Most people do not have a bowel movement for the first few days after giving birth, and when it finally comes, the stitches hold. The NHS says it outright: if you have had stitches, it is very unlikely you will break them or open up the cut or tear again.
That is the sentence I went looking for at two in the morning after my first, and I could not find it anywhere. So it goes at the top here instead of four screens down.
Nobody says that sentence out loud, so it goes first
The fear is not constipation. Almost nobody lies awake worrying about fiber. What people are actually afraid of is pushing, and something that was sewn shut two days ago coming apart while they do it.
I spent a long time standing in that bathroom with one hand on the door frame, doing arithmetic about how much longer I could put it off. Two days felt clever. Three days felt like a strategy. By the fourth I had made the exact problem I was avoiding considerably harder, and that is the part nobody says in advance.
ACOG names the fear directly. It says it may be hard to have bowel movements for a few days after delivery, and that you may be afraid to move your bowels because of pain from hemorrhoids or a tear in the perineum. So the fear is expected and documented. It is also the mechanism.
Being afraid of it is what turns a sore first time into a hard one. Not the stitches, not the delivery, not anything your body got wrong.
The three days before you sit down are the whole game
Here is what I did not understand until my second. Almost nothing you do in that bathroom changes the outcome. It was decided by what you drank and how much you moved in the days before you got there.
ACOG’s list for this is short and boring. Drink plenty of fluids, take short walks as soon as you can, eat foods high in fiber, and ask your ob-gyn about a stool softener or a laxative if you need one. The NHS says the same thing about food, naming fruit, vegetables, salad, whole grain cereals and whole wheat bread, plus plenty of water.
Water is the one that fails, and it fails for an idiotic reason. You are pinned to the couch under a baby who has decided to feed for the entire evening, and the glass is on the counter where you set it down before you sat. Those evenings have a name, and I did not know it existed until somebody used the phrase cluster feeding in front of me.
By my third I had a rule that I would not sit down anywhere without a bottle already within reach. Not a glass. A bottle with a lid, because it survives being kicked over by a foot, and it got kicked over most days.
The walking sounds like advice written for somebody else’s week. It is not exercise. With my son the most I could do was the length of the hallway and back, four or five times a day, mostly because the alternative was sitting still and thinking about it.
The stool softener is the one to ask about before you want it. Ask on the day, in the room, while somebody is still standing at the foot of the bed. Nobody enjoys making that phone call on day three, so most people do not make it.
What to do while you are sitting there, which is less than you think
Two things, and that is the whole bathroom protocol. The NHS says it might feel better to hold a pad of clean tissue over the stitches, and to try not to strain.
The tissue pad reads like nothing on the page. It is not nothing. It is counter pressure, and what it really does is convince the part of you that is bracing that the area is held, which is the thing that lets you stop clenching.
Not straining is harder to follow, because it sounds like an instruction to do nothing. In practice it means that if it is not happening, you stand up and come back later instead of sitting there working at it. I have sat there working at it. It speeds up nothing and it does something to your morale that lasts the rest of the day.
For the soreness around it, ACOG lists a sitz bath, which is sitting in warm shallow water, using a squeeze bottle of warm water while you are on the toilet, patting dry instead of wiping, sitting on a pillow, and ibuprofen.
The squeeze bottle changed more for me than anything else on that list. It takes about a day to stop feeling ridiculous holding it, and then it becomes the only reason that part of the day is survivable.
Hemorrhoids are not a bathroom problem either
If there is something there that was not there last week, it is very likely hemorrhoids, and ACOG explains where they came from. They can appear for the first time after delivery because of the intense straining you did during labor, and if you already had them in pregnancy they can get worse.
Nobody prepared me for this one at all. I found it myself, in the dark, and spent roughly forty minutes deciding whether it counted as an emergency before falling asleep still deciding.
The good news is that it is on a clock. According to the NHS, hemorrhoids are very common after birth and usually disappear within a few days or weeks, and both ACOG and the NHS say that straining makes them worse.
So this is not something you fix. It is something you stop making worse, which is this post’s one sentence again wearing a different hat. The treatment for the lump turns out to be the water and the walking and the stool softener, exactly as before, with a new reason attached to it.
For the pain itself, ACOG lists medicated sprays or topical ointments, dry heat such as a hair dryer turned on low, sitz baths, and cold witch hazel compresses. The NHS says a midwife or pharmacist can recommend creams and ointments if you are very uncomfortable.
I kept the witch hazel compresses in the refrigerator, which had not occurred to me the first time around. Cold is doing real work in that sentence and it is easy to read past it.
When this stops being waiting and becomes a phone call
Most of this passes on its own within a couple of weeks. Some of it does not, and the difference is not a feeling you are supposed to interpret. It is a list.
The NHS says to talk to your midwife or doctor about constipation that will not go away, and that a gentle laxative may help. It also says to tell them if stool is leaking or you are having a bowel movement when you do not mean to. That second one is the least appealing sentence in this post and it is the one I would most want somebody to actually say.
The CDC’s HEAR HER list of urgent maternal warning signs is the one worth keeping on your phone. It says to seek medical care immediately for a fever of 100.4°F or higher, heavy bleeding that soaks through one or more pads in an hour, clots bigger than an egg or passing tissue, or sharp, stabbing or cramping belly pain that does not go away or gets worse.
The CDC also points out that problems related to pregnancy can happen up to a year after delivery. I have watched people file this entire subject under finished on the day they got home. The six week checkup is the built-in place to raise whatever you have been quietly living with, and it goes on the list before you get there, because you will not remember it in the room.
Bleeding has its own thresholds and its own timeline, which we go through in how long postpartum bleeding lasts. At this stage it is genuinely hard to tell what is coming from where, and knowing which is which is worth the five minutes.
The short version
- The stitches hold. The NHS says it is very unlikely you will break them or reopen the tear, and that is the sentence to have before you go in.
- You probably will not go for a few days, and that is expected rather than a sign anything went wrong.
- The first one is decided before you sit down. Fluids within arm’s reach, short walks, high fiber food, and a stool softener you asked about on day one.
- In the bathroom: a pad of clean tissue held over the stitches, and no straining. If it is not happening, stand up and come back.
- Hemorrhoids are the same problem one step further along. You do not fix them in there, you stop adding pressure, and they usually go within days or weeks.
- Call for a fever of 100.4°F or higher, soaking a pad in an hour, clots bigger than an egg, or severe belly pain that will not go away.
Sources
- NHS, “Your body after the birth”, NHS pregnancy guide (last reviewed 2025)
- American College of Obstetricians and Gynecologists, “Postpartum Pain Management”, ACOG FAQ
- CDC, “Urgent Maternal Warning Signs and Symptoms”, HEAR HER Campaign (May 15, 2024)
A note on this post. Written and edited by the NewBloom editorial team. NewBloom is not written by doctors, nurses or midwives, and nothing here is medical advice. We read the current guidance from bodies like ACOG, the CDC and the NHS and write down what it says, with every claim traced to its source and named in the sentence where it appears. General guidance is not the same as an answer about your own body. Your doctor, midwife or health visitor can examine you and we cannot, so anything here that raises a question about your own recovery is a reason to ask them. If something is wrong right now, contact your doctor or your local emergency number. More about how we write these posts.