Common Bowel Problems After Pregnancy

Becoming a new parent is an extraordinary, life-altering experience—and it comes with its fair share of unexpected physical changes. Among these, gastrointestinal woes often rank high on the list of postpartum discomforts. The six to eight weeks following childbirth, known as the postpartum period, can introduce various stomach-related troubles.

Lopez-Gonzalez DM, Kopparapu AK. Postpartum care of the new mother. In: StatPearls. StatPearls Publishing; 2024.

These bowel-related issues commonly include constipation, diarrhea, hemorrhoids, and even fecal incontinence. Thankfully, your digestive system usually rebalances itself shortly after giving birth.

The culprits behind these postpartum bowel shifts are uterine contractions, weakened pelvic floor muscles, and fluctuating hormones. If your bowel movements don’t bounce back naturally, several treatment options may ease the journey. Here’s a detailed guide on managing diarrhea, constipation, and other bowel concerns after pregnancy.

Are Postpartum Bowel Problems Normal?

Yes—bizarre as it may feel, bowel changes are entirely normal after childbirth. Between 5% and 26% of postpartum individuals experience fecal incontinence, where controlling bowel movements becomes difficult. However, there’s good news: these issues typically resolve quickly.

"In most cases, these symptoms aren’t permanent. Recovery occurs over a few weeks as the body heals from the trauma of childbirth," explains Rita M. Knotts, MD, a gastroenterologist and assistant professor at NYU Grossman School of Medicine, speaking to Health.

It’s common for several days to pass before your first post-birth bowel movement—and it may be painful. Remember, every postpartum recovery is unique; what’s normal for one person may be vastly different for another.

Causes

Postpartum bowel changes arise from various factors:

• Hormonal Shifts: Pregnancy hormones like progesterone slow down the gastrointestinal (GI) tract, contributing to constipation.
• Dietary Factors: Labor often restricts solid food intake, which can reduce bowel movement frequency after birth.

• Fear of Tearing: Pain or soreness from perineal stitches—located between the vagina and anus—can deter bowel movements. 

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• Milk Production: Breastfeeding draws water from your body to produce milk, sometimes reducing hydration in the gut and causing firmer stools.
• Medications: Painkillers and antibiotics used during or after delivery can trigger constipation or diarrhea.
• Uterine Contractions: As the uterus shrinks back to its pre-pregnancy size, its contractions may produce loose stools.
• Pelvic Floor Weakness: The pelvic floor’s supportive muscles may weaken, leading to constipation or hemorrhoids.

Common Postpartum Bowel Problems

Time, patience, and proper care generally resolve these gastrointestinal hurdles. The following treatments may offer relief depending on your symptoms.

Constipation

Defined as fewer than three bowel movements a week, postpartum constipation may include:

• Dry, hard, or lumpy stool
• A sense of incomplete evacuation
• Painful, straining bowel movements

To alleviate constipation, increase your fiber intake and drink plenty of fluids. Fiber supplements, stool softeners, or laxatives can help, but avoid prolonged use—follow package instructions for safe duration.

Diarrhea

Passing loose, watery stools three or more times daily is diarrhea. Other signs include:

• Abdominal cramping
• Nausea or urgency
• Loss of bowel control

Postpartum diarrhea often stems from rectal muscle strain or tearing. Pelvic floor therapy, started about four to six weeks after delivery, can improve symptoms, according to Gabrielle Sandler, MD, a clinical assistant professor of obstetrics and gynecology at NYU Grossman School of Medicine.

Fiber supplements and anti-diarrheal medications like loperamide may provide relief.

Fecal Incontinence

Tears or damage to the perineum and anal muscles during childbirth can weaken nerves, leading to leakage or gas control issues.

Boosting dietary fiber and avoiding trigger foods—like caffeine, alcohol, and greasy or dairy-heavy items—can mitigate symptoms. Pelvic exercises to strengthen the anal sphincter may be recommended. If these measures fall short, surgery might be necessary.

Hemorrhoids

Hemorrhoids—swollen veins in the rectum—can cause:

• Rectal itching or pain
• Tender lumps near the anus
• Painful bowel movements
• Bleeding

Treatments include stool softeners (docusate sodium), hydrocortisone creams, and sitz baths to soothe discomfort.

When to Consult a Healthcare Provider

Before trying over-the-counter treatments, consult your healthcare provider. They may suggest lifestyle adjustments—for instance, limited physical activity after birth can exacerbate digestive sluggishness.

While bowel issues are common, report serious symptoms such as:

• Fever
• Swelling, pain, or discharge near stitches
• Reopened stitches or anal tears

"It’s crucial to raise these concerns with your provider. Even if they don’t mention it, you should feel empowered to start the conversation," advises Dr. Sandler.

A Quick Review

Postpartum bowel problems—whether constipation, diarrhea, hemorrhoids, or fecal incontinence—stem from hormonal changes, pelvic floor strain, and uterine contractions. Remedies like stool softeners, laxatives, and physical therapy may offer relief, but persistent issues warrant professional attention.