Constipation After Birth - Tips from a Midwife

Struggling to navigate that first post-birth poo? You’re not alone! Pooing after birth is something lots of people worry about, and some struggle with, so we caught up with Christie, one of our resident midwives, for a taboo-busting no-poos-barred conversation. There’s no shame here when it comes to bodily functions and birth, so if you’re looking for answers and reassurance, you’re in the right place…

When will I do my first post-birth poo?

Regular bowel movements should return a few days after the birth of your baby. It is worth taking into account what is normal for you and if you usually poo every day or every few days as this is likely to affect when you’ll first open your bowels postnatally. 

The worry

Often people fear this first poo, but planning ahead can make it comfortable and relieving.

First things first, let’s get the biggest of the most common worries out of way – and that is that you will damage any stitches you may have had following the birth. This is incredibly unlikely. It is better not to strain if possible but if you do find yourself putting in a bit of extra effort, please don’t worry that your stitches will break, open or be damaged. The stitches are very strong and able to withstand bowel movements. 

Another worry people often have is haemorrhoids, which you may have developed antenatally or during delivery. These can add to the discomfort of passing that first stool, so it’s extra important to bear in mind the tips documented below. Alongside this, you can get off-the-shelf creams to help with discomfort, but if you feel you need further help, please speak to your GP.  Haemorrhoids should self-resolve in the postpartum period.

How to prepare and ease symptoms

Diet and hydration

These are always top of the list.

Make sure you are drinking plenty (around 2 litres a day). If breastfeeding you are likely to need even more than this (3 litres a day). Ensuring good hydration will help keep those poos softer and easier to pass. 

In terms of diet, as always, a well-balanced diet is essential to good postnatal health. To avoid constipation, make sure you are eating plenty of fruit and veg, salad and wholegrain cereals, breads and pulses. This should add fibre to your poo to ease its passage through the bowel.

Practical help

Elevating your feet can really help to improve your position for comfortably passing stools. Getting a small step and resting your feet on that while pooing can have a huge impact on the ease of defecation and the movement of poo through your bowel and rectum. 

In terms of practical help for stitches and discomfort of your perineum, it can be really useful to hold a clean/cold/wet compress to your stitches during those early days and first few bowel movements. This can not only provide a sensation of relief and soothing to the area itself but in holding it you gain that extra level of support and counter-pressure, making it that much easier to go.

Laxatives

If you are someone that is prone to constipation, have struggled in your pregnancy or have reason to suspect you may be constipated postnatally it may be a good idea to plan ahead and have a gentle laxative available post-birth in case you do struggle.  Gentle laxatives such as lactulose are effective and available over-the counter. Some laxatives are available off the shelf, but I’d recommend speaking to a pharmacist and explaining the situation, as different laxatives do different things and they’ll be able to point you in the right direction. 

If you are needing to take iron supplements postnatally, I would ask to be discharged from the hospital with laxatives to take along-side the iron or contact your GP for a prescription. 

Hopefully this helps with easing any symptoms of constipation and making that first poo after the birth of your baby comfortable and easy to pass.