Postpartum Pooping: Advice from a Pelvic Floor Physical Therapist
Whether you gave birth vaginally or by C-section, there are many reasons your bathroom trips after labor and delivery may not be the most pleasant. Knowing why, as well as how to make it go more smoothly, can be very helpful. Just as you prepared to deliver a baby, you can prepare to deliver your early postpartum bowel movements.
What’s the Problem?
If pooping in the postpartum period is difficult or painful for you, you are not alone. In fact, constipation still affects about one-quarter of those who gave birth at three months postpartum. Here are some of the common reasons:
Pelvic floor injury. The pelvic floor is a group of muscles that forms a hammock in between the pubic bone and tailbone. These muscles spend nine months supporting your growing baby. During delivery, they can stretch anywhere from one and a half to three times their length These same muscles also help to control your bowel movements.
Anal sphincter injury. This can occur when forceps are used to help deliver your baby, there is a prolonged second stage of labor, or midline episiotomy, or you have a bigger-than-average baby. This can cause pain and difficulty passing stool.
Hemorrhoids.These enlarged blood vessels in the rectum often start in pregnancy and worsen during childbirth. Hemorrhoids can cause painful pooping and swelling at the anus.
Lack of hydration. Drinking enough water is important, but this can be challenging in those first few postpartum weeks, especially if you are breastfeeding. When you’re not hydrated, stool tends to be harder and more difficult to pass. Certain medications (such as opioids) that you may be prescribed if you gave birth by C-section can also cause constipation.
How to Poop Like a Pro
1. Stay calm. The anticipation of a painful pooping experience can make the situation worse. Fear, worry, and anxiety can cause pelvic floor muscles to tense, making it harder for stool to pass. Resources like this can help by preparing you for knowing what to expect.
2. Keep things soft. Hydration and a fiber-rich diet (fruits, veggies, and whole grains) are key for healthy bowel movements. Aim to drink at least half of your body weight in ounces of water each day (possibly more if you’re breastfeeding) and have fruit or veggies at every meal and snack. A stool softener can be helpful in the early postpartum period to lessen discomfort during bowel movements. Ask your doctor if this is right for you.
3. Practice proper pooping posture. Sit upright and use a toilet stool to bring your knees higher than your hips. This relaxes the pelvic floor and makes it easier to have a bowel movement.
4. Take a deep breath. Deep belly breathing is a great way to reconnect to your core to your pelvic floor as well as reduce stress. Stress has been known to disrupt the body’s ability to “rest and digest,” which can also lead to constipation. Exhale as you bear down to have a bowel movement instead of holding your breath. This helps to use your abdominal muscles to evacuate stool and allows the pelvic floor to relax.
Whether you have a vaginal or C-section delivery, many people who go through childbirth experience constipation in their postpartum period.
Several factors, including injury to pelvic floor muscles and surrounding areas and lack of hydration, can cause pain with bowel movements and lead to constipation.
Stress management, hydration, improving pooping technique, and deep breathing can improve bowel movements after baby. Stay calm and poop on.
Turawa, E. B., Musekiwa, A., & Rohwer, A, C. (2014). Interventions for treating postpartum constipation. Cochrane Database of Systematic Reviews, 23(9). doi:10.1002/14651858.CD010273.pub2
Ashton-Miller, J. A. & Delancey, J. O. (2009). On the biomechanics of vaginal birth and common sequelae. Annual Review of Biomedical Engineering, 11, 163-176.doi:10.1146/annurev-bioeng-061008-124823