The first bowel movements after birth can certainly be a nerve-wracking event, but a few practical changes can make them much easier while your body heals.

In this article

• Is it normal to have trouble pooping after birth?
• Why is it hard to poop after having a baby?
• How long does it take to have your first bowel movement after birth?
• How to make your first poop after birth easier
• Hemorrhoids, fissures and stitches
• Leaking, urgency and gas you can’t hold
• When to call your doctor or midwife
• How pelvic floor physiotherapy can help
• Frequently asked questions
• Where to start

Very few people spend pregnancy thinking about the first bowel movement after birth, and then, usually somewhere around the second day, it becomes the thing they’re thinking about most. Between the stitches, swelling, medication and the general sense that their body has already been through enough, it’s completely understandable to wonder how this is supposed to happen without making everything hurt more. You may be sent home with a stool softener and a general sense that your bowels will sort themselves out, and for many people they do settle within the first week or two. However, a Cochrane report found that around a quarter of women are still dealing with constipation at three months postpartum. Others are managing urgency, leaking or gas they can no longer hold as easily, which often doesn’t get mentioned unless someone asks directly. This guide explains why pooping can be harder after birth, how to make those first trips to the bathroom considerably easier and when it’s worth getting help.

Is it normal to have trouble pooping after birth?

It’s remarkably normal after both vaginal and caesarean birth. Postpartum constipation may mean hard or lumpy stools, discomfort or straining, and a feeling that you haven’t completely emptied. It’s most common during the first days and weeks and often improves as eating, drinking, movement and healing begin to settle into something more predictable, even if sleep is nowhere close to predictable yet. That doesn’t mean you need to spend weeks dreading the bathroom, especially if going is painful, if the constipation is continuing beyond the first few weeks, or if bowel urgency and leaking are part of the picture.

Why is it difficult to have a bowel movement after having a baby?

There usually isn’t one reason, and it helps to understand how many things can be contributing at once. Progesterone slows digestion during pregnancy, and its effects don’t disappear the moment your baby arrives. You may also have had very little to eat or drink during labour, lost fluid through birth and sweating, and then started using more fluid to produce milk if you’re breastfeeding. Together, those changes can leave stool considerably drier than usual. Medication may be part of it as well. Opioid pain relief used during or after birth can slow the bowel, and the bowel may stay sluggish for several days after abdominal surgery. Iron supplements, hemorrhoids, pain around a tear or episiotomy, and injury to the anal sphincter or pelvic floor muscles can all contribute too. Then there’s the part nobody quite prepares you for. If you have stitches, a sore perineum, hemorrhoids or a caesarean incision, it makes perfect sense to delay going when you feel the urge. Unfortunately, the longer stool sits in the bowel, the more water is drawn out of it, and the next attempt may be harder than the one you postponed. The pelvic floor may also tighten protectively instead of relaxing when it’s time to go, which can make emptying feel like pushing against a closed door. Add broken sleep and the near impossibility of sitting on the toilet unhurried while a newborn needs you, and it’s no surprise that the bowel takes some time to find its rhythm again.

How long does it take to have your first bowel movement after birth?

Most people have their first bowel movement within the first few days after birth. It may take a little longer after a caesarean while the effects of surgery and pain medication wear off. If you still haven’t had a bowel movement by around the fourth day, or you feel very bloated, increasingly uncomfortable or unwell before then, call your doctor or midwife rather than continuing to wait.

