Why does it happen
There are many reasons why you can become constipated in the post natal period:\
- The hormonal changes that start in pregnancy that slow the digestive tract causing constipation continue (read more here).
- The digestive system shuts down during birth so that the body can focus on birthing the baby. If labour is particulary long then the digestive system is off for some time and take a while to get moving again.
- The pain (or fear of pain) post delivery means that mums often delay opening their bowels and hence makes them more constipated.
- Dehydration is a big problems in new mums (especially those breastfeeding) which makes the stool harder and more difficult to pass).
Why Do We Want To Minimize It?
If a stool is too hard and difficult to pass often we have to strain to get it out. We don’t want to strain as this
- Puts increased stress on an already weakened pelvic floor muscles from pregnancy and birth.
- May reduce healing for both vaginal and c-section deliveries.
- Will likely make symptoms of a vaginal prolapse worse.
- Could cause hemorrhoids or fissures (small cuts inside the anus) which can be extremely painful.
- And being constipated just isn’t that nice!
How to minimize Constipation?
Firstly if you are concerned, then please speak with your Midwife or GP.
You are ideally looking for a Type 3-4 stool on the chart above. It should take less than a minute or so to pass your stool, if it takes much longer than this again you will be putting too much load on the pelvic floor.
Here are some tips about how you can help reduce constipation.
- The first poo post birth will feel quite stressful, but make sure you don’t put it off as this will make things worse. Try to stay as relaxed as you can.
- Get the consistency of the stool right (type 3-4). Start by increasing fluid intake and then food that may help (fruit, veg etc). If this doesn’t work and you are still passing a Type 1, then it may be worth having a conversation with your GP, Midwife of Pharmacist.
- Toilet positioning will help. Your knees need to be higher than your hips to help the rectum/end of bowel be in a good position to help pass easily. Put your feet on a stool (or a couple of toilet rolls under each foot) and lean forwards slightly. In Asia the culture is to squat on the toilet, which is actually a much, much more effective way to empty your bowel.
- As soon as you get the urge to go, then go straight away (or within 10 minutes). Do not try to go when you don’t have the sensation as this will cause extra strain. If you miss the window when you have the urge, you are better to wait for another urge than force it out.
- Do some deep breathing exercises and upper back mobility exercises in order to keep some movement through your trunk to aid the natural movement of bowel contents. Mums can get very stiff in the early few weeks with lots of feeding etc.
From a womens health physio perspective, getting the bowels sorted is more important than anything else. If you are having any pelvic health symptoms (leaking, pain, prolapse etc), a physio will make sure you are not constipated as the first priority and hence it is really important. Please reach out if you think you need some support.