Pregnancy and bowel movements. The topic is incredibly important and has so many facets. For example, hormone-induced constipation is a common side effect of pregnancy. But so are haemorrhoids, which affect around half of all pregnant women. Bowel movements are also a particularly sensitive and emotional issue in the postnatal period.
In the following interview, our founder Daniel talked about this topic in great detail with the renowned and experienced midwife Sissi Rasche and gained many new and very interesting insights.
Sissi is a freelance midwife in Berlin, podcaster, content creator and mother of four children herself. She has been passionately supporting families through pregnancy, postpartum and birth for 17 years - both as an attending midwife and as a homebirth midwife. Through her social media channels and podcast formats, she shares her experiences and expertise to reach even more families, give them helpful tips and create space for honest conversations about being and becoming a parent.
Daniel: Dear Sissi, I am delighted to have the chance to interview you on this important topic for our toilet stool blog! Can you tell us what problems pregnant women face during daily bowel movements and in which phases of pregnancy which complaints typically occur and what the respective causes are?
Sissi: Yes, it really is an important topic - and one that is unfortunately talked about far too rarely. Yet it affects so many pregnant women and can be quite stressful in everyday life.
In fact, bowel movements often change significantly during pregnancy - and in different phases. Right at the very beginning, the hormone progesterone ensures that the muscles in the body relax - including those of the digestive tract. This can slow down digestion and lead to constipation. If nausea, vomiting or reduced fluid intake are added to this, these symptoms are often exacerbated.
Other factors are added during pregnancy: the uterus grows, the abdomen becomes narrower and the intestines have less space - this can make digestion even more difficult, especially in the second and third trimester. Iron supplements, which many pregnant women take, can also make the stool firmer and increase unpleasant symptoms.
I think it's important not to simply suffer in silence or only treat the symptoms in the short term - but to do something as early as possible. Because if the constipation then develops into hemorrhoids, this is doubly unpleasant and often avoidable. So it's worth looking at it early and taking gentle countermeasures.
Daniel: Yes of course, that would definitely be worthwhile. I wouldn't have thought that the problem was so diverse and multifaceted. But that's not all. Women often still have a real problem with bowel movements after giving birth. Many are downright afraid of the first time. Can you explain to us what these problems are and what the reasons for them are?
Sissi: Unfortunately, that's true. Even after giving birth, bowel movements can be a real challenge for many women - especially the first time. After a vaginal birth, especially if there has been a perineal tear or incision, many women feel insecure or even anxious. The worry that the suture could come loose is widespread - but fortunately unfounded in most cases. A correctly treated perineal suture is stable. Even if it can tug or be uncomfortable, nothing usually happens.
It can be helpful to exert slight counter-pressure on the perineum with a soft pad during bowel movements - this gives many women more security. Hormonal changes, certain painkillers and a restrained posture for fear of pain also have an effect on digestion. All of this can slow down bowel movements.
An upright, relaxed sitting position with slightly raised feet - with the help of a toilet stool, for example - can make bowel movements much easier. Rest is at least as important. This is often easier said than done in the postpartum period, but if someone takes over the baby for a moment, there is space to concentrate on your own body in peace, without time pressure or stress.
Daniel: I can relate to that even as a man. Are there actually any differences between vaginal births and caesarean sections in terms of problems with bowel movements after the birth? How can the different birth methods affect bowel function?
Sissi: Both birth modes can cause problems. It is important to prevent fears and remove the taboo from the subject.
As just described, after a vaginal birth, the feeling of insecurity can lead to women unconsciously delaying bowel movements, especially if there has been a perineal tear or incision.
After a caesarean section, on the other hand, other factors often play a role. The operation itself, the administration of painkillers and initially restricted mobility can slow down bowel movements. Women often complain of a bloated feeling or constipation. It is particularly important to get up early and move around carefully to stimulate bowel movements. The feeling of tension around the scar can also lead to the abdominal muscles being unconsciously spared, which makes bowel movements even more difficult.
Daniel: What preventive measures can expectant mothers take to prevent bowel movement problems during and after pregnancy? Are there specific recommendations regarding diet, exercise or other lifestyle habits?
