It’s only normal for you to be slightly freaked about your first poo post-birth! So here are my essential tips to get you prepared & remove the fear when that number 2 comes a-knockin.
These tips are key to implement in order to protect your pelvic floor and c-section incision, and therefore facilitate your recovery.
1. Do not strain (push)
If you’ve just had a vaginal birth, it’s fair to say your pelvic floor has just gone through a lot! So we definitely don’t want to add to this by straining or pushing out a poo – especially if you’ve had stitches.
Likewise if you’ve had a c-section, the last thing we want is you straining through your abdomen.
2. Aim for a softer stool
A harder stool is more difficult to pass and may result in straining, so we need to make sure your stool is formed but soft (not hard pellets or runny). To achieve this, your hydration & diet is key.
3. Drink plenty of water
Childbirth is like a marathon so you need to rehydrate just like you do after sport! Ideally you’ve been sipping on water during labour, but because this may not have been on the top of your to do list, make sure you up the ante as soon as your baby is out! Drink enough water to rehydrate and then aim to drink 3L of water per day. Have a big water bottle with you plus get the nurses to refill the hospital jug. Aim to have a glass with each breastfeed. This will not only help your bowels but your milk production & overall health.
Having a hot drink the morning, such as herbal tea, can also help get the bowels moving.
4. Eat fibrous foods straight after birth
It’s pretty unlikely that you’ve had a proper meal in awhile, and we all know you need to eat to keep your metabolism ticking along. So make sure you have food organised for after birth. The type of food you eat is really important. Healthy, fibrous meals & snacks are key. As we all know hospital food can be very plain & full of drying foods for the bowels like white bread, cheese & crackers.
My advice- pack some healthy food in your hospital bag such as berries, peach, kiwi fruit, apricots, prunes, protein balls, sachet of porridge, yoghurt, avocado or anything that you know gets your bowels moving. Don’t be afraid to pack a pre-made meal like a salad or stew too and ask a nurse to heat it up in the microwave.
Also ask your partner/family to bring in some healthy salads/meals/smoothies when they visit.
5. Laxative support
If you’re prone to constipation, I highly recommend you take in a laxative that works for you into the hospital. Alternatively, ask the midwife for a laxative. Movicol or osmolax are good options.
If you’ve had a 3rd or 4th degree tear then you MUST take a laxative. The midwife should give this to you routinely. If not, make sure you ask!
If you’ve had a 2nd degree tear or episiotomy and feel like things aren’t moving then a laxative may be helpful.
You can continue taking the laxative for several weeks/months if you need.
6. Listen to the urge
If you get a strong urge then go, don’t put it off! This is because the stool dries out the longer is sits in your colon becoming harder in consistency, which is what we want to avoid.
7. Sit in the optimal position
To ensure your downstairs anatomy is in the best position to facilitate emptying your bowel, there is a method to pooing…
Step 1: Sit with knees higher than your hips using a foot stool.
Step 2: Keeping your back straight, lean forwards so your elbows are rested on your knees.
8. Breathe that poo out!
To relax your pelvic floor, it’s important that you breathe into your belly, relaxing your abdominal muscles & pelvic floor. To facilitate this you can make the sound “sssssss”. Sounds funny but it works!
Avoid bracing your abdominal muscles, holding your breath and tensing the pelvic floor.
9. Apply wound support
Perineal pressure:
It’s a good idea to apply pressure to your perineum, especially if you’ve had perineal stitches. To do so, fold some toilet paper over, place it on your fingers and support the area just before your anus.
C-section pressure:
If you’ve had a c-section, you might find it comfortable to hold a folded towel over the incision site as you use your bowels.
10. Early movement
Initially movement may be limited by pain or anaesthesia, but as soon as you can try to get out of bed and move around the room. Work up to doing this several times throughout the day and then walking around the ward. Not only is this important for bowel health but also to help with circulation and recovery.
Bowel frequency
Keep in mind that it might take you 2-3 days to use your bowels after birth because commonly the bowel empties during or before labour, so it will take some time to refill them. Hopefully after implementing all of the above strategies, your bowels will return to normal frequency very soon.
The other end of the spectrum
I think it’s also important to acknowledge that some women can have the opposite problem following birth, whereby they have an accident with their bowels. This can happen due to weakness in the anal sphincter caused by a 3rd or 4th degree tear, or nerve injury. I know how awful this sounds, but please know that there is a lot you can do to overcome this issue. Make sure you tell your Midwife if this happens to you, and also ask to speak to the Women’s Health Physiotherapist at the hospital.
You got this mama!