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When you’re expecting, here’s what no one tells you: You’re going to have three births.

Did she just say three births? Why yes, I did.

Let me explain:

  • Birth #1: baby
  • Birth #2: placenta
  • Birth #3: your first bowel movement

I’m not going to necessarily equate that first poop with having a baby, but it is terrifying.

After giving birth, you may have had tearing, you may have had stitches, you may have had surgery in the form of a C-section. Whatever the case, you are guaranteed to have ricocheting hormones, a weakened pelvic floor that has gone through the ringer, and a perineum that’s been stretched to its limit.

So pushing yet another object out of your body is, simply, the one thing you absolutely do not want to do.

But, alas. You will have to go number two, and you will likely go within two to four days after birth. So, let’s talk about how to take out the fear, and minimize the impact.

The hospital or birthing center will most likely offer a stool softener, such as Colace, which is safe to take in recommended doses, even when you’re breastfeeding.

Note: Stool softeners are not the same as stimulant laxatives, such as Dulcolax. Stool softeners work by adding moisture to the stool to soften it and make it easier to pass. A stimulant laxative, on the other hand, forces your intestines to contract and gives you the urge to poop. The stool softener is not for long-term use; it is to get you through the initial slow-down after birth.

You’ve been through the equivalent of about 10 marathons, so drink up.

Being hydrated is essential for healthy bowel movements. Here’s why: As food passes through your large intestine, it soaks up water while it digests and absorbs nutrients. And your large intestine is as greedy with water as an Arizona golf course.

Make sure there’s plenty of H2O to go around to grease the tracks and — forgive me here — create plump, soft, hydrated stools that are easy to pass. You’re looking for a solid mass; a series of small pebbles is a sign of dehydration.

Drink plenty of water and add coconut water to the mix. It’s high in potassium and works similarly to an electrolyte beverage but without the funky additives.

Eat prunes, these fiber-rich ingredients, warm liquids, and fiber cereal, or add a fiber supplement like Metamucil to your drink. Your system will be in the slow lane for the first week postpartum, however, constipation can be an issue up to three months postpartum.

Get a small step stool and rest your feet on it. Put your elbows on your knees and lean forward. The closer to a hunch position you are, the better. Toilets are great but sitting upright on them is counter to the natural way we’re supposed to eliminate waste.

Many of us take a breath, hold it, and bear down. That’s effective for pushing out babies, but bad news for going number two.

Here’s what to do instead: Breathe in and then start a gentle push as you continually breathe out. You need to be very careful here, especially if you have stitches. Also, only attempt to go when you have the urge!

In the first week or two, you’ll want to just use a peri bottle (filled with warm tap water) and gently blot dry with super-soft TP or, even better, medicated wipes (such as Tucks). You should be sent home with a peri bottle from the hospital — if not, ask for one before leaving.

It is so common for us to track baby’s bathroom habits like maniacs from day one and completely lose sight of our own. Don’t roll your eyes, but it’s smart to write down your bowel movements right alongside baby’s. No need for details — just an entry line to acknowledge if you went.

It’s all one big blur in the first few weeks, and it is incredibly easy to lose track of time. You may think you’ve only missed a day, but it could be three or four since you’ve gone and that’s a big deal.

Postpartum constipation is painful, and it can also springboard into other, more serious situations, like hemorrhoids or an anal fissure (small tears in the anal lining that cause bleeding and make defecating feel like you’re passing hot coals).

Remember: Prevention is always easier than treatment. Do not wait to be in agonizing pain. If you’re following the above tips and still getting backed up regularly or straining excessively, call your provider.

However baby came into this world, you birthed a human. Therefore, you are magic! And even magic people poop. Let’s talk about it. Let’s normalize it. Let’s be prepared for it. Postpartum is hard and complicated enough.


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Mandy Major is a mama, journalist, certified postpartum doula PCD(DONA), and the founder of Motherbaby Network, an online community for fourth trimester support. Follow her @motherbabynetwork.