That first poo after birth does not have to be a battle
Position, breath and a little preparation protect your pelvic floor, your stitches and your scar. Here is the five-step method midwives and physios teach.
Quick answer
To poo without straining after birth, sit fully on the toilet with your feet raised on a small stool, lean forward with your forearms on your thighs, and keep breathing out slowly rather than holding your breath and pushing. Support any stitches or a C-section wound by pressing a clean pad or folded tissue gently against them. Drink plenty of water and eat fibre-rich food so stools stay soft, and go as soon as you feel the urge. The NHS notes it is very unlikely you will break stitches by opening your bowels. If constipation will not settle, speak to your midwife, GP or pharmacist about a gentle laxative.
Why constipation is so common after birth
If you are dreading the toilet in the days after birth, you are in very good company. Pregnancy hormones slow the gut, labour and surgery disrupt normal rhythm, pain relief can make things sluggish, and it is completely natural to hold back when you are sore. Iron tablets, often prescribed after blood loss, can add to it: in the study below, iron supplements were associated with constipation during pregnancy.
of women met criteria for constipation at 3 months postpartum (Bradley et al., Obstetrics and Gynecology, 2007)
is how long the first poo can take after a C-section or opioid pain relief, according to Cleveland Clinic, versus a day or two after many vaginal births
women took part in the five trials in the 2020 Cochrane review of preventing postpartum constipation, which found too little evidence to recommend routine laxatives for everyone
24%
26%
16%
24%
Source: Bradley CS et al., Constipation in pregnancy: prevalence, symptoms, and risk factors, Obstetrics and Gynecology, 2007 (103 women, Rome II criteria).
That chart holds a quiet surprise. Constipation does not simply switch off once the baby arrives. In this small study, roughly a quarter of women still met the criteria three months after birth, the same proportion as early pregnancy. So this is not only a first-week problem, and the habits below are worth keeping going.
The reason it matters for recovery is pressure. Straining means holding your breath and bearing down, which drives pressure downward onto a pelvic floor that has just carried a baby for nine months, and forward against a stretched abdominal wall. We explain that mechanism in what intra-abdominal pressure means postpartum. Repeated heavy straining is one of the everyday loads physiotherapists ask mums to reduce.
Step 1: Keep stools soft before you need to go
The easiest poo is a soft one, and that is decided hours or days before you sit down. The NHS suggests plenty of fresh fruit, vegetables, salad, wholegrain cereals and wholemeal bread, alongside plenty of water. If you are breastfeeding you will likely feel thirstier than usual, so keep a large bottle within reach wherever you feed.
Gentle movement helps the gut too. A short walk, even around the house in the first week, is enough to start with. If you have been prescribed iron, do not stop it on your own, but do mention constipation to your GP or midwife, as there are often ways to manage both.
Step 2: Go when you feel the urge
It is tempting to put it off, especially if you are sore or the baby has just settled. Try not to. Holding on lets the bowel absorb more water from the stool, which makes it harder and the next attempt more uncomfortable. Many people find the urge is strongest after a meal or a warm drink, so a calm few minutes after breakfast is a good habit to build.
Step 3: Set up your position
This is the single most useful change, and it takes seconds. The NHS describes it clearly:
- Sit fully on the toilet seat rather than hovering.
- Raise your feet on a small stool, a step or a stack of books, so your knees are higher than your hips.
- Lean forward and rest your forearms on your thighs.
- Let your back stay long rather than slumped.
Raising the knees changes the angle between the rectum and the anal canal, which lets things pass with much less effort. It is the same principle behind the footstools sold for exactly this purpose, though any stable step works just as well.
Step 4: Breathe out and let go, do not push
Here is where most of the straining happens, and where you have the most control. The NHS advice is not to tighten your stomach muscles and to keep your breathing relaxed.
In practice: breathe in gently, then breathe out slowly through your mouth, as though sighing or softly saying "ahh" or "moo". Let your belly soften outward a little and let your pelvic floor relax and drop, rather than clenching. If you need a little more help, let your belly widen gently as you breathe out rather than holding your breath and bearing down. Give it time. It is fine to take a few minutes, and fine to get up and try again later.
This is the mirror image of the exhale-on-effort breathing you use when lifting, where the exhale helps the pelvic floor lift. On the toilet you use the breath to help it release. If you have not come across the lifting version yet, our guide to how to breathe when you lift postpartum explains the other half of the same skill.
