Constipation – a very annoying and common postnatal problem that no one talks about, but pelvic health physiotherapists are obsessed with it! No matter how your baby arrived in this world it is likely you may experience short-term issues having a poo in the early stages following your delivery.
What is constipation?
Constipation is basically when you are having a poo less often and stools become difficult to pass.
According to the NHS, the definition of constipation is having a poo less than 3 x per week however it is very hard to define what is normal when people vary so greatly in their bowel habits.
No matter what your usual bowel pattern looks like, the longer you stray away from this, the harder it can be for your poo to eventually pass.
Other key features that usually define constipation include:
- Your poo may be dry and hard.
- The experience can be painful and difficult.
- You have a feeling that you have not fully emptied your bowels.
Why has this happened to me?
- The hormones of pregnancy have a huge effect on your gut and digestive system. Add to this, the weight of your growing baby pressing down on your intestines, and you have a recipe for a slowing down of the gut.
- Oh, and during labour, your digestive system slows down even further
- Some of the commonly used opioid pain relievers used during labour are notorious for causing constipation.
- If you had a c- section birth it can take up to 4 days for your digestive system to kick back into its normal rhythm.
- Perineal pain: Many women postnatally may be scared of the ‘first poo’! Episiotomy wounds, perineal tearing or stretching may lead to a fear of tearing your stitches or pain. This fear may cause you to hold on and become further constipated.
- Dehydration: If we don’t drink enough our stools become more firm and dry and during labour as well as reduced fluid intake we may lose fluid through vomiting or blood loss.
- Iron tablets: Iron tablets are known to increase the risk of constipation.
The first poo…
It is never as bad as you imagine! Trust me.
It may be that if you have had a vaginal birth you still have some numbness present down below. The nerves in your perineum and vagina have been stretched so you may not be able to feel what is happening.
If you needed to have stitches, or you have piles, you may have soreness around your perineum and back passage as you pass the stool.
With more serious tears or if you have a wound down below that is taking some time to heal, it may be that you are given something to soften your stools. In all cases, we would advise against any straining and ‘bearing down’.
Top tips:
- When you feel that first urge to go to the loo, don't ignore it.
- Relax, breathe slowly and deeply, find a comfortable position (see the squatty potty position in the image below), and take your time.
- If you’re worried about your stitches, it may feel comfortable to ‘splint your wound’ by holding a clean sanitary pad or folded tissue and supporting the perineum/ stitched area as you open your bowels.