Everybody poops. It’s the fact I tell myself when I start any type of comparison game in my head. (That mom looks so great; hair, makeup all done, cute outfit…not yelling at her kids…she poops just like me. Comparison game done and smile on my face.)
But what about during pregnancy (and postpartum)?
How do you manage pooping during these normal phases of life? Do things change? Do things go back to normal?
We’ll go over the expected changes, the unexpected changes and all the questions you never wanted to ask your provider. Around here, the goal is for a nice healthy non-straining poop about once a day. Pooping is normal people!
(As usual, I am not your medical provider or midwife and this blog is for informational/educational purposes. For any questions or concerns, use this education to learn more and then discuss your particular health, conditions or questions with your provider or midwife. Read more at the disclaimer.)
What To Expect During Pregnancy
After that second line shows up on the pregnancy test, your hormones start to ramp up pretty quickly to help the pregnancy and your uterus grow to support the baby. Right out of the gate, you have a lot of fatigue that makes you want to lay on your couch every day for 6 hours instead of doing your normal activities. This is normal – your body is growing a human inside you and it takes a lot of energy.
But it’s not just you who feels the slow down. Your bowels slow down too from a hormone called *progesterone*.
First Trimester Expectations
The biggest change in the first trimester is the start of constipation. It comes from a few places.
First, if you have nausea or vomiting, you are likely eating or drinking less, or in a state of milk of dehydration. All of these will cause less water to be present in your large intestine or colon and your stools will be harder.
Second, one of the most common medications to manage nausea and vomiting in early pregnancy that is prescribed to people is Zofran. Guess what the main side effect of zofran is? Yep, constipation. Unfortunately it’s not a common point of education from providers and the pooping slows down pretty fast once the zofran starts.
Third, progesterone slows down your bowel motility in pregnancy – in other words, things are moving slower and it will take longer to get places than usual. Constipation tends to be worse in the first trimester than the other trimesters but you can experience constipation throughout the entire pregnancy. Regular issues with constipation usually causes hemorrhoids.
Second Trimester Expectations
Second trimester starts at 14 weeks of pregnancy. You may still have some constipation at this point but usually everything has gotten better and pooping has it’s routine. The goal is for a nice soft, non-straining poop every 1 to 2 days.
The most common thing I see between 14-28 weeks of pregnancy (your second trimester) is a triage visit or call for a GI bug. A lot of GI bugs are caused by a virus and when the virus causes an infection in your GI tract, you will have nausea, diarrhea, abdominal pain and maybe a fever or chills. Our bodies are really smart and try to get rid of this virus at the ends of our GI tract – your bum or your mouth – with either vomiting or diarrhea. In pregnancy, short term diarrhea (1-2 days) is generally okay as long as you can eat and drink normally. But the inability to eat or drink normally can dehydrate a pregnant person really quickly and generally warrants a call to your provider, a triage visit or the ER. Your provider will give you something for nausea and maybe some IV fluids depending on the degree of your dehydration. Most of the time, we don’t try to stop the diarrhea because that’s your body’s way of getting rid of the virus.
Third Trimester Expectations
Constipation is not as common in the third trimester, but if you are not pooping regularly, your constipation can cause a lot of abdominal discomfort at this time. The discomfort comes from the hard stool getting squished by the growing uterus and baby. Most of the time, this discomfort is in the lower left quadrant of your belly.
Pooping and Birth
Sometimes pooping happens during labor. Once contractions start, you may find that you are pooping a few times at home during the early parts of labor. This is totally normal too and generally a sign that you are going into labor. If someone calls me in early labor and is contracting regularly/painfully and having a little diarrhea, I always think “Yeah! She’s in labor!”
Am I going to poop at birth? Maybe. About 10-20% of births I attend have either mama poop or baby poop (meconium) at them…sometimes both! The baby’s head has to pass over the rectum to exit the pelvis. If there’s any poop in your rectum, hard or soft, it’s going to come out with pushing. (Your birth team is totally used to this – please don’t spend one more thought thinking about it. If you are worried about the smell, pack a diffuser for your birth.)
What To Expect In The Hospital After Birth and Postpartum
After birth, when you poop next depends on when you pooped last. Before discharge home from the hospital, you should be passing some gas/farting. But most birth places don’t require pooping. to get discharged back home – this includes cesarean sections. (The exception here are people with 3rd/4th degree lacerations and any abnormal complications postpartum.)
