Pooping After Birth: What No One Told You (But Should Have)
Written by Ali Anderson, PT, DPT, CAFS, PCES
Reviewed by Anna McMaster, PT, DPT, PRPC
First of all, congratulations, Mama. You did something incredible. Now, as you settle into those first raw, beautiful, and exhausting days postpartum, I want to talk about something most people don't warn you about: pooping after a vaginal birth.
Yes, we're going there. Because the fear, discomfort, and yes, even pain that can come with your first bowel movement after birth is real and you deserve to know what's normal, what's not, and how to make things a little easier.
Why Is Pooping So Hard After Birth?
After pushing a baby out, your pelvic floor muscles are tired, stretched, and potentially healing from tearing. You may also be sore, swollen, or dealing with stitches. Combine that with hormonal changes, pain medications, less movement, not drinking enough fluids, and potentially slowed digestion — and pooping can feel like a monumental task. Research confirms just how common this is: constipation affects approximately 47% of women in the first few days after vaginal delivery, nearly double the rate seen in non-pregnant women.
The Hemorrhoid Reality
Hemorrhoids (swollen veins around the anus) are extremely common after vaginal birth, especially if you did a lot of pushing. They can feel like painful lumps, itch, or bleed when you have a bowel movement. And they can definitely make you dread that first bowel movement.
Here's the good news: there are ways to manage.
A Note on C-Section Recovery
If you delivered by c-section, bowel recovery comes with its own set of challenges. Research shows that constipation affects around 57% of women in the first few days after a c-section, compared to 47% after vaginal delivery. The reasons are similar but with some additional factors: abdominal surgery slows the gut down, anesthesia and pain medications affect bowel motility, and the instinct to avoid any abdominal engagement while healing is understandable but can make things harder. The same principles below apply — hydration, fiber, a squatty potty, gentle movement, and stool softeners if needed — but you'll also want to be mindful of your incision site when bearing down. Supporting your abdomen gently with your hands or a small pillow can help reduce the feeling of pressure near the incision. If you're not moving your bowels within a few days of your c-section, let your care team know.
Tips from a Pelvic Floor PT to Help You Poop with Less Pain
Breathe and relax your belly. Don't hold your breath or push like you're giving birth again. Instead, exhale gently and let your belly soften. Think of "breathing your poop out" rather than straining.
Use a stool (literally). Put your feet on a low stool or stack of books when you sit on the toilet. This brings your knees above your hips and helps straighten the rectum, making it easier for stool to pass.
Hydrate and eat fiber. Drink plenty of water, especially if you're breastfeeding. Aim for whole fruits, veggies, and whole grains to soften your stool and prevent constipation. Research supports that dietary factors including water intake play a meaningful role in postpartum bowel recovery.
Talk to your doctor about stool softeners. If you're still having trouble, stool softeners, laxatives, and in some cases suppositories can help you get going. Don't suffer through it — these are safe and commonly recommended in the postpartum period.
Don't rush it. Give yourself privacy and time. Trying to poop when you're tense or rushed can make things worse.
Support your perineum. If you're sore or have stitches, roll up a clean pad or use your hand covered with tissue to gently support your perineum (the area between your vagina and anus) when you bear down. This can relieve pressure and feel more secure.
Soothe hemorrhoids. Use witch hazel pads, cold compresses, or a sitz bath to soothe swelling. If they're painful or persist, talk to your provider — there are safe treatments available.
When to Seek Help
If you haven't had a bowel movement within 4 to 5 days, are having severe pain, bleeding, or feel like something isn't right, please reach out to your provider. And don't suffer silently — pelvic floor physical therapists are trained to help you recover everything down there, including bowel issues.
The good news is that for most women bowel function does return to normal relatively quickly. Research shows that by one month postpartum, constipation rates drop significantly — to around 9% after vaginal delivery and 15% after c-section. Your body is healing, even when it doesn't feel like it.
You just brought a human into the world. Let's make sure your body is healing well, inside and out.
For personalized postpartum pelvic floor support, Amie offers programs designed by pelvic floor PTs for every stage of your recovery.
References:
Kuronen M., et al. (2021). Pregnancy, puerperium and perinatal constipation: an observational hybrid survey on pregnant and postpartum women and their age-matched non-pregnant controls. BJOG: An International Journal of Obstetrics and Gynaecology, 128(5), 911-919.
Rungsiprakarn P., et al. (2015). Interventions for treating constipation in pregnancy. Cochrane Database of Systematic Reviews, 9, CD011448.
Turawa E.B., et al. (2021). Interventions for preventing postpartum constipation. Cochrane Database of Systematic Reviews, 4, CD011625.
Bradley C.S., et al. (2007). Constipation in pregnancy: prevalence, symptoms, and risk factors. Obstetrics & Gynecology, 110(6), 1351-1357.