How to make your first poop after birth easier

It helps to start before the urge arrives. Keep a large water bottle wherever you usually feed so that drinking regularly doesn’t depend on remembering to walk back into the kitchen. A warm drink in the morning helps some people get things moving, while adding fibre gradually through foods such as oats, pears, kiwi, prunes, beans and lentils can soften stool over several days. Gentle walking helps too, even if that currently means a few slow laps of the hallway. Stool softeners and gentle laxatives are commonly offered after birth. A Cochrane review found that laxatives may help more people have a bowel movement within the first day, although the evidence was very uncertain, so this isn’t an area where one product or routine is right for everyone. Your pharmacist, doctor or midwife can help you choose an option that suits your recovery and can be used while breastfeeding. How you sit makes far more difference than most people expect. Place your feet on a small stool so that your knees are higher than your hips, lean forward with your forearms resting on your thighs and let your belly soften. We recommend the squatty potty – they work well to keep your legs in a good squatting position while you’re sitting on the toilet. Instead of holding your breath and bearing down, breathe out slowly as though you are fogging a mirror and give the pelvic floor time to release. If you have stitches, gently holding a clean folded pad or toilet paper against the perineum can make the area feel supported. After a caesarean birth, holding a small pillow against the incision can offer the same kind of support through the abdomen. Try to go when you first feel the urge rather than waiting for a quieter moment that may not appear for several hours. Afterwards, rinsing with a peri bottle and patting dry is usually much more comfortable than wiping.

Hemorrhoids, fissures and stitches: what’s behind the pain?

Hemorrhoids are swollen veins in and around the anus, and the pressure of late pregnancy and pushing during birth make them remarkably common afterwards. They may itch, ache or leave a small amount of bright red blood. Cool packs, a sitz bath in a few inches of warm water and keeping stools soft can all help. If you have stitches from a tear or episiotomy, check with your doctor or midwife before using medicated creams or suppositories near the healing perineum. An anal fissure is a small tear in the lining of the anus, often caused by passing a hard stool. The pain is usually sharp during and after a bowel movement, and you may notice bright red blood on the paper. Fissures often heal once the stool is soft again, but please mention the pain to your doctor, especially if it continues. Worrying about the stitches is one of the main reasons people delay going, but a bowel movement is very unlikely to cause them to open. Supporting the area, keeping stool soft and breathing out rather than straining are the most useful things you can do for a healing perineum. If the wound is becoming more painful, red, swollen or smells off, or the stitches appear to have separated, have it checked promptly.

Leaking, urgency and gas you can’t hold

Some bowel changes after birth involve the opposite problem and can be much harder to bring up. You may suddenly need to rush to the bathroom, find that you cannot hold gas the way you did before or occasionally leak stool. We ask about these symptoms directly at Oona because many people understandably won’t mention them unless someone makes it clear that they are relevant. These changes are more likely after a third- or fourth-degree tear, also called an obstetric anal sphincter injury. Studies report that in the first six months after one of these tears, roughly 30 to 50 per cent of women have difficulty controlling gas and around 5 to 10 per cent experience some stool leakage. Similar symptoms can also happen without a recognized tear, particularly after a long pushing stage or assisted delivery. Please bring them up. Pelvic floor physiotherapy is often a useful part of treatment, and your doctor may also need to assess the anal sphincter and healing.

When to call your doctor or midwife

Most postpartum bowel changes improve with time and a few practical adjustments, but some need a prompt medical review. Call your doctor or midwife if you haven’t had a bowel movement by around four days after birth; you have severe or worsening abdominal pain, bloating or vomiting; or you develop a fever or a perineal or caesarean wound that is becoming redder, more swollen or more painful. Please also call if there is more than a small streak of blood from the rectum, you have a very painful hard lump around the anus, or you are having difficulty controlling stool or gas. Iron supplements can make stool look very dark, but if you aren’t sure whether a colour change is from the iron, ask rather than guessing. If you notice gas or stool coming through the vagina, contact your doctor or midwife right away because this can be a sign of a rare complication that needs medical care. Heavy bleeding, severe pain or feeling very unwell should take you to the nearest emergency department. Not sure where to start? A free 20-minute Care Navigator call gives you a place to explain what has been happening before you decide what to book. We’ll help you work out whether pelvic floor physiotherapy, naturopathic care or another discipline makes the most sense as a first step. Book through our Toronto clinic or our Newmarket clinic.

