, but you can also consider taking coconut water. Coconut water is rich in potassium and works like an electrolyte beverage.(18)
  • Have Fiber-Rich Foods: Include fiber-rich ingredients, fiber cereal, warm liquids, or you can even include a fiber supplement to your milk or other beverage. The first week postpartum will be a bit slow, but constipation can remain a problem for up to three months after giving birth. Adding more fiber to your diet will help reduce the chances of constipation.(19)
  • Use a Step Stool: Consider getting a small step stool to put your feet on it while having a bowel movement. Rest your elbows on your knees and lean forward. Try to attain a hunch position to have a more effortless bowel movement.
  • Focus on Your Breathing: Breathe in and start with a gentle push while you continue to breathe out. If you have stitches, though, never attempt to push it all out in one go, even if you have the urge to poop.

Conclusion

Postpartum problems with bowel movements are more common than you may think. Never hesitate to reach out to your doctor if you have been back home for a few days and have not yet had a bowel movement. Complications with bowel movements are rare, so there is not much to worry about. In most cases, bowel movement issues tend to resolve themselves with some patience and basic home remedies.

References:

  1. Hiser, P.L., 1991. Maternal concerns during the early postpartum. Journal of the American Academy of Nurse Practitioners, 3(4), pp.166-173.
  2. Shaw, E. and Kaczorowski, J., 2007. Postpartum care–what’s new?. Current Opinion in Obstetrics and Gynecology, 19(6), pp.561-567.
  3. Paladine, H.L., Blenning, C.E. and Strangas, Y., 2019. Postpartum care: an approach to the fourth trimester. American family physician, 100(8), pp.485-491.
  4. Shamshiri Milani, H., Amiri, P., Heidarnia, M., Abachizadeh, K. and Abadi, A., 2015. The Effects of Postpartum Home Care on Constipation and Hemorrhoids at‎ Sixty Days Postpartum. Journal of Babol University of Medical Sciences, 17(12), pp.26-32.
  5. Hendrick, V., Altshuler, L.L. and Suri, R., 1998. Hormonal changes in the postpartum and implications for postpartum depression. Psychosomatics, 39(2), pp.93-101.
  6. Harris, B., Johns, S., Fung, H., Thomas, R., Walker, R., Read, G. and Riad-Fahmy, D., 1989. The hormonal environment of postnatal depression. The British Journal of Psychiatry, 154(5), pp.660-667.
  7. Turawa, E.B., Musekiwa, A. and Rohwer, A.C., 2020. Interventions for preventing postpartum constipation. Cochrane Database of Systematic Reviews, (8).
  8. Bradley, C.S., Kennedy, C.M., Turcea, A.M., Rao, S.S. and Nygaard, I.E., 2007. Constipation in pregnancy: prevalence, symptoms, and risk factors. Obstetrics & Gynecology, 110(6), pp.1351-1357.
  9. Shin, G.H., Toto, E.L. and Schey, R., 2015. Pregnancy and postpartum bowel changes: constipation and fecal incontinence. Official journal of the American College of Gastroenterology| ACG, 110(4), pp.521-529.
  10. Gorrie, T.M., 1979. A postpartum evaluation tool. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 8(1), pp.41-47.
  11. Fonti, Y., Giordano, R., Cacciatore, A., Romano, M. and La Rosa, B., 2009. Post partum pelvic floor changes. Journal of prenatal medicine, 3(4), p.57.
  12. Kahyaoglu Sut, H. and Balkanli Kaplan, P., 2016. Effect of pelvic floor muscle exercise on pelvic floor muscle activity and voiding functions during pregnancy and the postpartum period. Neurourology and urodynamics, 35(3), pp.417-422.
  13. Wachsberg, R.H., Kurtz, A.B., Levine, C.D., Solomon, P. and Wapner, R.J., 1994. Real‐time ultrasonographic analysis of the normal postpartum uterus: technique, variability, and measurements. Journal of ultrasound in medicine, 13(3), pp.215-221.
  14. Zakerihamidi, M., Roudsari, R.L. and Khoei, E.M., 2015. Vaginal delivery vs. cesarean section: a focused ethnographic study of women’s perceptions in the north of Iran. International journal of community based nursing and midwifery, 3(1), p.39.
  15. Park, H.S. and Han, D.S., 2009. Management of antibiotics-associated diarrhea. The Korean Journal of Gastroenterology, 54(1), pp.5-12.
  16. Webb, S., Sherburn, M. and Ismail, K.M., 2014. Managing perineal trauma after childbirth. bmj, 349.
  17. World Health Organization. 2021. Iron supplementation with or without folic acid to reduce the risk of postpartum anaemia. [online] Available at: <https://www.who.int/elena/titles/iron_postpartum/en/> [Accessed 7 November 2021].
  18. Tariq, N., The Best Laxative Foods for Natural Constipation Relief.
  19. Yang, J., Wang, H.P., Zhou, L. and Xu, C.F., 2012. Effect of dietary fiber on constipation: a meta analysis. World journal of gastroenterology: WJG, 18(48), p.7378.