Birth and Bowel Movements: Tips for the first BM after delivery

Bowel movements?!?  Really?!?  You want to talk about bowel movements?  

Yes. Yes, I do.  

This is one thing I certainly never expected or cared to research when I was having kids.  I was just focused on gearing up to get the baby out - I didn’t think so much about after the fact!  One would think that a bowel movement would be nothing in comparison to pushing out an 8 pound baby, no?!? Well…

Many women don’t anticipate this being an issue after delivery, especially if you’ve never had issues with constipation before.  However, a multitude of factors can throw things off and leave you feeling all “backed-up”.  Medications, prolonged sedentary positions and/or an altered diet are just a couple of potential culprits. Regardless of the reason(s), it makes for a less than ideal experience when the time comes to void those bowels.  Your healthcare provider will most likely be asking you and keeping track of how this process is going.  However, if you are having trouble in this department after giving birth, don’t be afraid to ask for help so they can set you up with a variety of resources like stool softeners and enemas to help move things along.  

Here are some additional tips that you can do yourself should you find you’re in the situation of dreading bowel movements after giving birth.  (These tips also work great for general constipation too).  

  1. Relax - Way easier said than done especially if you’ve had any type of tearing, an episiotomy, a C-Section or are just dreading having to “push” one more time!  Pelvic floor muscles relax and open much more easily when you are not stressing about it or anticipating pain.  How do you relax the pelvic floor specifically? One way is to use your breathing - inhale and simultaneously visualize opening the anus.  Sometimes it works well for people to visualize widening the SITs bones away from each other as you inhale (the “SITZ bones” are the two boney points you feel in your backside when sitting in a chair).  This relaxing or opening should NOT feel like you are pushing downwards, it’s simply a reflexive response to the breath. If you’re having trouble getting this down, ask for some help from one of our amazing physiotherapists.  
  2. Don’t clench your jaw - Also, if you’re having trouble relaxing the pelvic floor, check and make sure you aren’t clenching your teeth.  Strangely enough, keeping this area relaxed can also help relax the pelvic floor.
  3. Knees higher than hips - Those fancy commodes are handy so you don’t have to squat down so low, but sitting high doesn’t do much for optimizing the position of the rectum when trying to void those bowels.  Grab a stool or improvise with a garbage can (preferably empty!) tipped on its side.  Place feet up on something secure so your knees are higher than your hips and legs are supported and relaxed.  This can help align things more optimally for faecal evacuation.
  4. Position some more - Lean forward and rest elbows on your knees. This allows for further relaxation.  Let the tailbone untuck slightly to allow for easier passage of stool pass this area.  
  5. C-Section? Splint lower abdomen - If you’ve had a C-section, place a towel or your hands between thighs and lower abdomen for added support at the incision site.  Try not to block your belly totally however as forward movement of the abdomen can further help the muscles surrounding the anus to relax.  I know it’s going to feel like things will burst wide open if you strain too hard, but keep in mind that the surgeon stitches you up with the goal of keeping you closed.  If they thought the forces generated by pooping were going to be a hazard, they would tell you not to poop for 6 weeks or something crazy like that until things are all healed up.  Plus, after reading this article, you now have some strategies to minimize that horrible feeling of pain/pressure/pulling at the incision site! Ready for some more awkward suggestions??  I’m just warming up!
  6. “Moo”, “Grr”, “Hiss” or pretend to “Blow through a very small straw” - Ummm, WHAT?!??! If you didn’t already think I was crazy, I realize I just tipped the scale.  Please, bear with me (no pun intended).  Using your breath or vocalizations on the exhale can help modulate intra-abdominal pressure and act as an effective tool for assisting with a less strenuous bowel movement.  It can help you avoid the Valsalva Maneuvre (breath holding) that can increase downward pressure on the pelvic floor and/or the outward pressure on the C-Section incision site (if you have one).  Try all four sounds out - see which one feels like it opens the anus the most.  Generally speaking, half of these vocalizations will feel like they make you tighten at the anus, and the other half will create an opening effect.  However, which one is most effective will vary from person to person.  When you find one that feels like it creates the greatest opening effect (eg. “Moo”), use that as your go-to vocalization when on the toilet.  If you are having trouble finding one that works, make sure you try again using a low-pitched voice versus a high-pitched voice.  In attempts to try and redeem myself, I’m going to throw in here that you don’t actually have to make the sound so they can hear you at the nurses’ station (although that would be entertaining).  Simply causing that air movement with a whispered “Moo” can be just as helpful.  

Strange tips, I know, but these simple things can make a huge difference in keeping that first bowel movement or two after delivery a much less torturous experience.

If you have any questions about pelvic floor physiotherapy or preparing for birth, please call Rebirth Wellness Centre at, 226-663-3243, or email us at info@rebirthwellness.ca.