How pelvic floor physiotherapy can help with postpartum bowel problems

A pelvic floor physiotherapist looks at how the muscles around the bladder, bowel and vagina are working, including how well they contract and, just as importantly, how well they relax. Relaxation matters a great deal for constipation because muscles that stay tense can make emptying harder. In that situation, adding more Kegels may be the opposite of what the area needs. The first visit begins with a conversation about the birth, your bowel habits and what is bothering you most. An assessment may include an internal examination if you are comfortable with one, but it is always your choice and there is still plenty we can assess without it. Treatment may include toileting position and breathing strategies, gentle work around perineal or caesarean scar tissue, strengthening for the anal sphincter and pelvic floor when urgency or leaking is part of the picture, and a bowel routine that has some chance of working around life with a newborn. The same assessment can include changes that often appear together, including leaking urine, pelvic organ prolapse, tailbone pain and painful sex after birth. You can book a pelvic floor physiotherapy initial assessment in Toronto or pelvic floor physiotherapy in Newmarket, and there is more information about what to expect on our Toronto and Newmarket pelvic floor pages. If a caesarean scar feels tight, numb or sensitive, we also offer C-section scar treatment in Toronto and in Newmarket. When iron supplements or eating patterns seem to be part of the problem, a naturopathic doctor can look at nutrition, hydration and supplements together and discuss options that may be gentler on digestion. You can book a naturopathic appointment in Toronto or in Newmarket. Please continue taking prescribed iron until you have spoken with the practitioner who prescribed it.

Frequently asked questions

Is it normal not to have a bowel movement for a few days after giving birth?

It’s normal for the first bowel movement to take a few days, especially after a caesarean or opioid pain relief. If you haven’t gone by around the fourth day, or you feel increasingly bloated, uncomfortable or unwell before then, call your doctor or midwife.

Will pushing to poop tear my stitches?

A bowel movement is very unlikely to damage your stitches. Keeping stool soft, breathing out rather than straining and gently supporting the perineum with a clean folded pad can make going feel considerably more manageable.

Are stool softeners safe while breastfeeding?

Many stool softeners and gentle laxatives are commonly used while breastfeeding, but the right option depends on your health, medications and recovery. Ask your pharmacist, doctor or midwife what makes sense for you.

How long does postpartum constipation last?

For many people, postpartum constipation eases within the first couple of weeks, although around a quarter of women are still experiencing it at three months. If it is continuing beyond the first few weeks, becoming more painful or changing how you eat because you are worried about going, it is worth having assessed.

Why do I suddenly need to rush to the bathroom since having my baby?

Urgency after birth may be related to changes in the pelvic floor or anal sphincter, particularly after a third- or fourth-degree tear. Please tell your doctor or midwife, and consider a pelvic floor physiotherapy assessment rather than trying to manage it alone.

Can pelvic floor physiotherapy help with constipation?

Pelvic floor physiotherapy may help when tense or poorly coordinated muscles are making it difficult to empty. A physiotherapist can assess whether the pelvic floor is relaxing properly and work with you on toileting position, breathing and muscle coordination.

Do I need a referral to book pelvic floor physiotherapy at Oona?

You don’t need a referral to book any service at Oona, so you can book pelvic floor physiotherapy in Toronto or in Newmarket directly.

Where to start

Trouble pooping after birth is remarkably normal and usually comes from several things happening at once, including hormones, medication, fluid loss and a very understandable reluctance to put pressure on a sore, healing body. Drinking regularly, adding fibre gradually, raising your feet on a small stool and breathing out instead of straining are useful places to begin. If things aren’t settling, going to the bathroom is painful, or you are dealing with urgency, gas you cannot hold or stool leakage, please bring it up. Those symptoms deserve a proper assessment too. You can book pelvic floor physiotherapy in Toronto or in Newmarket. If you would like help deciding where to begin, book a free Care Navigator call through Toronto or Newmarket. No referral is needed, and we are accepting new patients. Sources: Turawa et al., Interventions for preventing postpartum constipation, Cochrane (2020); Turawa et al., Interventions for treating postpartum constipation, Cochrane; The OASI clinic, The Obstetrician & Gynaecologist (2024); Repair of episiotomy and obstetrical perineal lacerations, AJOG (2023)