Step 5: Support your stitches or your scar
Fear of stitches is one of the biggest reasons mums hold back. The NHS is reassuring here: if you have had stitches, it is very unlikely you will break them or open up the cut or tear again by pooing.
- After a tear or episiotomy: fold a clean pad or some tissue and press it gently against the stitches from the front while you go. The counter-pressure makes it feel much more secure.
- After a C-section: press a clean pad or a small pillow gently against your lower tummy over the wound. Our C-section recovery timeline covers what else to expect in those first weeks.
- Afterwards: pat rather than rub, and keep the area clean and dry as your midwife has advised.
The short version
Soft stools, go when you feel it, feet up, lean forward, breathe out slowly, support the sore spot. None of this costs anything, and every step reduces the downward pressure on a pelvic floor that is trying to heal.
When to get help
Talk to your midwife, health visitor, GP or pharmacist if constipation is not settling with these changes. A gentle laxative can help, and they can advise on options suitable if you are breastfeeding. Honest context from the evidence: the 2020 Cochrane review by Turawa and colleagues found too little good-quality research to recommend routine laxatives for every new mum, which is why advice is tailored to you rather than handed out as a blanket rule.
Seek advice promptly if you notice bleeding from your bottom, severe pain when you go, a lump that is very painful, or any difficulty controlling wind or bowel movements. Trouble with bowel control after birth is more common than many people realise and is very treatable, often with pelvic floor physiotherapy. A feeling of heaviness or bulging in the vagina is also worth mentioning, and our guide to pelvic organ prolapse after birth explains why.
If you are also thinking about pelvic floor exercises, a reminder app can help you stay consistent. We compared one of the best known, in Squeezy app vs Mumma Glow, including which situations each suits. For the broader picture of the first weeks, our postpartum recovery checklist for the first 6 weeks gathers everything in one place.
Rebuild the pressure system from the inside
The Core Reconnect Program teaches the breathing and deep core coordination that helps your pelvic floor and tummy share pressure again, in ten to fifteen minute sessions while the baby naps. One payment, no subscription, and yours to keep. Use code GLOW20 for 20% off. Results vary from mum to mum.
Frequently asked questions
How long after giving birth should I have my first poo?
It varies. Cleveland Clinic notes that many people go within the first day or two after a vaginal birth, while after a C-section or opioid pain relief it can take three or four days. If you are worried, or you feel bloated and uncomfortable, tell your midwife or doctor.
Can pooing break my stitches?
It is very unlikely. The NHS says that if you have had stitches, you are very unlikely to break them or open the cut or tear again. Pressing a clean pad or tissue gently against the stitches while you go can make it feel more comfortable and secure.
Is it safe to take a laxative after birth while breastfeeding?
Some laxatives are commonly used while breastfeeding, but the right choice depends on you. Ask your pharmacist, midwife or GP, and tell them you are breastfeeding and about any other medicines, including iron.
Why does straining matter for my pelvic floor?
Straining means holding your breath and bearing down, which pushes pressure downward onto the pelvic floor and outward against the abdominal wall. Repeated heavy straining is a load physiotherapists ask mums to reduce while the pelvic floor recovers. Breathing out slowly with your feet raised makes going much easier without it.
What is the best position for pooing after birth?
Sit fully on the toilet with your feet raised on a small stool so your knees are higher than your hips, then lean forward with your forearms resting on your thighs. This position, recommended by the NHS, straightens the passage and reduces the need to push.
Sources: NHS, Your body after the birth; NHS Devon pelvic health service, Caring for my pelvic health following birth; Bradley CS et al., "Constipation in pregnancy: prevalence, symptoms, and risk factors", Obstetrics and Gynecology, 2007; Turawa EB, Musekiwa A, Rohwer AC, "Interventions for preventing postpartum constipation", Cochrane Database of Systematic Reviews, 2020; Cleveland Clinic, What to know about pooping after giving birth.
This article is general education, not medical advice. Results vary from mum to mum. Please speak to your midwife, health visitor, GP, pharmacist or a women's health physiotherapist about your own recovery, and seek prompt advice if you have bleeding from your bottom, severe pain, or any difficulty controlling wind or bowel movements.