Difficulty pooping postpartum
Reader’s question about having a hard time pooping after childbirth
I gave birth 6 weeks ago without any major complications. For a while now I’ve had trouble with my bowel movements. Everyone talks about anal incontinence but I‘m facing the opposite issue. I have a hard time getting the poop to come out. I also find it difficult to discern when it’s time to “go”. I’m so very scared that something in my pelvic floor is broken and that they didn’t tell me about it at the labor ward. What should I do?”Reader’s question
HI! AND CONGRATULATIONS ON YOUR NEW BABY!
There are several reasons why one can have difficulty pooping after giving birth. It takes up to a year for the muscles in the pelvic floor to recover fully. Your body has just about finished the “acute” phase of healing. I read somewhere that 20% of all women have constipation postpartum, but also that 20% of the population of the world suffer from constipation in general.
WHAT MIGHT HAVE HAPPENED?
During the birth all tissues in the pelvic floor are distended and stretched to about 300% of their regular length, including the vaginal walls and pelvic floor muscles. Some also experience reduced sensation or other symptoms in their genital area caused by nerve damage due to the nerves having been stretched or compressed during the birth. Nerves heal slowly, about one millimeter per day, which is why it may take a long time before the sensation in your pelvic floor area is back to normal.
WHAT CAUSES DIFFICULTY TO POOP?
Injury to the pelvic floor muscles can cause urinary or fecal incontinence, but some injuries can also make it harder to pass stool. If you have difficulty pooping, a bulging posterior vaginal wall may be the reason. Having a hypertonic pelvic floor is another possible reason. Vaginal childbirth is in itself a great trauma to the pelvic floor and it can be enough to hamper the muscles ability to relax, causing hypertonicity and thereby difficulty to pass stool.
HOW DO YOU KNOW WHAT THE CAUSE IS?
My answer to this question is: Your issues might be caused by having sustained muscle injury or a bulging vaginal wall from childbirth, but your issues might also just be part of the typical pelvic floor recovery process postpartum. You won’t actually know which until several weeks or months have passed. Have a look at the posts listed at the end of this post for more info.
HERE ARE SOME KEY POINTS AS TO WHY THIS ISSUE CAN ARISE:
- You had a baby. The muscles and nerves of your pelvic floor have been stretched, pulled and compressed. You have swelling and bruising. Your tissues are slowly recovering, but the body memory of the pain is still fresh.
- Just having had a baby you might be moving less than usual. Less movement means slower passage of food through your digestive system. You might also be forgetting to drink and eat enough. If you are breastfeeding, some of the fluid you drink will be used to make milk for your baby. This means less fluid will be available in your digestive system for keeping your stools soft. Maybe your mealtimes are no longer regular, or you might be eating different foods than you are used to.
- All of the above makes you a little constipated. Coupled with the body memory of pushing while giving birth, along with worrying that pooping might hurt, makes pooping an all around unpleasant idea. This makes your pelvic floor tense and unable to relax, hampering bowel movements further, making you even more constipated.
- All in all, it is very easy to end up in a downward spiral and end up having difficulty pooping.
SOME SIMPLE ADVICE WHICH YOU PROBABLY ALREADY KNOW:
– Eat at regular meal times
– Eat foods rich in fibre
– Drink extra fluids, especially if you are breastfeeding
– Move as much as your body allows you to. Moving less than usual will make your intestines work slower, increasing the risk of constipation.
– Listen to your body and the signals it is giving you. Go poop immediately when your body tells you it is time to go. If you don’t go at the first signal, the feces will remain in your bowels. The longer the feces stay in your intestines, the more fluid is absorbed by the intestines from the feces, making the poop dryer and harder. The next time you get the signal to go, the poop will be more difficult to pass.
SOME SIMPLE ADVICE YOU MIGHT NOT HAVE COME ACROSS:
- Use a foot stool while on the toilet. Sitting in a position where your knees are higher than your hips will help your pelvic floor relax and open up. You will notice the difference!
- Apply counter pressure on your perineum. Your perineum is the area of skin between your vaginal opening and your anus. Pressing on your perineum with clean fingers or some toilet paper can make pooping easier.
HOW TO POOP WITH A TENSE OR HYPERTONIC PELVIC FLOOR:
It might be enough to just shift your focus away from pooping. Distract yourself while on the toilet, maybe by reading something?
If this is not enough, do the following:
Sit on the toilet. Prop your feet up on a foot stool.
- Place your hands on your belly
- Tighten your abdominal muscles as if bracing for a punch
- Relax and let your belly expand fully into your hands
- Repeat the tightening and relaxation 10 times
- Finish by relaxing fully for 10 seconds while also trying to relax your pelvic floor.
If you feel the urge to poop, push gently while exhaling.
If not, repeat the procedure of tightening and relaxing another 10 times.
HERE ARE SOME MORE POSTS WHICH MAY BE HELPFUL:
- Tips for when you are constipated after giving birth (swedish post)
- How do I care for my bulging vaginal walls postpartum? (english post)
- What is the difference between “bulging, lax vaginal walls” and a prolapse? (english post)
- How to care for your perineal tear and pelvic floor postpartum (Swedish post)
- Advice on living with levator ani injury (Swedish post)
- A physiotherapeutic post on poop (swedish post)
- Relaxation of the pelvic floor (english post)
TRANSLATE WEBSITES WITH GOOGLE TRANSLATE:
This website is mainly in swedish. If you want to read more about pelvic floor issues and pelvic organ prolapse, you can use Google translate to read the swedish posts.
On your computer, go to Google Translate.
In the text box, enter a URL.
To choose the language you want to translate to, at the top right, click the Down arrow .
On the right, click the URL that appears. The URL will open a new tab and the website will be translated.