Jaclyn Seebach, PT ~ Certified Pelvic Health Physiotherapist

Thanks, But No Thanks: Dealing gracefully with unsolicited advice

Thanks But No Thanks Blog.png

When my newly pregnant friends ask me what’s the one thing I wish I had known earlier, it’s simple - I wish I had a strategy to deal with the cascading stampede of unsolicited advice. It begins the moment people know that you are pregnant and apparently doesn’t end anytime soon either. I confess how unprepared I was until one day I had reached my limit.

The mother in me had had ENOUGH!

The therapist in me was fascinated with the motivations of people to want to dole out what was ‘clear as mud’ unwelcomed micromanaging of motherhood.

The therapist in me recognized that we can’t change other people’s behaviour but we can be in control of ourselves – how we choose to see, interpret and manage other people’s behaviour; and, so this post is to help demystify why people might be bursting with unsolicited advice and some strategies to handle it with grace.

Now, before I go further.  I would like to add that not all unsolicited advice is "bad" or "unwelcome."

Sometimes we don’t know that there’s a solution to our struggle unless someone else recognizes it and steers us to a better outcome. The wisdom of ‘been there, done that’ can be helpful.

Sometimes someone may notice something potentially dangerous in the short or long term and if it could save my child’s life or keep them safe from serious harm I would absolutely want to know.

Unsolicited advice can be a blessing when it is:

  • given in genuine kindness      
  • spoken with sensitivity      
  • humble enough to know that it’s 1 of many ways of doing something, and    
  • most importantly, honours the characteristics and relationship of the parent and child together

So why do strangers, family, and friends feel compelled to give advice?

Let’s assume with the benefit of grace that it’s coming from a place filled with the best of intentions… Maybe it’s because:

  • This was hard won wisdom – things that they wished had someone told them and this is a way to pass it forward
  • Just want to be helpful/ needed – in the absence of concrete action ways to help, they offer advice (which they believe to be less intrusive)
  • 'Know it all’/ ‘survived it all’ types – some people believe that the way they did it was best
  • Assuming they have a right to give advice – often a generational thing, where older generations feel this is their role in society and in many cultures the role of an elder is highly valued
  • Nostalgia – Comes often from a place of longing to once again experience this phase of life and feeling that it went by too fast. For those past child-bearing years, there may be a sense of wanting a “do over” with the wisdom they gained from trial and error the first time around.

"Nice Words" and Boundaries

So what to do when you’ve had enough…

To the stranger:

DEEP BREATHS, SMILE and say “Thank you” – The End.

  • If you found it valuable, consider it. If not, fluff it off. That was easy, right? Because you’ll likely not see this person again frequently and you have no vested interest in the relationship. But that’s easier said than done when it’s someone you care about and have a relationship with. You can thank them for noticing you and your beautiful child in a busy world without committing energy.

To the person who is TICKING you off:

“Please help me understand where you are coming from, because this is how it is coming across to me…. As (your feeling)”

  • This is likely a communication problem that causes misunderstanding. By acknowledging how it makes YOU FEEL, you allow them the opportunity to re-phrase and apologize. If they will not see how they caused you hurt that’s a bigger problem.

To the know-it-all:

“I know you mean well, but please don’t assume that my approach will be the same as yours”

  • It gracefully honours that there is more than 1 “right” way to do things and reminds this person of boundaries.

To the person who challenges your decisions over and over:

“Thank you but I’m already operating with an informed decision.”

  • This type of person will likely want to get into a whole long drawn argument until you give in and cede to their point of view. If you have already decided what is best for you and your family, it is energy draining and counterproductive to engage this type of person in a “rational” argument. They want to WIN not necessarily understand your decisions. Disengage and move the focus to something else that is neutral.

To the micro-manager:

“Please just enjoy being a __(role)___ and leave the parenting to me/us”

  • Do you have someone hovering over your shoulder and clicking their tongue “tsk tsk” as you try to change a diaper, nurse, give a bottle, shush and rock the baby and on and on. Or swoop in and “re-do” it “correctly” and it seems that nothing you do is “right” or “good enough”. This sort of behaviour needs FIRM boundaries, left unchecked it can undermine your confidence as a parent

What's my favourite line, you ask...

Finally when you need to shut it down once and for all, a gentle but clear reminder that you are ALWAYS on the mission to do what is BEST for YOUR CHILD. Here’s my favourite line:

“The thing I LOVE about being (child’s) MOM is that I know him/her better than anyone else”

Please pardon me …. This one piece of advice….

