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Constipation

Constipation After Birth: Common, very treatable

Constipation is one of the most common postnatal complaints. The first bowel movement after birth often feels daunting, especially if you have stitches, haemorrhoids, or a caesarean wound. The good news: a few simple measures usually sort it out quickly.

This page explains why it happens, what helps, and when to seek further support.

Why constipation is common after birth

Several factors combine in the first days after birth:

  • Pregnancy hormones that slowed your bowel are still settling.
  • Pain relief medications (especially opioids like pethidine, codeine, or those used after caesarean) significantly slow the bowel.
  • Iron supplements, if you needed them, can cause constipation.
  • Reduced movement in the first days after a difficult birth or caesarean.
  • Reduced food and fluid intake during labour and the first day or two.
  • Fear of pain at the stitches or perineum, leading to “holding on.”

All of these resolve in time, and a few simple changes ease things along.

Self-help: what to do

Hydrate well

Aim for 2 litres of water a day. Warm drinks first thing in the morning often help.

Eat fibre

Wholegrain bread, oats, brown rice, beans, lentils, fruit (especially pears, kiwis, prunes), vegetables. Aim for 5 portions of fruit and vegetables per day.

Move gently

Walking, even short walks several times a day, wakes the bowel.

Don't ignore the urge

When you feel the urge, go. The longer you hold on, the harder the stool becomes.

Use the right toilet posture

Knees raised, lean forward, relax.

Use a gentle laxative if needed

If hospital prescribed a laxative (e.g. lactulose), take the full course. Over the counter options that are safe in breastfeeding include lactulose, ispaghula husk (Fybogel), and macrogols (Movicol). Avoid stimulant laxatives (like senna) routinely; ask your pharmacist.

Get the toilet posture right

A simple change in how you sit makes a real difference:

  • Knees slightly higher than hips. Use a small footstool, around 15 to 20 cm high, under your feet.
  • Lean forward, elbows on your knees.
  • Relax your shoulders, jaw and pelvic floor.
  • Breathe gently, don’t hold your breath.
  • Don’t strain. Bear down gently with a slow exhale, then relax. Repeat as needed.

If you have stitches and are nervous, support the perineum with a clean folded pad or a clean hand. This protects the stitches and provides reassurance.

When to See Your GP

Most postnatal constipation settles. If yours doesn’t, get help.

  • You have no bowel movement for more than 3 to 5 days after birth, despite the steps above.
  • You have severe abdominal pain or vomiting alongside constipation.
  • You see fresh red blood on the toilet paper or in the bowl.
  • Your stomach is hard and distended, and not settling.
  • You have a persistent feeling of incomplete emptying, even when you do go.
  • You have stitches that are very painful, or you suspect they have opened.