If you pooped a lot during your labor or at birth, you might not poop again while you are in the hospital. You also might poop the same day you have the baby, the day after, or the day of discharge. All of this is normal.
In the hospital, the provider usually orders a series of medications to help you poop or manage gas (generally these are Colace/docusate sodium, miralax/Polyethylene glycol 3350, GasX/simethicone, or Milk of Magnesia/Magnesium hydroxide). Sometimes these medications are shceuled and the nurse will bring them to you regularly and sometimes you will have to ask your nurse for these.
The urge to poop after you have a baby will feel the same. When you feel that urge, that’s the time to go sit on the toilet. The best tip I can give for that first few days of pooping is to use a squatty potty of a stack of some large books to prop up your feet off the floor (about 4-6 inches off the floor). Elevating your feet off the floor straightens your rectum and sphincter anatomy and makes it easier for you to poop. The video below does a great job of explaining this.
In your postpartum bathroom, you are usually provider some TUCKS pads/witch hazel pads and a peribottle. After pooping, use your peribottle to clean the vagina (just squirt warm water on your vagina and let it drain into the toilet) and then use your TUCKS pads to wipe instead of toilet paper (they are flushable). If you feel like you need to dry your vagina, just use some toilet paper and PAT it dry for that first week.
If you have hemorrhoids or stitches from a tear in the vagina, after you clean everything up, you can take a TUCKS pad a place it on your hemorrhoids between your butt cheeks for some extra relief. You can pace another TUCKS pad on your vagina where your vagina is sore, itchy, or swollen. Leave those TUCKS pads in place until you go to the bathroom next.
Repeat as needed those first few days (or weeks) postpartum.
FAQs
What can I do to help myself poop regularly?
Great question. Prevention is the key. Drinking plenty of water (that’s half your body weight in ounces), eating fiber (fruits, veggies, whole grains, oatmeal…) and going for a 20 minute walk every day are going to prevent a lot of constipation problems for you. These are small , but impoactful habits for your bowels during pregnancy.
Is it normal to poop more when you are pregnant than not pregnant?
Yes. Some people have more frequent poops than when they are not pregnant.
What about the baby’s poop? Where does that go during pregnancy? Do you poop for the baby during pregnancy?
The baby gets rid of waste (i.e. poop) differently inside the uterus. The baby’s waste products are passed through the placenta by the process of diffusion when you are pregnant. The woman’s body absorbs the waste into the blood stream and disposes of these wastes through normal bodily processes.
What is meconium?
While the baby’s intestines are forming, there is a substance called meconium that forms inside the intestine. The meconium generally stays inside the baby until after birth (the majority of babies don’t poop until after birth). The first few poops that babies pass are made up of meconium and are thick, sticky and yellow, green or black in color.
Some babies can pass meconium while they are still inside the uterus. This happens in about 20% of pregnancies. Meconium in the amniotic fluid is a problem for the baby if the baby inhales or gasps the meconium into their lungs while inside the mother (you can read more about this here).
Can babies fart inside you?
No, this is thought to be impossible. In order to have air in your intestines, you have to be able to breathe in air and the baby’s lungs are filled with fluid until their first breaths into the world.
What if I feel that I need to poop…but I can’t poop. What can I do?
There are a number of things you can try.
- For starters, ensure that you are plenty hydrated. Pregnant people need to drink half their body weight in ounces each day. If you weigh 160 pounds, you need to drink about 80 ounces of water.
- Go for a long walk.
- Try drinking 8 ounces of prune juice.
- Drinking coffee or tea is also helpful to stimulate a bowel movement. Up to 300 milligrams daily is considered safe in pregnancy (Mother To Baby, 2023). An 8 ounce cup of coffee has about 137 milligrams of caffeine. A cup of black tea has about 50 milligrams of caffeine.
- Next, you can try an abdominal massage if you are comfortable. Generally, you are massaging your large intestine, not the baby or the uterus, and this can stimulate your bowels to move without needing medication. This video does a nice job of explaining how to do a massage.
- Try an over the counter stool softner, bowel stimulant or fiber supplement.
