What this experience covers
This is a composite account of how people manage postpartum constipation and its potential to cause anal fissures. It draws from many anonymised stories of people navigating the postnatal period.
The pattern
Why constipation happens postpartum
Constipation after childbirth is extremely common. The causes include:
- Hormonal changes that slow gut motility
- Iron supplements prescribed for anaemia
- Pain medication (particularly opioid-based) used after delivery
- Dehydration from breastfeeding and recovery
- Fear of straining — especially after a vaginal delivery or episiotomy
- Reduced mobility in the first days after delivery
- Disrupted eating and drinking patterns with a newborn
The fissure risk
Hard stools after delivery, combined with tissue that may already be stretched or traumatised from childbirth, create conditions where a fissure can develop. People describe the first postpartum bowel movement as one of the most feared moments of the entire birth experience.
What helps
- Starting stool softeners before or immediately after delivery — many midwives and doctors recommend this
- Staying hydrated — particularly important when breastfeeding
- Fibre intake — even when appetite is disrupted
- Not delaying bowel movements — the longer you wait, the harder the stool becomes
- Gentle toilet posture — using a footstool, breathing rather than pushing
- Reassurance — the first bowel movement is almost always less painful than people fear
The reality of timing
Preventing fissures postpartum competes with every other demand of having a newborn. People describe forgetting to drink water, missing stool softener doses, and eating whatever is quickest rather than what is best for their digestion. Self-compassion is important here. The priority is doing what you can, not achieving perfection.
Navigating this during pregnancy or postpartum adds extra complexity. Our chat can help you think through what is safe and what to prioritise.
When to contact your doctor
Seek medical attention if you experience:
- Heavy or persistent bleeding that does not settle
- Severe pain that is getting worse rather than better
- Fever or signs of infection
- Symptoms that have not improved after 4 to 6 weeks of self-care