You can file this as item number 9,675 under Universal Challenges No One Talks About That You'll Face After Childbirth. (That's a mouthful, but you get the idea.) The first bowel movement after a vaginal or Cesarean birth can be painful and scary, which adds stress to an already challenging time.
According to one study, between 16-38% of pregnant women report being constipated. And after childbirth, something once taken for granted (going to the bathroom) can suddenly feel really ominous: How will it work? What's it going to feel like?
“The postpartum woman is often afraid to poop after they have a baby. The fear of straining too hard, of ‘opening back up’ is common,” says Brie Abbe, a labor and delivery nurse in Bar Harbor, Maine. With my professional experience as a birth and postpartum doula (and my personal experience as a once-constipated new mom), Brie and I can both attest that postpartum constipation is exceedingly common. So take some consolation in not being alone, if you're going through it.
A small silver lining is that it probably won't last that long. “Anecdotally,” Abbe offers, “I would say that most women poop within 24 hours of having a vaginal delivery and within three days after a C-section.”
If you’re one of the lucky ones still waiting on that post-delivery delivery, you should know it’s not just stress making you feel blocked up. Your body is actually encouraging some retention. “The hormones of pregnancy function to slow intestinal motility. So physiologically, it is harder to poop for most women during their pregnancy — and immediately after,” Abbe explains. She suggests eating a diet rich in fiber, staying hydrated, moving around as you are able, and utilizing over-the-counter medications as needed.
Most importantly, she says, “Don't be afraid. Procrastinating pooping just makes it harder.” Read on for more tips to getting through that dreaded first deuce.
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Legumes, roughage, fruit, and seeds can all help to create a bowel movement. Abbe suggests reaching out to family and friends to help cook for you after your baby is born. “Home-cooked meals that are rich with green leafy vegetables and whole grains take time to prepare when you are taking care of a newborn," Abbe says. "Instead of a million onesies at your baby shower, why not have everyone plan a nutritious meal to be delivered for the healing mother after the baby arrives?” For a couple of ideas to get them started: Veggie chili with extra greens can be made in advance and frozen. Bean and cheese burritos can be eaten one-handed! (If you don’t have a baby yet, you’ll soon learn how useful this is.)
If your support network isn’t down for the meal train, or you simply need more fiber-rich foods than you’re willing to ask for, there are super simple snacks that can help get these nutrients in before and after your baby is born. Try having:
● Prunes smeared with peanut butter (There’s a reason your granny always keeps prune juice in the house. This is a tastier and more filling way to get it in.)
● Oatmeal with chopped up prunes and ground flax or chia seeds. (Both seeds are rich in fiber and healthy fats, and absorb water which draws it into your gut to help get things moving.)
● Fruit smoothies with greens, coconut water, and ground flax or chia seeds. (Hold the banana!)
In addition to a fiber-rich diet, please drink A LOT of water. No matter your birth experience or how you're feeding your baby, you need to take extra care of yourself in the postpartum period, and drinking water is an important part of that. “Hydration and early ambulation can help with peripheral swelling — in the feet and legs — and with increasing the motility of the intestines,” Abbe explains. In other words: Try to walk around a little. And drink, drink, drink (mostly water).
If fiber, hydration, and walking aren’t cutting the mustard, gentle over-the-counter medications can be very helpful. “Colace is a stool softener and senna is a naturally derived bowel stimulant. These are the most common and first line for postpartum constipation. If that doesn't work, bisacodyl suppositories are often the next step,” says Abbe. A bisacodyl rectal suppository, available under the brand name Dulcolax, works fast, usually in under an hour, by drawing fluid into your intestines and creating enough stimulation to produce a bowel movement.
While you should always discuss new medications with your Ob/Gyn or midwife, the previously mentioned medications are generally considered safe for the postpartum period and for breastfeeding.
Probiotics, magnesium citrate, and milk of magnesia may also help to gently produce a bowel movement. While conducting a metadata study, researchers in London found that taking probiotics can help balance gut flora and increase the number of weekly bowel movements. While not as medically sound (meaning studied and proven) as your regular over-the-counter meds, Natural Calm and other magnesium supplements offer magnesium citrate. It is believed that those who are deficient in magnesium are more likely to suffer from constipation and therefore a supplement can help create the balance their body needs to poop. According to Mayo Clinic, milk of magnesia works by “draw[ing] water into the colon to allow easier passage of stool.” It’s safe to use for temporary relief, but shouldn’t be relied on for long term issues.
With any luck, you don't have to try all of these tips, because the first one or two give you the result you're after. And then, you can focus on that other person's poops, your new favorite topic of conversation.