If you are pregnant, you have a lot on your mind - finishing up the nursery, finding a pediatrician, stocking up on diapers and maybe even a last minute trip to the dentist (yes - this should be on your to-do list!). Your first postpartum poop may have not even crossed your mind! Very soon, however, this will be a terrifying reality. You just had your baby. Whether c-section or vaginal birth, within 24 hours you’re going to have to, yet again, try to push another thing out of your body. That task is daunting. What makes it even harder? You shouldn’t push! Yikes - how will it even come out?

Trust me when I say you won’t even want to push - that’s going to feel terrible. After birth the perineum (bicycle seat area of the body) is very swollen and there is a high chance that you may have hemorrhoids. On top of that, if you’ve had a c-section, pushing won’t feel good for your abdomen. No matter your birth experience, pushing will feel *very* wrong. So how to do get out your poo? Here are some ways to promote a successful first postpartum bowel movement:

1. Soften your poo: You are a superhero and just went through labor and delivery of your baby. It is almost a guarantee that you’re dehydrated. This isn’t good news for your poo. You need water to keep your poo soft and the harder the stool, the harder it is to get out. So make sure to preemptively take stool softeners and drinks lots of fluids!

‍2. Position yourself for success: Your position on the toilet matters. Most likely, your pelvis is in a tailbone tucked position. This happens automatically to slacken through the pelvic floor and abdomen - but it does make getting out a poo harder! When you’re sitting on the toilet, make sure to have both of your feet planted on the floor (a foot stool would be even better!). Lean forward from your hips without hunching through your back and rest your forearms on your thighs. Once in this position, gently move your pelvis out of a tucked tailbone position. Move very slowly. You should not feel any pulling - especially on any perineal tear or the c-section scar.

3. Use your breath. When you take a breath in, your abdomen expands and your pelvic floor opens up. When you exhale, your abdomen and pelvic floor shorten. You can use these known principles of breath to help promote a successful first postpartum bowel movement: As you take a breath in, feel how this opens through your perineum. On your next inhale, gently target your pressure downwards. If this feels too uncomfortable in the perineum, lighten the pressure. If it is still too much, just focus on how your breath helps to open up the exit (anal opening). Do not bear down on the exhale (you’ll be trying to push out your poo against a closed door!)

4. On your next inhale, gently target your pressure downwards. If this feels too uncomfortable in the perineum, lighten the pressure. If it is still too much, just focus on how your breath helps to open up the exit (anal opening). Do not bear down on the exhale (you’ll be trying to push out your poo against a closed door!)

5. Splint your abdomen: Adding a counter pressure on your abdomen will feel really good. Whether you’ve had a c-section or vaginal birth, your abdomen probably feels like a popped balloon. To support your belly, you can take a pillow and gently press it against your abdomen. Keep the pillow here while you are using your breath to generate pressure.‍

6. Press into something: Pushing into something can be very helpful to stabilize yourself on the toilet and generate pressure. Whether you push into your thighs, the wall in front of you or pull down on some towels, this can be very helpful.‍

7. Tap, don’t wipe: After giving birth, wiping the perineum is not a good idea. Instead, use a peri-bottle (you should be sent home with one from the hospital) to spray warm water onto the perineum and then gently tap the area dry. You can also use medicated wipes to help with cooling and healing.

Most importantly, know that you’ll get through it! You just delivered a baby - you can deliver a poo! Make sure to continue to use these principles for the first couple weeks postpartum. As you are healing, the last thing you want is to also be constipated. Especially as your milk starts to come in, drinking lots of water becomes even more important.

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