Regardless of how you delivered your baby there is often one common fear for new moms. The first postpartum bowel movement can be terrifying, and it’s honestly for a good reason. You are sore, in all sorts of places and having a bowel movement can cause significant perineal and abdominal pain.
Postpartum constipation is very common so in this article we will break down why you are feeling constipated postpartum, how you can treat it naturally, and the best stool softener postpartum that are safe and recommended to avoid unfortunate postpartum bowel movements! Let’s dive in and get you feeling better soon!
Key Takeaways:
- Constipation postpartum is common. Your hormones will naturally slow down your bowel function along with pain medications you may have received during birth.
- The first bowel movement doesn’t have to be scary if you take steps to prevent constipation or hard stools.
- Stools softeners are very safe and can be use prophylactically to support that first poop.
Table of Contents
Whats the Deal with the First Postpartum Poop?
Lets get really real right now. There is a reason there is so much fear around the first bowel movement, and it’s not unreasonable. Your body has just gone through a marathon event and has been stretched an pulled in many directions. You will likely have a few new battle scars. If you’ve had a cesarean delivery you are recovering from multiple incisions and can be extremely uncomfortable. Between a sore abdomen and possible very sore perineum you could be quite concerned about such a normal bodily function.
How Common is Postpartum Constipation
A recent study conducted in a hospital in Finland, and published in 2020, found that out of 403 postpartum women compared to 200 non pregnant women the incidence of constipation was 52% in postpartum women and 21% in the control group (women that had not been pregnant or postpartum in the last 12 months).
The highest prevalence of constipation postpartum occurred within the first month. So being proactive in prevention can significantly improve your postpartum experience.
What are the Causes of Postpartum Constipation?
There are several reasons why constipation might happen, and understanding them can help you find relief.
- Hormones: During the postpartum period, your body is still buzzing with elevated levels of hormones like progesterone and estrogen. Research shows that higher levels of estrogen might slow down your bowel movements. This can make it tougher for your body to move stool through your gut, leading to postpartum constipation.
- Pain Medicine: Certain medications can also affect your digestion. If you received an epidural or any narcotics during or after labor, you might notice a slowdown in your gut motility. That means your digestive system might not be working as quickly as usual. For those who experienced a C-section, you might be prescribed painkillers for a few days after giving birth. While these can help manage your pain, they can also increase the risk of postpartum constipation.
- Dehydration: You might find yourself a bit dehydrated after giving birth or when you start breastfeeding. Dehydration can be due to insufficient fluid intake, excessive sweating, or loss of blood during delivery. The large intestines job is to draw out water from your stool to be used by the body. If you’re not drinking enough fluids, your body will reclaim most of that water, leaving you with stool that’s tougher to move through your system. Staying hydrated is key to keeping things flowing smoothly.
- Tear or Stitches: Having a bowel movement could be painful, due to a tear, hemorrhoids, or an episiotomy, and this could make you hesitant to go when you need to. This fear of causing more pain or straining your stitches might make you hold it in, but that can actually increase your risk of constipation. Try to listen to your body and not hold off on using the bathroom—it can make things harder in the long run.
- Iron supplements: Taking iron supplements, which might be part of your prenatal vitamins, can play a role in constipation. Your doctor may also recommend iron supplements after delivery if you’ve experienced blood loss, which can also contribute to constipation.
- Reduced physical activity: After birth you are resting to recover from birth. Although rest is very important postpartum the reduction in activity can lead to slower gut motility. It is good to get up and do light exercise such as walking to or from the bathroom or kitchen in the immediate postpartum period, and short walks as your feel you are ready.
Natural Ways to Prevent Postpartum Constipation
Let’s talk about some effective ways to ease postpartum constipation. Fortunately, there are several strategies you can try to get things moving more smoothly. I had a fourth degree tear, and I was terrified of any and all poop for 6 weeks. I had no desire to cause any strain on my stitches and I did my best to do some of these, but honestly stool softeners were my friends. Be sure to chat with your healthcare provider to ensure what’s right for you.
