For many new mothers, the first bowel movement after childbirth can be a source of significant anxiety, particularly when stitches are involved. This concern often stems from worries about pain or the stitches potentially tearing. Understanding this process can help alleviate apprehension.
Types of Postpartum Stitches
After childbirth, the type of stitches depends on the delivery. Vaginal births may result in perineal stitches, used to repair tears in the perineum—the area between the vagina and the anus—or an episiotomy, a surgical cut to enlarge the vaginal opening. Perineal tears range from superficial first-degree to more extensive fourth-degree tears involving the anal sphincter. These stitches can be internal or external, designed to aid healing and close the wound.
For a C-section, stitches close the surgical incision made through the abdominal wall and uterus. Most stitches used after birth are dissolvable, naturally breaking down as the body heals. Non-dissolvable stitches or staples, sometimes used for C-sections, are typically removed by a healthcare provider after five to seven days.
The Truth About Straining and Stitches
Many new mothers fear that straining during a bowel movement could cause their stitches to rip or undo. However, it is highly unlikely for stitches to completely tear or open up. Surgical stitches are designed to be strong and resilient, holding healing tissues together.
Discomfort or stretching can occur when passing stool, especially if the area is swollen or tender. While complete ripping is rare, straining may cause temporary discomfort or minor irritation of healing tissues. Significant damage to stitches is uncommon, and any minor issues typically heal quickly as the body integrates the stitches into the tissue.
Making Postpartum Bowel Movements Easier
Several steps can ease postpartum bowel movements and reduce straining. A fiber-rich diet, including fruits, vegetables, and whole grains, is important. Adequate hydration is also essential; drinking plenty of water helps soften stool and promote smoother passage. Aim for at least eight to ten glasses of water daily, especially if breastfeeding.
Healthcare providers often recommend over-the-counter stool softeners, which add moisture to stool for easier passage. These are not laxatives and do not stimulate bowel contractions. Proper toilet positioning can help; elevating your knees with a footstool mimics a squat, straightening the colon and easing stool passage.
When an urge to defecate occurs, do not delay. Instead of forceful straining, breathe out gently while pushing, avoiding holding your breath. For C-sections, apply gentle pressure over your incision with a pillow for support. Pain relief can help relax the area and make bowel movements less daunting. The first bowel movement may take a few days after birth, which is normal.
When to Contact Your Doctor
Certain signs warrant contacting a healthcare provider. An increase in pain, spreading redness, swelling, or a foul-smelling discharge from the stitched area can indicate infection. A fever is also a sign of potential infection.
Seek medical attention if there is significant bleeding beyond minor spotting after a bowel movement, or if the wound appears to open. Severe, unremitting pain not improving with medication should be evaluated. Contact your doctor if a bowel movement has not occurred after three to four days, or if there is persistent inability to pass stool.