The First Postpartum Poo: How to Protect Your Pelvic Floor, Perineum and Stitches After Birth

If you’ve had a vaginal birth, particularly if you’ve experienced tearing, grazes or stitches, it’s completely normal to feel anxious about going to the toilet in those first few days.

The good news is that there are simple things you can do to support healing, reduce discomfort and help your bowels move more comfortably.

What to Expect in the First 48 Hours

Many women don’t have their first bowel movement until 2-3 days after birth, and this is completely normal. Your body has been through an enormous physical experience, and your digestive system may need time to settle.

In the first 24-48 hours, focus on gentle hydration and don’t put pressure on yourself. By the end of the first week, most women find their bowel movements begin to normalise.

Support Your Perineum Whilst It Heals

In the early days after birth, your perineum can feel bruised, swollen and tender.

After using the toilet, a peri bottle filled with warm water can help gently wash your vagina, vulva and anus without the need for excessive wiping. You can then gently pat dry if needed.

Being gentle with the area and keeping it clean can help reduce irritation and support healing.

The Best Position for a Bowel Movement

Many women don’t realise that the way we sit on the toilet can make a significant difference.

When having a bowel movement:

• Place your feet on a stool or footrest
• Position your knees higher than your hips
• Lean forward slightly
• Relax your jaw and pelvic floor muscles
• Avoid straining

This position creates more space for the bowel to empty naturally and places less pressure on your healing tissues.

Preventing Postpartum Constipation

Constipation can increase pressure on the pelvic floor, perineum and anal sphincter, making recovery more uncomfortable. Hormonal changes after birth can also slow down digestion, making constipation more likely.

Your healthcare provider may recommend stool softeners in the early postpartum period, particularly if you’ve experienced significant tearing or have stitches.

It’s also important to:

• Drink plenty of water
• Include fibre-rich foods in your diet
• Prioritise gentle movement when you’re ready
• Add chia seeds or flaxseed meal to yoghurt, smoothies or drinks

My Easy Psyllium Husk Jelly Recipe

This is a simple way to increase fibre intake and support healthy stool consistency.

Ingredients

• 1 tablespoon psyllium husk
• 1 cup juice of choice

Method

Mix well and leave in the fridge until it forms a jelly-like consistency.

Remember that fibre works best when paired with adequate hydration, so continue drinking water throughout the day.

What Should Your Stool Look Like?

Ideally, you’re aiming for a soft, easy-to-pass stool that requires minimal effort.

If your stool is hard, dry or difficult to pass, consider increasing your fluid intake and discussing stool softeners with your healthcare provider.

Managing Haemorrhoids After Birth

Many women develop haemorrhoids during pregnancy or birth. These can make bowel movements uncomfortable and may cause bleeding.

Warm baths, avoiding straining, and keeping stools soft can help. If haemorrhoids are causing significant discomfort, speak to your midwife or GP about treatment options.

What to Wear During Recovery

Loose, comfortable clothing made from natural fibres such as cotton or bamboo can help reduce irritation around the perineum.

Many women find that avoiding tight waistbands and restrictive underwear feels more comfortable during the early healing phase.

If you’re at home and comfortable doing so, spending some time without underwear can help keep the area dry and reduce friction.

Warm Baths Can Help

Short warm baths with Epsom salts can be soothing for bruised and inflamed tissue and may help you feel more comfortable during recovery.

Many women find that warm water provides temporary relief from tenderness and swelling.

Supporting Tissue Healing

Your body is doing an enormous amount of healing after birth.

Including protein-rich foods such as eggs, fish, meat and bone broth can support tissue repair. Some women also choose to include collagen supplements as part of their postpartum recovery plan.

When to Seek Help

Don’t ignore pain or concerns. Contact your midwife, GP, obstetrician, women’s health physiotherapist or maternity care team if you experience:

• Severe pain during bowel movements
• Inability to pass stool after 4-5 days
• Signs of infection (increased pain, unusual discharge, fever)
• Concerns about how your stitches are healing
• Significant bleeding from haemorrhoids

You do not need to wait until your six-week postnatal appointment. Recovery after birth deserves attention and support. You shouldn’t have to navigate concerns about healing alone.