Sissi: Yes, there are actually a number of ways in which expectant mothers can specifically support their digestion during pregnancy and also in the postpartum period. It is often small, conscious changes in everyday life that have a big impact.
A balanced, high-fiber diet - for example with wholegrain products, pulses, lots of vegetables and fresh fruit - is a good basis. Adequate fluid intake is just as important: two to three liters of water or unsweetened tea a day help to keep the stool smooth. This is particularly important if you eat a high-fiber diet - because fiber can only work properly with sufficient fluids.
Exercise also plays a key role. Even regular walks or gentle activities such as swimming can stimulate bowel activity. Swimming also relieves pressure on the pelvic floor, which can reduce the risk of complaints such as hemorrhoids.
A relaxed toilet situation is also helpful: sufficient time, an upright position with slightly elevated feet - for example with the help of a toilet stool - and a calm atmosphere support the natural movement.
After the birth, the following applies: gently get moving again without overexerting yourself. Early, gentle mobilization, targeted pelvic floor exercises and the above-mentioned tips on nutrition help the body to regain its balance. And it is also worth paying attention to sufficient fluid intake in the postpartum period - it often quickly fades into the background in the new everyday life with a baby.
Daniel: What tips can you give women who have problems with bowel movements during pregnancy? What role do toilet stools in particular play during pregnancy?
Sissi: A really helpful tip is the correct sitting position on the toilet. In most western toilets, we sit in a rather upright position, which is not ideal for defecating. A toilet stool that you place under your feet can help here. It lifts the legs and brings the body into a natural “squatting” position, opening up the angle in the rectum. This position promotes easier evacuation as the pressure on the rectum is reduced, which can also reduce the risk of hemorrhoids.
For constipation and hemorrhoids, home remedies such as psyllium husks or flaxseed can also help to aid digestion and soften stools. Prunes and prune juice also have a laxative effect and can be helpful for occasional constipation.
In addition, when taking iron supplements, care should be taken to ensure good bioavailability and that they are taken with vitamin C in order to avoid constipation.
Daniel: I'm pleased that we can really support women in this phase with our toilet stool. Last question: What tips can you give specifically to women who have problems with bowel movements in the weeks or months after pregnancy? What support do toilet stools offer during this phase?
Sissi: Many of the tried and tested measures from pregnancy remain helpful in the postnatal period - especially if bowel movements continue to cause discomfort. Gentle exercise, such as walks, adapted yoga exercises or postnatal gymnastics, stimulate bowel movements and strengthen the pelvic floor at the same time.
Toilet stools can also provide valuable support during this phase. The adapted sitting position straightens the rectum, which makes bowel movements easier and at the same time reduces pressure in the pelvic floor - particularly beneficial after a vaginal birth or a perineal tear or incision.
It is important to take enough time to go to the toilet. A relaxed atmosphere, calm breathing and as few distractions as possible help the body to engage in natural emptying. If the baby is cared for briefly by another person during this time, this can provide additional relief and reduce stress.
For gentle care of haemorrhoids or irritation in the anal area, a bottom douche with calendula essence or a soothing sitting bath - for example according to Ingeborg Stadelmann's recipe - can have a beneficial effect and support healing.
Home remedies can also help to regulate digestion: Psyllium husks swell up in the intestine and stimulate intestinal activity due to their volume. Sufficient fluid intake is important here - otherwise they can have the opposite effect. Warm drinks on an empty stomach, such as an unsweetened herbal tea immediately after getting up, can also stimulate intestinal peristalsis.
If the symptoms persist or worsen, it is advisable to consult your gynecologist or midwife. In consultation with specialists, gentle medication can then also be considered.
Daniel: Wow, that was such an informative and interesting interview. I think it can be a very important basis for many expectant mothers to experience the most pleasant pregnancy possible and to be able to fully look forward to the baby.
Thank you so much for this really valuable contribution!
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MORE ABOUT OUR INTERVIEW PARTNER
SISSI RASCHE, MIDWIFE, PODCASTER, INFLUENCER
Website | Podcast "Hebammensalon" | Podcast "Sounds Familiar" | Instagram
