In the nine months leading up to birth, mums-to-be steel themselves knowing that at the end of their pregnancy journey, you have to endure all the pain and discomfort that comes with bringing a baby out into the world. 

Once you've got through labour and delivery, there is a sense of relief, but wait... there's more. You have to overcome another unexpected hurdle: your first bowel movement. Many mums would agree that the first poop after giving birth can hurt, even more than labour and delivery. 

Why is that exactly? Here are six reasons.

You have likely been constipated for days

After birth, it will take a while for the body to heal and resume its normal processes, including metabolism and digestion. Medication intake and dehydration also play a role in postpartum constipation.

In mums who delivered via caesarean section, constipation can be a common problem, especially as the anaesthesia wears off. This is why it may take a while before your first poop after giving birth.

You most likely neglected stool softeners

The importance of stool softeners after birth is often overlooked, but they can greatly help ease bowel movements. Stool softeners are one of the methods to poop after giving birth with stitches. This is the case whether you have perineum stitches or stitches from your C-section.

Ask your doctor for a prescription for stool softeners. Do not worry, this is safe even if you are breastfeeding.

Note that there is a difference between stool softeners and stimulant laxatives. The former adds moisture to the stool so it becomes softer and easier to pass. The latter makes your intestines contract, giving you the urge to pass stool.

Another thing to note is you only need stool softeners for a short time. This is to help you poop after giving birth.

You may have experienced vaginal tearing

Many women who deliver through normal vaginal delivery have to undergo an episiotomy, or the surgical cutting of the area between the vagina and anus to widen the birth canal. Tearing of the vulva and perineum can also happen spontaneously during labour.

When you have a severe perineal tear, bowel movements after giving birth can be more complicated. When your perineal tear degree is third or fourth, you may have swelling and experience poop leakage.

When you're at six weeks postpartum and you experience poop leakage with your third or fourth degree perineal tear, talk to your doctor. She may recommend pelvic floor physical therapy or refer you to a sub-specialist.

You may have swelling

Even if you did not experience vaginal or perineal tearing, you might still have some rawness and swelling down there. Remember, you just pushed out a baby. So it may take a while before your body goes back to normal. This is why the first poop after giving birth may be scary.

Your stitches are still raw

After tearing or episiotomy, doctors stitch up the cut to allow healing. The healing of perineum stitches can last for days or weeks. Even in mums who delivered via C-section, the stitches can still feel tender.

So when you've finally done the first poop after birth, how should you wipe? Gently, and avoid it if you can. Mums may use a peri bottle or a squeeze bottle and fill it with warm water. Then you can let it air dry so you don't have to wipe once you're done.

Another way to help in terms of how to poop after giving birth with stitches is to stay hydrated. Drinking lots of water will help your large intestine and aid in forming stools that are easier for you to pass.

How can new mums ease the pain of pooping after giving birth?

Consult your doctor for the right medication to manage your discomfort. Ibuprofen, cooling creams and stool softeners can help. Applying counter pressure is one measure to manage pain during bowel movements.

Avoid cheese or stool-hardening foods like white bread, white rice, pasta, and eggs. Go for fresh fruits and vegetables; avoid the canned kind. Fatty and processed foods are also a no-no. Prunes and cranberry juice can be helpful. Fibre-rich foods are also ideal. You can also add a fibre supplement to aid in your pooping.

You can also make use of a frozen diaper or maternity pad and press it lightly against your vagina. Before delivery, you can also make your own 'padsicles' and stick them in the freezer. 'Padsicles' are sanitary pads with alcohol-free witch hazel, pure lavender oil, and pure unscented aloe vera gel.

When you're in the toilet, resting your feet on a step stool may help. Putting your elbows on your knees and leaning forward will help you achieve a hunch position. This is what you need to do to help your body poop easier.

You can also try breathing in and gently pushing as you breathe out. Do this carefully and keep in mind your stitches.

If the pain does not subside with each bowel movement, consult your doctor in order to determine what causes to further address to help you on your road to recovery, in order to truly enjoy the first few months of motherhood.

Caring for your perineum stitches

If you've had a first-degree vaginal tear, you may not need stitches. If it's a second, third, or fourth, you will receive stitches. With these types, the stitches will heal and dissolve on their own within six weeks.

But if you have a severe case of tearing and have an injury to the anal sphincter, it needs to be repaired. While this heals, you may do the same tips mentioned above in terms of easing the pain of pooping after birth.

If you experience your perineum stitches itching, you may ask your doctor if it's safe to take an antihistamine. You can also apply a cool compress to the area. You may also use a barrier cream like zinc oxide to protect from irritation. Another way to address perineum stitches itching is to wear breathable underwear.

While you are still in the stages of perineal wound healing, look out for signs of an infection. These may indicate your perineal tear has reopened. Symptoms include a foul-smelling or yellow discharge from your stitches after birth. You may also get a fever, as well as feel pain that doesn't go away even with medication.

If you experience these while in the stages of perineal wound healing, inform your doctor.

Perineal wound breakdown

An infection, or pressure on the stitches from bleeding underneath may cause the perineum stitches to break down.

How do you know if your stitches have ripped after birth?

If you have a pus-like or yellow discharge from stitches after birth, this may be a sign that you have a perineal wound breakdown.

You may notice that some of the stitches have come undone after delivery, or see that your wound has opened up. Symptoms also include pain and bleeding.

ALSO READ: Episiotomy stitches after giving birth: The 'husband stitch' is not a myth

This article was first published in theAsianparent.