Constipation Postnatally

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.
Squats - Constipation Postnatally

What can I do to avoid constipation?

  • Hydrate- Aim for 8-10 glasses per day as a general rule.
  • Move- gentle early movement is important- even in those first few days, walking short distances is important.
  • Eating- aim to eat regularly, as soon as you are able, being mindful of slowly building up your fibre intake.

Some ‘go to’ foods:

  • Cooked oatmeal
  • Dry fruits and nuts, dates, raisins, prunes, dried cranberries or apples
  • A spoon of flaxseed or flaxseed oil with your morning yoghurt
  • Cereals- multi-grain cereals + nuts.
  • Beans and pulses
  • Fruits such as peaches, apples, bananas, and berries can help move your gut in the morning.
  • Spinach is easily digested and can cleanse the system!
  • Yoghurt works differently for some people so it can be good or bad for constipation but those with 'good bacteria' can support gut health.

Things to possibly avoid:

  • White flour and white rice can slow down the gut.
  • Red and processed meat like hotdogs, sausage, and bacon.
  • Some people find dairy constipating (cheese, milk, cream) so be aware of this.
  • Alcohol

What treatment is available?

The good news is that for most women if steps are taken early, constipation is likely to clear up within a week of giving birth. If you are having ongoing issues after this time, please talk to your GP, health visitor or care provider because there are various treatments available:

Diet management: advise on increasing intake of fibre.

Stool softening medication or bulk-forming laxatives: are a common first-line treatment and are often prescribed routinely for women who have had a more severe tear or are taking iron supplements.

Physiotherapy: Mummy MOT practitioners are well-placed to assess you if you are having ongoing difficulty with constipation post-natally. After a full assessment, to establish the underlying causes, physiotherapy treatment may include the following:

  • Pelvic floor exercises to work on length and strength.
  • Relaxation and breathing techniques.
  • Education and advice regarding improving diet, toileting positioning and bowel habits.
  • Core strengthening.

If you feel you are struggling with constipation post-natally, please don’t suffer in silence because there is so much, we can do to help you. If you would like to book a Mummy MOT please get in touch and we can guide you towards a healthier life on the loo!

For Reference:
Constipation – NHS (
Trottier M, Erebara A, Bozzo P. Treating constipation during pregnancy. Can Fam Physician. 2012;58(8):836-838. PMID: 22893333

Turawa EB, Musekiwa A, Rohwer AC. Interventions for treating postpartum constipation. Cochrane.