Bowel care during pregnancy and after the birth
bowel; motion; movement; action; poo; constipation; haemorrhoids;
During pregnancy and birth, changes in bowel actions (poo) are common.
Before the birth a woman may have fewer, firmer bowel actions than usual due to the effects of the hormone progesterone which relaxes the muscles of the bowel - but also due to increased fluid absorption from the bowel, and the increased pressure of an enlarged uterus and baby.
It is not uncommon for some women to experience loose bowel actions, just prior to or during the early stages of labour. This then can delay the first bowel movements during the 48 hours after the birth, and it may take a few days for bowel movements to return to normal.
After the birth
The first time you need to empty your bowels (do a poo) it may feel strange and possibly a little uncomfortable - this is due to the normal stretching of the perineum and the pelvic floor muscles during the birth. Any bruising, swelling and trauma (such as a tear or episiotomy) will add to this.
It is normal to worry about opening your bowels after giving birth – but it will not cause further damage, and it is safe to do.
Take your time, get comfortable on the toilet, lean forward with your forearms on your thighs and possibly raise your feet using a footstool. This will help to ease the discomfort and stress.
It is important that you go to the toilet when you feel the urge to empty your bowel. If poo sits for long in the bowel, more fluid is removed and the poo will become harder. This can cause constipation and make it more uncomfortable and difficult to pass poo later.
Pregnancy and birth stress the pelvic floor muscles (see the topic 'Pelvic floor exercises'). Constipation may add to this, weakening them further. This may lead to haemorrhoids, and to incontinence (leaking from the bowel or bladder) either in the days after the birth or later in life.
Haemorrhoids are common during pregnancy. They are swollen veins around the anus.
One of the main causes of haemorrhoids is constipation, but the increased pressure of your growing baby, increased blood flow and pregnancy hormones also contribute.
Some women develop haemorrhoids during the second stage of labour. Haemorrhoids are uncomfortable, they can be painful and sometimes they bleed.
Most haemorrhoids that have developed through pregnancy or labour shrink during the weeks following the birth. However in some cases you may need to seek further advice from a health professional. Simple pain relief such as paracetamol or ibuprofen can be used. Ice packs and avoiding constipation are good ways to help deal with the discomfort of haemorrhoids.
Managing constipation and haemorrhoids
It is important that you have a good diet with plenty of fresh fruit, vegetables and fibre. Also have frequent drinks – 2 to 3 litres of water or other drinks each day. These help to keep the poo soft. Gentle exercise such as walking also helps.
If you are still constipated you could try laxatives that contain psyllium (such as Metamucil**).
If the haemorrhoids are painful there are some creams that may be helpful. Your midwife, pharmacist or doctor will be able to help you select the best ones.
Some medicines can affect how the bowel works, and lead to an increase or decrease in bowel movements. Read the drug information leaflets that you get with the medication and consult a health professional if you are concerned.
**Any products referred to in our health topics are usually well-known brands readily available in Australia. The brand names are given as examples only, and do not necessarily represent the best products, nor the full range of effective products on the market.
Pregnancy, birth and baby
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see your doctor or midwife.