Postnatal Constipation: The First Poo After Birth & What Can Help

Let’s talk about something that doesn’t get nearly enough airtime when we prepare people for having a baby: the first poo after birth.

For some people, it’s absolutely fine. For others, the thought of opening their bowels after a caesarean section, stitches, a tear or an episiotomy can be genuinely terrifying.

Constipation is also very common after having a baby, and there are several reasons why your bowels might suddenly decide they’re not interested in cooperating.

Why can constipation happen after birth?

There isn't always one single cause.

Pregnancy itself can slow the digestive system, and after birth your body is undergoing another enormous hormonal and physical adjustment.

Other contributing factors can include:

• Reduced mobility, particularly after a caesarean birth or difficult delivery
• Dehydration
• Changes in your normal eating pattern
• Iron supplements
• Pain relief, particularly opioid medications
• Abdominal or perineal discomfort
• Fear of opening your bowels because of stitches, tears or an episiotomy
• Changes to your routine while caring for a newborn

If you've had a caesarean birth, your bowel can also take a little time to get moving normally again following surgery.

The dreaded first poo

One of the most common worries is:

"Will my stitches burst?"

It can feel frightening to bear down when your perineum is sore or you've had stitches following a tear or episiotomy.

Similarly, after a caesarean, the idea of using your abdominal muscles to open your bowels can feel incredibly uncomfortable.

Try not to delay going when you feel the urge. The longer stool sits in the bowel, the more water is absorbed from it, making it harder and more difficult to pass.

You may find it reassuring to hold a clean maternity pad against your perineum while opening your bowels if you've had stitches. This can provide some gentle counter-pressure and help you feel more secure.

If you've had a caesarean, holding a folded towel or pillow gently against your abdomen can sometimes make coughing, moving and using the toilet feel more supported.

What can help prevent constipation?

Start with the basics.

Fluids

Make sure you're drinking regularly.

This is particularly important if you're breastfeeding, when you may find yourself much thirstier than usual.

Keeping a large bottle of water nearby when you're feeding your baby can be an easy way to remind yourself to drink.

Fibre

Try to include fibre-rich foods such as:

• Fruit and vegetables
• Wholegrain bread and cereals
• Oats
• Beans and pulses
• Nuts and seeds

Increase fibre gradually and make sure you're drinking enough alongside it.

Movement

Gentle movement can help get the bowel moving.

You absolutely do not need to be marching around the block immediately after having a baby, but getting up and moving around your home regularly can help if you're physically able to do so.

Don't ignore the urge

Newborn life can make going to the toilet feel like an event that needs to be scheduled three working days in advance.

But if you feel the urge to open your bowels, try to go.

Repeatedly ignoring it can contribute to constipation.

Think about your position

Your position on the toilet can make a difference.

Placing your feet on a small stool so that your knees are slightly higher than your hips can help put your body into a more effective position for opening your bowels.

Try to relax your abdomen and breathe rather than holding your breath and straining hard.

What if lifestyle changes aren't enough?

Sometimes water, fibre and a gentle walk aren't going to cut it.

If you're uncomfortable or struggling to open your bowels, speak to your midwife, GP or pharmacist.

Laxatives or stool-softening medications can be used after birth when appropriate, and there are options compatible with breastfeeding.

If you're taking medication that commonly causes constipation, particularly opioid pain relief, your healthcare team may recommend medication to help keep your stools soft.

You don't need to wait until you're severely constipated before asking for help.

When should I seek medical advice?

Get medical advice if you're experiencing significant or worsening abdominal pain, persistent vomiting, a very swollen abdomen, blood in your stool, severe rectal pain or constipation that isn't improving despite treatment.

You should also seek advice if you feel generally very unwell or something simply doesn't feel right.

A final reminder

Your bowels might not be the first thing on your mind when you've just had a baby, but postnatal constipation can make an already physically demanding recovery much more uncomfortable.

Drink regularly. Eat fibre. Move gently when you can. Don't repeatedly ignore the urge to go. And if you're struggling, ask for help early rather than suffering through it.

And if you're currently sitting there terrified that your first poo is going to undo your stitches...you're definitely not the only person who's worried about it.