Postpartum Constipation: 8 Ways to Get the Poop Out

Unfortunately, constipation isn’t just a pregnancy thing — pooping can be just as hard postpartum. One study shows that while 40% of people report constipation during pregnancy, nearly 52% of people experience constipation after they deliver.

No matter where you are in your postpartum journey, we’re going to break it all down for you. From what causes postpartum constipation, to tips to try at home, to who to reach out if your DIY options fail. Keep reading to get your bowels back on track.

What causes postpartum constipation?

Postpartum constipation is when you have fewer than three bowel movements a week, along with hard, dry, or lumpy stools that are difficult or painful to pass. 

Postpartum constipation can be caused by a host of contributing factors, including:

• A slower gut: During pregnancy, high progesterone levels slow down your digestive tract. This means that poop is in your intestines for longer, leading to drier, harder stool. Progesterone levels are lower after birth, but because of changes related to both pregnancy and birth, it can take a while for your system to get back on track. 
• Pain medication side effects: If you had an epidural or any other forms of pain medication, constipation is a common side effect. Opioids specifically, can tighten up your anal sphincter, making it hard to relax enough to poop effectively.
• Perineal or anal sphincter injury: If you had a vaginal delivery, it’s common to injure your perineum (the space between your vaginal and anal openings) to be injured in the process. More severe tears can even affect the muscles in your anus. 
• Dehydration: After birth, assume you’re somewhat dehydrated — no matter how much you were allowed to drink during labor. Things like limited fluid intake during labor, blood loss during birth, postpartum sweating, and the dehydrating nature of breastfeeding can all contribute to dehydration.
• Reduced physical activity: It’s important to take a break from activity in the early postpartum, so that your body can heal and recover. But this lack of physical activity can impact digestion and contribute to constipation
• Dietary changes: The busy postpartum period can disrupt your regular eating habits, impacting when you are eating, and the quality of your diet.
• Psychological factors: It doesn’t matter if it’s your first time or fifth, adjusting to a new baby is always stressful. This stress and anxiety can really impact your digestive health and contribute to constipation.

8 Ways to relieve postpartum constipation

Luckily, if you're struggling with postpartum constipation, you have options. Here are 8 strategies you can try at home.

1. Hydration

Your first line of defense is to try to keep your poop as soft as possible, so it doesn’t get stuck in your sluggish gut. The best, most natural way to do this is through hydration.

Everyone’s hydration needs are different, and can depend on factors like whether you’re breastfeeding, your body size, how recently you had your baby, and your activity levels.

In general, you can let the color of your urine guide you. Drink enough liquid so that your urine is a pale-yellow to clear. If you’re lactating, you’ll need to drink more water than usual — somewhere in the ballpark of 16 glasses daily. 

Water isn’t the only way to stay hydrated either. Whole fruits and vegetables provide your body with a ton of hydration, as well as liquids like milk, tea, coconut water, and even coffee.

2. Fiber

Adding fiber to your diet can help ease constipation by adding bulk and hydration to your stool, and helping it move better through your gut. Upping your fiber intake can also go a long way in keeping your poops a nice, soft texture. 

Not into dry bran cereal or prunes? Try a snack of fresh veggies like carrots and celery, or add a scoop of flax or chia seeds into your pancakes, smoothie, or yogurt bowl. Other high-fiber options include whole grains, whole fruits, and legumes. Avoid eating large amounts of white rice, bread, and wheat pasta as these foods can constipate you further.

Pro tip: As you increase your fiber, make sure you are also drinking plenty of water. Without enough liquid, fiber can actually make you more constipated.  Soup can be a great way to combine fiber and fluids at the same time. 

3. Stool softeners

If you’re prone to constipation, you may want to start taking a stool softener in the days leading up to delivery. Start with a small amount to avoid diarrhea, which can be dehydrating. 

Magnesium, which is available as a powder to mix with a liquid or in gummy form, is a natural option that can help with constipation as well as muscle cramps and other complaints. Again, start with a small amount at first.

4. Belly massage

Another helpful strategy is a digestion-promoting belly massage. Belly massage (aka bowel massage) eases constipation by stimulating the peristalsis in your large intestine to help move food through your intestines, following the natural clockwise path of the large intestine (colon) around your abdomen. 

To give yourself a belly massage:

1. Gently massage your belly in a clockwise direction, beginning in the lower right side of your abdomen. Keep the pressure gentle, especially on tender areas.
2. Move upward along the right side of your belly, and then continue across your upper abdomen.
3. Then, move downward along the left side of your belly. Continue massaging along this path for several minutes. For more specific instructions, check out our full blog on bowel massage here). 
4. Practice deep belly breathing during the massage. The pressure changes from your breath can act as a pump, and help with peristalsis.

If you’re really backed up, start your bowel massage with gentle circles and strokes on the lower left side of your belly first (still working clockwise). Gradually work your way along the colon’s path, ending on the lower right side. Pay extra attention to areas that feel firmer or more tender, as these may where stool is stuck. Use light pressure on these spots, gently working to soften the area. 

‍Note: If you’re having sharp or intense abdominal pain, especially in your right lower belly area, and are feeling unwell, reach out to a health professional to rule out appendicitis.

5. Sitz bath or warm compress

When your bottom is sore, the thought of “unclenching” for a bowel movement can be very nerve wracking. It can help to take a warm bath or use a warm compress on the sore area beforehand.

