Postpartum Constipation Relief: Quick Tips & Long-Term Solutions
One of the most common yet surprising concerns I’ve heard from postpartum women over the years as a women’s pelvic floor occupational therapist is this: "Why didn’t anyone tell me pooping would be so hard after having a baby?" Many new moms have told me that they felt more prepared for labor and delivery, but less prepared for the realization that pooping after birth might be just as - if not more - stressful. If you're nodding your head right now, you're not alone.
Postpartum constipation is incredibly common —and the good news is, it’s also very treatable! In this post, I’ll walk you through some simple strategies you can use immediately after childbirth, and explain how pelvic floor therapy for constipation can additionally make a huge difference, especially if symptoms stick around for longer than anticipated.
What Causes Postpartum Constipation?
Constipation is defined as infrequent, hard, or difficult-to-pass bowel movements. It often comes with straining, bloating, or a feeling of incomplete emptying. Studies show that roughly 1 in 4 women experience constipation after childbirth, especially within the first three months.¹
Several factors contribute to postpartum bowel problems:
Hormonal changes that naturally slow digestion during and after pregnancy
Pain medications, especially opioids commonly prescribed post-delivery, which decrease bowel motility
Fear of straining due to stitches, perineal pain, or surgical recovery
Hemorrhoids or rectal pressure discouraging normal urges
Vaginal delivery, which increases the odds of postpartum constipation by 47% compared to Cesarean section²
Spontaneous perineal tears, which raise the risk by 40% compared to no tearing²
Pelvic floor dysfunction and constipation, where uncoordinated or tense pelvic floor muscles make bowel movements more difficult and uncomfortable
How to Poop Postpartum: Tips to Get Things Moving
Whether you’re concerned about that dreaded first poop postpartum, or want to manage more long-term postpartum constipation issues —there are ways to make it less scary and more successful. Here are evidence-informed, therapist-approved tips to support natural constipation relief postpartum - both in the early days and beyond.
Use stool softeners and stay hydrated: Take Colace (or another stool softener) especially in the first few days after birth and prior to your first bowel movement. This is advice I wish every pregnant woman knew prior to giving birth! Also, drink plenty of water, and gradually increase your fiber intake. Pain medications like opioids often slow the gut, so taking medications to soften the stool and staying hydrated are absolutely essential during the early postpartum period.
Relax your pelvic floor: Use 360-degree breathing, exhale as you bear down, and practice reverse Kegels for constipation to soften and lengthen your pelvic floor muscles during bowel movement. When bearing down, try performing a gentle “shh” breath, or blow through a fisted hand, to reduce tension and encourage release of stool.
Use optimal toilet posture: Sit with knees elevated above hips (using a Squatty Potty or step stool), lean slightly forward, and allow your elbows to rest on your thighs to support a relaxed position. This position will optimize the rectum’s position and allow the pelvic floor to more naturally relax.
Try abdominal massage: Abdominal massage can be a gentle and effective way to stimulate bowel movements. To begin, lie on your back with your knees bent or sit in a reclined position. Use your fingertips to apply light pressure in a clockwise direction, following the path of your colon. Start at the lower right side of your abdomen (just above your hip bone), move up toward your ribcage, across to the left side, and then down toward the lower left side. Move slowly and breathe deeply as you massage, spending about 1–2 minutes in each section. Try doing this at the same time each day, such as after waking or following a meal, to encourage a regular bowel routine.
Tailor your fiber intake: Focus on whole-food fibers (like oats, flax, or fruits) and increase gradually. Some types of fiber, like psyllium, may cause more bloating or discomfort in the early stages.
Avoid straining: Resist the urge to push hard or hold your breath. Instead, use gentle breathing techniques and allow your body to do the work without added pressure.
Signs Your Pelvic Floor May Be the Problem
If it’s been a few weeks and you’re still struggling to go, it’s worth exploring whether your pelvic floor physical or occupational therapy needs attention. Many people with high-tone pelvic floor dysfunction experience pain or fear when trying to poop. You might feel like you can’t fully let go or empty your bowels, even after sitting for a while. Straining or breath-holding might become a regular part of your bathroom routine, and lingering hemorrhoids or a sense of pressure in your rectum can be signs your muscles are holding tension.
When the pelvic floor muscles are tight—often without your awareness—they can block the natural movement needed for healthy bowel movements. Over time, this can create a frustrating cycle of incomplete emptying, compensation, and worsening muscle tension. In these cases, internal pelvic floor therapy and strategies like pelvic floor downtraining can make a tremendous difference in both comfort and regularity.
When to See a Pelvic Floor Therapist
If you’re still dealing with constipation after childbirth beyond 4–6 weeks—or if pooping feels uncomfortable, stressful, or painful—it’s a good idea to book an evaluation. You don’t need to wait until things continue to linger and become more severe; in fact, the earlier you get support, the easier it is to resolve the issue.
During your pelvic floor therapy sessions, you’ll start with a comprehensive assessment of both the external and internal pelvic muscles. Your therapist will gently check for pelvic floor muscle tension, coordination, and muscle strength to understand what might be contributing to your constipation. They'll also go over your daily toileting habits and routines to identify any small changes that could make a big difference in relieving your constipation. You’ll learn how to properly coordinate your breathing with relaxation techniques, and you may receive manual therapy for constipation, which includes soft tissue techniques for scar tissue or tight muscles.
Stretches and targeted exercises will help you reconnect with your pelvic floor and improve muscle control. Most importantly, you’ll leave with a personalized home program designed to support regular, comfortable bowel movements that suit your lifestyle and postpartum needs.
It’s Never Too Late to Seek Help
Even if it’s been months—or years—since giving birth, you’re absolutely not out of options. While pelvic floor dysfunction can persist long after postpartum, pelvic floor therapy for constipation remains effective no matter your timeline since giving birth. Whether you’ve relied on laxatives for years or just feel like you never “got back to normal,” it’s not too late to restore function and feel better.
Final Thoughts
Postpartum bowel issues are incredibly common, but they don’t have to become your normal long-term. With therapeutic support, proper education, and the right tools, you can find relief from constipation after childbirth and reclaim your comfort when toileting.
If you’re local to Youngstown, OH, or Canfield, OH, and are searching for a pelvic floor therapist near me, here at Calko Pelvic Rehabilitation & Wellness, I’d be honored to walk alongside you in your pelvic health wellness journey. If you’re located elsewhere in the United States and are seeking out further healing, I would highly recommend finding a pelvic floor physical or occupational therapist near you through the reputable online directory, www.pelvicrehab.com.
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