- Docusate sodium (Colace)
- Magnesium citrate
- Metamucil cookies
- Methylcellulose fiber (Citrucel)
- Milk of magnesium
- Psyllium (Metamucil)
- Polycarbophil (FiberCon)
- Polyethylene glycol (MiraLAX)
Get this list of mediations here: FREE Safe Over The Counter Medications & Products During Pregnancy
And then…repeat. Some of these interventions work well for some people and some interventions won’t work for you. Try one at a time. When you find something that works for you, keep at it.
Does pooping hurt the baby or pregnancy?
No. But if you sit on the toilet for a long time and have lots of straining with your poops, you will likely get hemorrhoids and these will make your pregnancy more uncomfortable.
What do hard poops mean?
Hard poops are small, round or pellet shaped and difficult to pass. Usually these are present with constipation or dehydration.
What do loose poops mean?
Looser poops are not necessarily diarrhea and are usually from the type of food you ate, some caffeine you ingested, or even just irritable bowels. Diarrhea is defined THREE loose or watery stools in one day.
What are some interventions for diarrhea during pregnancy?
My favorite non-medical interventions are easy to get and so simple.
Drink a cup of peppermint of chamomile tea. These teas are herbal and non-caffeinated. Both peppermint and chamomile are easy to find at a store and are very soothing to upset GI tracts. (The app HerbList is a great one for education and uses of herbs during pregnancy or postpartum.)
Also soothing to the GI tract is peppermint essential oil. Peppermint essential oils are easy to find over the counter but it is a VERY potent oil and should always be used with a carrier oil. (How to use: Pick your carrier oil, i.e. coconut oil, olive oil, etc… put a small amount of oil in the palm of your hand. Drop 1-2 drops of peppermint oil into your carrier oil and combine. Rub combination on your belly for some relief. If you are new to essential oils, always test out a small area of the oils on your hand before applying liberally.
As for the evidence supporting the use of essential oils during pregnancy, it’s limited. Essential oils are sneaking their way into various medical fields to lend a helping hand in reducing pain, taming nausea, and soothing anxiety. Labor and delivery units and emergency room units are using this intervention more and more to help their patients.
How can I make pooping easier during pregnancy (and postpartum!)?
Use a squatty potty. Drink, eat fiber and exercise. Make time for oppoing, don’t rush it. Don’t strain. If you have hemorrhoids, take care of them so they don’t get sore, tender or bigger.
Where can I get a squatty potty?
Just about anywhere online or major retailers. If money is an issue, just use a stack of encyclopedias or old yearbooks.
How do I know if I have hemorrhoids?
You may or may not know if you have hemorrhoids. A hemorrhoids ia a vein that has become larger and more dilated from the pressure of the anatomy around it. A lot of people have hemorrhoids and don’t know because they hemorrhoid isn’t causing them any pain or discomfort.
Hemorrhoids can be inside your anus or on the outside (you will either see them or they are hidden). Sometimes, you can have a hemorrhoid that’s on the inside that will come out when you poop and then go back inside – this is okay, think of this guy as a neighbor that comes out to say hi to you and then goes back into his house.
Hemorrhoids cause cramping and some pain with a bowel movement. And they can get swollen or tender. Especially if you are having diarrhea and pooping more than normal.
Can I see my hemorrhoids with a mirror?
If they are external hemorrhoids, you should be able to see them. You can also feel them.
What can I do for hemorrhoid pain?
Use TUCKS pads when wiping or for relief as needed. Use a squatty potty to make pooping easier. Use sitz baths if they become sore or tender. Try to prevent constipation or any straining as this can make hemorrhoids worse. Also try to avoid prolonged periods of standing in the third trimester – this can increase the pressure on the pelvis and cause the hemorrhoids to get bigger or more swollen.
Will my hemorrhoids go away after pregnancy or birth?
Maybe. It is hard to predict. Sometimes the hemorrhoid will go away but leave a skin pouch behind. – these usually stay around for life.
What other resources do you recommend?
- Constipation by American Urogynecologic Society (AUGS)
- Constipation (NHS)
- Taking Good Care of Yourself During Pregnancy (ACNM)
- What can help with constipation during pregnancy? (ACOG)
That’s a wrap on poop. If you found this post helpful, check out the FAQ page.
If you are looking for more Q+A education to improve the care you are getting in pregnancy, invest in the pregnancy guides today. You’ll save yourself time an money and instantly improve the care you are getting during your pregnancy for you and your baby. The guides are on sale through the end of the month!