A sitz bath is a shallow, warm bath that soothes and cleanses your genital area. To do a sitz bath:

1. Fill a regular tub or a specialized sitz bath with warm (not hot) water.
2. You can add herbs like calendula or witch hazel to your witch hazel, which have healing properties. Or, try epsom salt to calm muscle pain and tension.
3. Soak in the bath for 10-15 minutes, making sure your bottom is fully submerged.
4. Practice deep breathing and visualize relaxing your pelvic floor muscles as you soak.

If taking a sitz bath isn’t available to you, try applying a warm compress (made using a clean wash cloth and warm water) to the area for a few minutes before sitting down on the toilet. Or, gently rinse your perineum and anus with warm water using a peri-bottle. 

If you’re still feeling pain and tightness in your anal or vulvar areas after you have fully healed from birth, reach out to a pelvic physical therapist to help you to soften any scar tissue or tight, painful muscles.

6. Squatty potty

The squatty potty raises your knees above your hips to mimic a natural squatting position. This makes pooping  easier by lengthening your pelvic floor from around your rectum, and allows for a more direct path for stool to exit your body. Some research has shown the stools like the squatty potty can reduce straining, speed up bowel movements, and help you empty better.

If you don't have a Squatty Potty specifically, you can also try a regular step stool, yoga block, or even just raise your heels.

To use a squatty potty (or other stool):

1. Place your feet on the Squatty Potty
2. Allow knees to spread wider than your hips
3. Lean slightly forward, keeping you back tall and straight
4. Relax your belly and pelvic floor
5. Breathe deeply and avoid holding your breath
6. Gently push, imagining your belly expanding outward

7. Physical activity

Physical activity can be really helpful in promoting healthy digestion. However, when you’re postpartum, it's important to adjust your activity level to your specific recovery progress.

In the early postpartum, focus on:

• Short walks around the house can help stimulate digestion
• Gentle twists and stretches that focus on your hips and core can help aid bowel movements (if you don't have a recent cesarean scar)
• Exercises that move your back like a cat/cow stretch, can stimulate intestinal nerves

Once your OB clears you for more activity, you can slowly work your way back to your normal activity levels and exercise routine. 

While some muscle soreness is normal when increasing activity, reduce your movement intensity and consult your healthcare provider if you experience any of the following:

• Sharp pain around your perineum or C-section incision
• Feelings of significant pelvic pressure or heaviness

8. Hemorrhoid care

Hemorrhoids, fissures, and other anal pains are common postpartum issues that can cause significant discomfort. While many cases resolve on their own with time, some may require additional medical attention.

To ease bowel movements and reduce irritation, consider applying a lubricating agent to the anus before a bowel movement. This can be:

• Hemorrhoid cream
• A soothing salve
• Petroleum jelly

This approach can be more effective than applying cream only after a painful bowel movement.

Between bowel movements, rectal suppositories can be beneficial for:

• Promoting healing
• Reducing swelling
• Lubricating irritated tissue

These suppositories may be medicated or contain soothing ingredients like vitamin E and oils. Consult your doctor for specific recommendations tailored to your situation.

If symptoms persist or worsen, you may need to explore additional treatment options:

• Hemorrhoid-specific treatments
• Pelvic floor physical therapy to help improve pelvic floor muscle function.

Remember, while many people recover fully from pregnancy-related hemorrhoids with time and proper care, it's essential to seek medical advice if you're struggling with ongoing discomfort.

How to reduce postpartum constipation while breastfeeding

There's one foolproof way to reduce constipation while breastfeeding, and that's to seriously boost your fluids.

First of all, keep a large water bottle next to wherever you tend to nurse your baby or use your pump, and try to drink more fluid during each feeding session than you are giving away in milk (remember, you need fluids for your body as well as your baby’s!).

Not into drinking plain water? Try adding some flavored electrolyte powder, or even just a squeeze of lemon or splash of juice. Herbal tea is also a great option, whether it’s served  hot in the winter or iced in the summer. There are even special teas with ingredients designed to help boost your milk supply, if this is something you are struggling with.

You will have to drink more fluids than you ever have before in order to keep up with the new demands on your body!

How long does postpartum constipation last? 

Postpartum constipation usually gets better within the first couple of weeks after delivery, but things like dehydration, certain medications, and pelvic floor muscle dysfunction can cause it to stick around for much longer. If your postpartum constipation is persistent, it’s important to reach out to your primary care provider or a pelvic health physical therapist for more help.

Treatment for postpartum constipation

Pelvic floor physical therapy can be a game-changer for postpartum constipation. That's because pelvic floor muscles play a huge role in your control over your bowel function. But both pregnancy and birth (vaginal or cesarean) can increase your risk for developing pelvic floor muscle dysfunction and contribute to constipation. 

To treat your symptoms, a pelvic PT will provide:

1. A comprehensive assessment of pelvic floor function
2. Education on proper bathroom posture and habits
3. Techniques for pelvic floor relaxation
4. Abdominal massage instruction
5. Customized exercise programs
6. Dietary and lifestyle recommendations

Pelvic PTs are like "poop detectives," asking detailed questions about your bowel habits to provide individualized solutions. If you're experiencing ongoing constipation issues, don't hesitate to reach out to a pelvic floor physical therapist. Origin Physical Therapy offers specialized care for postpartum constipation. Schedule an evaluation today to start your journey towards comfortable, pain-free bowel movements.