Being a new parent is challenging enough. However, if you know what to expect, that makes for a smoother transition. One of the most common changes after pregnancy is bowel problems, including hemorrhoids, constipation, fecal incontinence, and diarrhea.
Changes to bowel movements after pregnancy happen due to uterine contractions, pelvic floor issues, and changing hormones. However, your bowel movements should become regular shortly after giving birth.
Still, if you have trouble returning to regular bowel movements, some treatments might help. Here's what you need to know about postpartum diarrhea, constipation, and other bowel problems.
Are Bowel Problems After Pregnancy Normal?
Changes in bowel movements are not uncommon after giving birth. Fecal incontinence, the inability to control your bowels, affects anywhere from 5% and 26% of postpartum people.
However, those bowel changes tend to go away fairly quickly, Rita M. Knotts, MD, a gastroenterologist and assistant professor at the NYU Grossman School of Medicine, told Health.
"Most of the time, the symptoms aren't chronic. Most resolve after a few weeks as your body recovers from childbirth," noted Dr. Knotts.
However, what is normal for one person may not be normal for someone else. So, keep in mind that every person has different changes during and after pregnancy.
Causes of Postpartum Bowel Problems
Immediately after giving birth, you may notice pain near the perineal area, which is between the vagina and the anus. If you received perineal stitching after birth, that might also cause soreness. Together, that pain may affect the ability to have regular bowel movements.
According to Dr. Knotts, there are several reasons for postpartum changes to bowel movements, such as:
- Uterine contractions: During pregnancy, your uterus expands. Then, after childbirth, your uterus must contract to return to its normal size. Those contractions may cause loose stool.
- Changes to your pelvic floor: Your pelvic floor is a hammock of muscles and tissues supporting your bladder and bowels. Changes to your pelvic floor can result in constipation and cause hemorrhoids. Hemorrhoids can also be a side effect of diarrhea, which can cause anal irritation and discomfort.
- Changing hormones: High progesterone levels during pregnancy help maintain pregnancy and slow down your gastrointestinal (GI) tract.
Other factors may alter your bowel movements depending on how you give birth, vaginally or by Cesarean delivery (C-section). For instance, people who give birth vaginally can experience perineal tearing, stitching, and straining, all of which may lead to constipation.
If you give birth by C-section, certain medications, eating restrictions during labor, supplements, or perineal stitching can cause diarrhea or constipation.
"Pain medications are also frequently used during and after birth, which can make your bowels slower, resulting in constipation," explained Dr. Knotts. Also, some antibiotics may cause diarrhea.
How To Treat Postpartum Bowel Issues
With attention, time, and patience, postpartum bowel changes should disappear. Depending on your bowel changes, some of the following treatments may help.
Increasing your dietary fiber and water intake can help treat hemorrhoids, suggested Dr. Knotts. Stool softeners, such as Colace (docusate sodium), may also help. Hydrocortisone creams, suppositories, and sitz baths can reduce swelling, discomfort, and itching.
Eating a high-fiber diet and drinking plenty of water can alleviate postpartum constipation, Gabrielle Sandler, MD, an OB-GYN and clinical assistant professor of obstetrics and gynecology at NYU Grossman School of Medicine, told Health. Fiber supplements, stool softeners, or a laxative, such as MiraLAX (polyethylene glycol 3350), can also help.
However, avoid taking stool softeners and laxatives for long periods. You might develop a dependency and reduced bowel function. Instead, follow the instructions on the package when it comes to how long to take the medicines.
Fecal Incontinence and Diarrhea
Postpartum diarrhea is common among people who stretch or tear their rectal muscles during labor. Often, you can resume bowel regularity by mending your pelvic floor.
Starting pelvic physical therapy four to six weeks after delivery (and continuing for at least five months) may be effective, said Dr. Sandler.
Also, you can treat postpartum diarrhea with fiber supplements and bulking agents, like psyllium, and anti-diarrheal medicines, like Diamode (loperamide), added Dr. Sandler.
When To Consult a Healthcare Provider
Before you head to the store to buy over-the-counter (OTC) treatments, talk with a healthcare provider about what might work best for you. An OB-GYN might point out some lifestyle changes that can help. For example, decreased physical activity after childbirth might contribute to digestive system problems, said Dr. Knotts.
Changes in bowel movements after pregnancy are normal. However, notify a healthcare provider right away if you notice any alarming symptoms.
The following symptoms may indicate an infection:
- Severe abdominal pain
- Tears in perineal stitches or near the anus, also known as anal fissures
- Pain, discharge, or swelling near perineal stitches
"Yes, this an issue that you and [a healthcare provider] should discuss prior to birth, given how prevalent it is. If [a healthcare provider] does not bring this up, you should feel empowered to start the conversation," mentioned Dr. Sandler. That said, speaking up if you're uncomfortable is key.
A Quick Review
Bowel problems, such as hemorrhoids, constipation, fecal incontinence, and diarrhea, are common among postpartum people. Those changes are typically due to uterine contractions, pelvic floor issues, and changing hormones.
Some treatments, like laxatives, stool softeners, and pelvic floor therapy, may help. However, if postpartum bowel problems last or you develop symptoms of an infection, consult a healthcare provider right away.
Chin K. Obstetrics and fecal incontinence. Clin Colon Rectal Surg. 2014;27(3):110-112. doi:10.1055/s-0034-1383903
MedlinePlus. Episiotomy - aftercare.
Pascual ZN, Langaker MD. Physiology, pregnancy. In: StatPearls. StatPearls Publishing; 2022.
Bužinskienė D, Sabonytė-Balšaitienė Ž, Poškus T. Perianal diseases in pregnancy and after childbirth: Frequency, risk factors, impact on women’s quality of life and treatment methods. Front Surg. 2022;9:788823. doi:10.3389/fsurg.2022.788823
Turawa EB, Musekiwa A, Rohwer AC. Interventions for preventing postpartum constipation. Cochrane Database Syst Rev. 2015;2015(9):CD011625. doi:10.1002/14651858.CD011625.pub2
March of Dimes. Warning signs of health problems after birth.