Here are some natural ways to prevent bowel issues:
Hydration:
Hydration:It is so important to increase electrolyte and water intake throughout the day to keep your stools soft and easy to pass. The amount of water you need depends on if you are breastfeeding, sweating, and the climate where you live.
Stay hydrated by keeping a water bottle near you. Or giving your significant other the job of making sure you keep taking sips. Teas, prune juice, and even broth in the mornings can help keep dehydration away. Setting up an easily accessible water bottle wherever you may feed the baby is helpful as well. A good way to see if you are hydrated is to check the color of your urine, the clearer it is, the more hydrated you are.
Fiber Rich Diet:
High-fiber foods are a great support to better motility through the gut. Dietary fiber is a bulking agent meaning it gives your stools more weight, size, and softens the stools making it easier to pass through your digestive tract. Consuming more fiber rich foods such as fruit and vegetables, beans and legumes, bran (muffins, cereal, etc.), and whole grain breads will help ensure that your digestion system is getting the fiber it needs to move your stools more smoothly through.
Regular Physical Activity:
I know that this seems impossible postpartum or post C-section. However, any type of movement will naturally get your pipes running more smoothly again. Even if it is simply a turn about the house. After your initial days of rest, you can help your body out by taking a simple slow walk.
Properly Toilet Habits:
This means going when you have the urge to go, do not hold it. Take adequate time for bowel movements, avoiding straining, and using proper posture on the toilet. Relaxing your pelvic floor muscles can also improve your bowel movements. You can do this by unclenching your jaw and mouth and breathing through your bowel movements. Holding your breathe can actually tighten your pelvic floor muscles.
Magnesium Supplementation:
Magnesium helps you poop by drawing water into the bowels to help keep things moving. That is why it’s considered a natural laxative. There are several different types of magnesium supplements so please consult with your health care provider.
**If you are a breastfeeding mom read more about the benefits and safety of magnesium supplements while breastfeeding.
Herbal Tea:
Some herbal teas can have a natural laxative effect by stimulating your bowels or adding bulk to your stools. Again please talk to your medical provider about what might be the right option for you. Warm liquids can be very beneficial postpartum and increase your water intake.
Prune Juice:
This has had a long reputation of constipation relief. Many studies have supported that reputation and show that the high amounts of sorbitol (sugar alcohol) and dietary fiber are the reason for this positive effect.
Are Stool Softeners Safe for Breastfeeding?
The good news is that, yes, stool softeners are safe to use while breastfeeding. They are a common medication prescribed to new mothers after giving birth. Since passing hard stools can be painful, doctors often recommend stool softeners after delivery. It’s generally a standard practice for people to be given a stool softener when they leave the hospital as a precaution.
Stool softeners can also be beneficial for managing constipation caused by opioid pain medications. For those with more severe perineal tears, such as third- and fourth-degree tears, keeping stools soft is crucial to avoid straining the stitches and causing additional discomfort.
Other Tips
Other tips I found extremely helpful from others and that I employed during my recovery are:
- Grab a little step stool to rest your feet on while in the bathroom, so you are not straining while going number two
- We typically tend to hold our breath and then bear down or push when we are pooping. However, the opposite is what we should do while pooping. While pooping take deep breaths and on the exhale bear down so you don’t strain.
- Wipe gingerly if at all. Use peri rinses, sitz baths, witch hazel or padsicles to help decrease inflammation in your perineal area.
- Talk to a pelvic floor specialist as they can help with gentle exercises and techniques for pooping.
What is the Best Stool Softener Postpartum to Prevent/Treat Constipation?
Stool softeners are considered very safe and effective for postpartum constipation. Many providers will write you a prescription for them before leaving the hospital although you can purchase many over the counter. Although they are considered generally safe it is always best to consult with your medical provider to ensure that it is safe for you and your particular situation. In some cases it may be contraindicated.
You have a variety of options and I would love to walk you through the best over the counter options
Docusate/Colace
How it works: It works by dissolving water and fats in your stool to soften it and helps prevent straining.
How long before you see an effect: About 12-72 hour per the manufacturer. If you start it early you may prevent constipation from the start.
Things to know while taking it:
- Drink plenty of water while taking Colace.
