Everything You Didn’t Know You Needed to Know About Postpartum Poop
Last updated: Dec 06, 2019
As appears in: verywell family
You delivered your baby, so the hard part is over, right? Wrong. You’re not off the hook until you’ve successfully had your first postpartum bowel movement, and believe me—it’s not as easy as it sounds.
Everything changes after you have a baby...and that includes your digestive system. Organs are shifting around, hormones are fluctuating, your uterus is shrinking back to its usual 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.)
We totally get it. That’s why we’ve assembled this guide to postpartum poop: what’s normal and what’s not, why you’re struggling, and what you can do about it.
Are postpartum poop problems normal?
Yes! We all have trouble staying regular from time to time, 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. Basically, anything goes when it comes to, you know, going after birth. Sitting around waiting for that first postpartum poop? It can take two or three days for it to happen, though some women may have one sooner.
OBGYN 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 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.”
Why does giving birth affect bowel movements?
There are physiological, environmental, and psychological reasons why the first several days after giving birth are a gastrointestinal minefield.
Body changes, such as:
- 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 cortisol can cause constipation or diarrhea, depending on the person (and becoming a new mom brings a lot of anxiety...and a lot of cortisol!).
- Hemorrhoids. Pushing the baby through the birth canal during labor can leave you with a bad case of hemorrhoids and a reluctance to have that first postpartum bowel movement, which leads to constipation.
Lack of self-care, such as:
- 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.
- Fatigue and hunger. When you’re a new mom, you’re often so busy taking care of your baby (and possibly other older children as well), 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.
Medical interventions, like:
- Medications given after birth. Dr. Masterson says that percocet, an opiodpain 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 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 birth1 , 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 may also cause it to feel excessively tight (you might feel like bearing down to have a bowel movement will “pop” your stitches...it won’t, but the fear is real!).
- Cesarean sections. Since you are numbed from the waist down for a while after giving birth—and not exactly in marathon form after the epidural wears off, either—you’re not going to have a lot of mobility. Unfortunately, neither will your intestines, and that can lead to a massive slow-down in your gut.
Vaginal versus cesarean delivery:
Women who give birth vaginally are definitely susceptible to constipation postpartum, thanks to tearing, stitches, and muscle strain that occur commonly during labor. But women who get c-sections are also at risk, since they often receive more medications before and after labor (and have restricted movement postpartum). Basically, you’re not off the hook no matter how you give birth.
Fear and embarrassment, because:
- You're sore. After you give birth, your vaginal region will feel like a battlefield. (Even the first postpartum pee is an intimidating and often uncomfortable prospect, especially if you had a vaginal delivery.) The thought of bearing down yet again so soon after hours of labor is enough to make anyone afraid of going to the bathroom.
- You’re sharing a hospital room with another new mom (or two). 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 curious onlookers right outside the door. In case you don’t already know, putting pressure on yourself to have a bowel movement right nowbasically ensures you won’t be able to have one.
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.
How to troubleshoot postpartum poop problems
If your digestive issues are mild or moderate, you can try resolving them at home before reaching out to your doctor. (If you're having severe issues, don’t hesitate to call...but more on that later.) But what should you try first, and which treatments are safe for breastfeeding moms? Here’s the scoop.
If you’re having constipation:
- Make sure you’re drinking enough water. Dr. Masterson says that breastfeeding moms should aim for 80-100 ounces per day.
- 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.
- If you’re still struggling, stool softeners are generally considered safe to use while breastfeeding . Colace is a popular brand often recommended by health care professionals; your doctor may even recommend you start taking them right away, to make that first postpartum poop go smoothly.
- You may not feel much like exercising (and we don’t blame you!) or you may even be restricted from exercising thanks to a c-section...but if you can manage it, simply taking a walk around the block—with or without your new baby—can help keep things moving in your intestines.
- Apply witch hazel pads regularly. You can even keep them chilled in the fridge for extra relief.
- 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 whenever possible, under the supervision of your doctor. 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 OTC ibuprofen or acetaminophen instead.
- Use a sitz bath or donut pillow to help heal hemorrhoids, which won’t help you poop but will reduce your discomfort around the idea of anything else coming out of that entire region down there.
If you’re having diarrhea:
- Check how much caffeine you’re having per day. (It’s probably not a ton if you’re breastfeeding, but still.) 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.
- Think about working in more “binding” foods, like bananas and rice. When in doubt, follow the BRAT diet: bananas, rice, applesauce, 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).
- 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.
What’s normal...and what isn’t?
Dr. Masterson 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.
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 movements per day.
You should also call your doctor ASAP if you notice blood in your stool, changes in color, or unusually painful bowel movements. These could be signs of an anal fissure .
According to a 2014 study in BJOG: An International Journal of Obstetrics and Gynaecology, 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 percent 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 complication7 that shouldn’t be ignored, such as 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 happen...probably way more commonly than you think. That doesn't make them any easier, though, so 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—most likely, you'll be able to resolve your constipation (or diarrhea) with some basic home remedies.