Experiencing blood when having a bowel movement postpartum can be a concerning symptom for new mothers. While alarming, it is often related to common and treatable conditions that arise due to the physical changes and demands of childbirth and recovery. Understanding the underlying causes can help alleviate anxiety and guide appropriate care during this unique period.
Common Causes
One of the most frequent reasons for blood during postpartum bowel movements is hemorrhoids, which are swollen veins in or around the anus and rectum. These can develop or worsen due to the increased pressure on pelvic veins during pregnancy, the intense pushing efforts during vaginal delivery, and the common occurrence of postpartum constipation. This pressure can cause blood to pool in the veins, leading to swelling and potential bleeding, especially with straining.
Another common cause is anal fissures, which are small tears in the thin lining of the anal canal. These tears often result from passing hard or large stools, particularly when compounded by constipation. The process of childbirth itself can also contribute to anal fissures due to the stretching and potential tearing of the anal tissues.
Constipation is a significant contributing factor to both hemorrhoids and anal fissures postpartum. Hormonal changes, reduced physical activity, dietary shifts, iron supplements, and pain medication can all contribute to slower digestion and harder stools after birth. The fear of pain during bowel movements, especially after an episiotomy or tearing, can also lead to holding stools, further worsening constipation.
When to Seek Medical Attention
While many instances of postpartum rectal bleeding are due to common, non-serious conditions, certain signs indicate a need for prompt medical evaluation. Contact a healthcare provider if there is heavy bleeding that does not slow or stop, or if large blood clots are passed, especially those larger than a golf ball. Any persistent or increasing bleeding warrants attention.
Other symptoms that signal a need for medical consultation include severe or worsening pain in the rectal area, dizziness, fainting, or blurred vision, which could indicate significant blood loss. A fever or chills, along with rectal bleeding, could suggest an infection. Changes in stool color, such as dark red, maroon, or black, tarry stools, might indicate bleeding higher in the digestive tract and should be reported immediately.
Management and Prevention
Managing and preventing blood when pooping postpartum primarily involves promoting soft, regular bowel movements and reducing strain. Increasing dietary fiber intake is a fundamental step, with recommendations including fruits, vegetables, whole grains, and beans. Gradually adding fiber can help avoid gas and bloating.
Adequate hydration is equally important, as drinking plenty of water helps soften stools and prevent constipation. For breastfeeding mothers, at least eight cups of water daily are often recommended. If diet and hydration are insufficient, a healthcare provider might suggest a fiber supplement or a stool softener to ease bowel movements.
Practicing gentle bowel habits is crucial. It is best to respond to the urge to have a bowel movement promptly, as delaying can make stools drier and harder to pass. Avoiding straining during defecation helps prevent further irritation or damage to the rectal area. Gentle exercise, such as short walks, can also promote regular bowel movements and improve circulation.
To soothe discomfort and aid healing, warm sitz baths can be beneficial. Soaking the perineal area in warm water for 10 to 20 minutes, several times a day, can increase blood flow, reduce swelling, and alleviate pain and itching. Applying cold compresses or witch hazel pads to the affected area can also provide temporary relief from swelling and discomfort. Maintaining proper hygiene by gently patting the area dry after bowel movements, rather than rubbing, helps prevent irritation.