- Take it at night to have an easy bowel movement in the morning
- You shouldn’t take it for more than a week. If you are feel like you need it for longer, you should be discussing your constipation with your provider.
- It is not a long term option.
Possible side effects: allergic reaction (itching, rash, hives, or swelling), diarrhea, stomach pain
Bisacodyl/Dulcolax
How it works: is a laxative not really a stool softener that stimulates the bowels to increase the movement of stool through the GI tract.
How long before you see an effect: About 6-12 hours if taking an oral tablet and 15 min – 1 hour if taking a suppository.
Things to know while taking it:
- There is conflicting advice about it’s safety while breastfeeding. Lactmed gives the okay to take while breastfeeding showing that it was not found in breastmilk after consuming.
- Should not be taken long term. Should only be taken as a 1-2 x event when needed.
- Should be discussing taking this medication with your provider as it may not be a viable option for all postpartum women.
- Drink plenty of water while taking this medication.
Possible side effects: stomach pain/discomfort, light headedness, and rectal burning.
Miralax
How it works: increases the amount of water in the intestinal tract to stimulate bowel movements.
How long before you see an effect: should produce a bowel movement within 1 to 3 days of using the medication.
Things to know while taking it:
- It should only be used once per day. If you are still constipated or having irregular bowel movements after 7 days call your medical provider.
- Store at room temperature and away from moisture or heat.
- Always consult with your provider before taking as it may not be appropriate for all postpartum clients.
Possible side effects: bloating, gas, upset stomach, dizziness or increased sweating.
Phillips
How it works: pulls water and lipids to the stool to make it softer and easier to pass.
How long before you see an effect: You will typically see a bowel movement within 12-72 hours.
Things to know while taking it:
- Drink plenty of fluids while taking it.
- If you don’t see a bowel movement within a week you should talk with your doctor.
- Like the other options this is not a long term option for constipation.
- Avoid mineral oil unless given permission by your provider.
Possible side effects: stomach cramping/pain, or diarrhea.
Metamucil
How it works: The main ingredient psyllium fiber when combined with water, it swells and produces more bulk, which stimulates the intestines to contract and helps speed the passage of stool through the digestive tract.
How long before you see an effect: Between 12-72 hours.
Things to know while taking it:
- Needs to be mixed with water when taken.
- Is from plant based ingredients to improve regularity of bowel movements.
- Can be taken daily.
- Talk with your provider before starting a regular regimen.
Possible side effects: gas, bloating, and nausea.
Natures Sunshine
How it works: It acts as an osmotic and bulking agent. It pulls water into the stool, fiber adds bulk to the stool, and has herbs that have a gentle laxative effect to help pass stool easily.
How long before you see an effect: You will typically see a bowel movement within 12-72 hours.
Things to know while taking it:
- As it is a herbal supplement talk with your doctor about the safety of this supplement and other possible medications you may already be taking.
- This is not FDA approved as it is an herbal supplement
- Discuss the safety of use if breastfeeding with your provider.
Possible side effects: diarrhea, stomach discomfort, and gas.
Final Thoughts
Postpartum constipation is a common experience for many new moms and can happen for a variety of reasons. Hormonal changes, medications, dehydration, and recovery from childbirth can all contribute to constipation. But while it might be uncomfortable, there are ways to manage it. If you need extra help, talk to your healthcare provider about using stool softeners, especially if you’re taking pain medication.
Remember, every mother’s journey is different, so find what works best for you. With a little patience and these tips, you can get things running smoothly and focus on enjoying time with your new baby!
Let us know in the comments below if you were worried about your first postpartum poo, or if you struggled with constipation and what helped!
Niki Cowan has a background in Medicine and Public Health. She is a Certified Health Education Specialist as well as a Medical Assistant. She’s passionate about Women’s Health and empowering women in their journeys. She is married to her wonderful husband Kevin, and they have an active son. While trying to have another little one hasn’t worked out yet, she is pursuing her passions and hoping to gain further education and experience in the area she loves, while playing with her son. She’s an avid reader, Original Great British Baking Show watcher, and very amateur kickboxer.
Leave a Reply