Postpartum constipation and fissures

Published 13 March 2026 ·Last reviewed 13 March 2026 by the editorial team ·How we create our content

A composite account, drawn from many real anonymised experiences. It is not any one person's story.

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

When to seek care Heavy bleeding or feeling faint? Get emergency help now. Emergency: 911

Not sure how urgent it is? Get help today.

Emergency
Heavy bleeding, black tarry stools, feeling faint, severe pain or trouble breathing.

Call 911 or go to the ER.
Today
Fever, pain getting worse, a hot swollen lump, or trouble passing urine.

Call your doctor or go to urgent care.
Soon
Bleeding or bowel changes nobody has checked, or anything lasting 3 weeks.

Book a doctor’s appointment.

Feeling overwhelmed? Call or text 988, any time.

See all the signs

For this topic, get medical advice if you notice:

Severe or worsening pain
Heavy bleeding
Fever
Black stools
Fainting or dizziness
Pus or unusual discharge
Inability to pass stool or gas
Unexplained weight loss

Recording how you feel is not the same as being checked. These are the signs that need a doctor’s attention.

Call 911 or go to the emergency room now if you have:

bleeding that will not stop, a lot of blood (the toilet water turns red, or you pass large clots), or any bleeding with feeling faint or dizzy
fainting, a racing heart or trouble breathing
confusion or slurred speech, extreme shivering, no urine in a day, or blotchy skin
sudden severe belly pain, or a swollen, hard belly with vomiting or not passing stool or gas
you cannot pass urine at all, or your bladder feels full and painful and you can’t empty it
redness, swelling or severe pain spreading quickly around your anus, genitals or groin, especially with a fever or feeling very ill
a fever with a painful swelling near your anus if you have diabetes or a weakened immune system (for example, from chemotherapy or transplant medicines)
black, tarry stools

Call your doctor or go to urgent care today (or the ER if you can’t be seen today) if you have:

a temperature of 100.4°F (38°C) or higher, chills, vomiting, or feeling generally unwell
pain that is getting worse over days, or severe pain that stops you sitting or sleeping
a hot, swollen or very tender lump near your anus or at the top of the crease between your buttocks, or foul-smelling discharge
trouble urinating
bleeding that is getting heavier or more frequent, or blood mixed into your stool
feeling much more tired than usual, looking pale, or getting out of breath more easily than you used to
not passing stool for several days, or new belly pain

Make an appointment with your doctor if:

you have never had these symptoms checked by a doctor or nurse — whatever your age
you have had rectal bleeding for more than 3 weeks
your bowel movements have been looser, thinner or more frequent than usual for 3 weeks or more, or you have lost weight without trying
symptoms have not settled after a week or so, or keep coming back
you notice a new lump near your anus, between your buttocks or in your belly, or an itch or discharge that does not clear
you have new leakage or trouble controlling your bowels
you are 45 or over, or have a family history of bowel cancer or inflammatory bowel disease, and any of these symptoms are new for you

If you are unsure, it is always reasonable to ask. If things feel overwhelming, call or text 988 (Suicide & Crisis Lifeline) or chat at 988lifeline.org, any time. If you don’t feel safe, call 911.

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Discreet symptom tracking

Symptoms that come and go? Keep track, day by day.

For hemorrhoids, fissures, fistulas and other anal and rectal problems. A short, discreet email asks how things have been, and saves each answer, so you can look back at every flare and every good week in your own words. If you haven’t had your symptoms checked, see your doctor first.

About ten seconds a check-in. No app, no password.
Nothing in the subject or preview says what it’s about.
Each Sunday, a link to your week, ready for your next appointment.

Start tracking →

Your notes

Your check-in

Takes about ten seconds.

20:00

Example. Nothing on the lock screen hints at symptoms or conditions.