RECLAIM your CONFIDENCE, EMBRACE your LOVE

 and know that

YOU’VE GOT THIS!!!

xo Ramona

Ramona Fernandez, Psychotherapist

For the last 10 years I have dedicated my professional work to specialize in women’s reproductive health, fertility and reproductive loss as a counsellor, researcher, ethicist and professor.  I am humbled by the majesty of nature, that brings together so many things with such precision at exactly the right times to make a life. I also bear witness to the deep suffering that comes when the imagined future didn’t work out as hoped.  My knowledge to be your guide as you navigate this path comes from my professional training but also from the empathy of personal knowledge, as I’ve borne 5 pregnancies to bring into the world 1 beautiful child that lived.  I am a psychotherapist with a specialization in perinatal health and reproductive loss. I have a Master’s in Counselling Psychology, Certificate in Grief & Bereavement, and a PhD in Health Professional Education on the topic of high risk pregnancies involving fetal anomalies. I’m currently an adjunct professor at Western University in Counselling Psychology and have taught at Western, Ryerson and Yale Universities. 

Six Steps to Escape the Mom Spiral

6 Steps to Escape the Mom Spiral.png

Today felt like a mom fail. I couldn't get anything right. According to my toddler, the pants were wrong, the shirt was wrong, the breakfast was wrong, the shoes were wrong and even the method of transportation to school was wrong. It was a GREAT start to the day. You know, one of those days where you're right on the edge of falling apart or not giving a *!@#...it could go either way. 

Step 1: Questioning

So after dealing with an epic temper tantrum throw down at daycare drop off, I climbed back into our minivan (infant in tow) and began the process of what I like to call "the mom spiral". For me, the mom spiral is not just a downward one; it's full of all sorts of fun ups and downs. Mom spirals may be different for everyone and have different triggers, but for me it usually goes like this: step one is an incident resulting in me questioning a parenting choice (big or small). 

Step 2: Indecision

I am wracked with indecision over what I should or should not have done, could have done better or should have known better about.  Step two almost always involves some aggressive Googling; and, even though I am always the first to advise my other mom friends to NEVER Google something when in this state of mind…I of course ignore my own advice and type on.

“Hmmmm maybe someone else has gone through the same thing,” I think to myself.  

This quickly turns into “I must have done something that contributed to my child behaving this way”, or, my favourite, “how could I not have known that when it seems that all these other moms in this forum from 2011 knew about it.”

Either way, it is not often a constructive use of my time and definitely allows my mom spiral to continue. 

Step 3: Mom Guilt

This part of the mom spiral is the most draining and consuming. Unfortunately, this is the part of the mom spiral that I find myself stuck in and obsessing over the longest.  

Step 4: The Punishment

Since I clearly don’t have it together I guess I better punish myself with tasks, errands and chores. I often catch myself in this pattern where I keep busy with “things to do”. These are things that I have decided HAVE TO GET DONE now. As a result, anything else that I had planned for myself must wait. 

Once I’ve spent some time trying to run away from these feelings of self-doubt and mom guilt through obsessive multitasking it's time for…

Step 5: Exhaustion

I stop for a moment and look around only to realize that maybe I overreacted. 

How do I escape the "mom spiral"? 

Step 6: Commence Pep Talk

Ok breathe…don’t be silly. You’re not a bad mom. There is nothing you could have done differently. You did the best you can. A few years from now you won’t even remember this and more importantly neither will the kids. They will remember you being happy. They will remember you having confidence in yourself and encouraging them to do the same. They will remember you leading by example and picking yourself up after a bad day. They will learn to be kind to themselves if they see you being kind to yourself. So, yup, today was a bad day. I got yelled at by my toddler in public and had to make an impromptu performance of my parenting skills in front of some daycare parents and a few pedestrians. I got to take a spin on the "mom spiral". But it's ok. Tomorrow is another day and until then I am going to lean into the moments of joy, hug my kids a little harder at the end of the day and go to bed with a full heart ready for a fresh start.

Does the pep talk always work? No, of course it doesn't.  But I have always found remembering my successes as a mom helps a lot. So does a good cry.

If any of you moms out there have encountered “the mom spiral” or perhaps have dealt with your own version of it, please know that you are not alone. And the next time you are out and about and see another mom who is maybe having a bad day, send a little smile their way so they know they are not alone either. A little smile goes a long way on a bad day.

xo Adrienne

Adrienne MacDonald, Postpartum Doula

I am a mother of two children, two dogs, one horse and a cat.  I am currently completing my Postpartum Doula certification through Doula Training Canada and am fully insured as a postpartum doula in training. Some previous work experience that I bring into this new role includes many years volunteering in crisis intervention with Victim Services as well as a career as a legal assistant, where I learned both compassion and professionalism.

New parenthood can feel both exciting and overwhelming. Nothing can prepare us for this journey. Sometimes, the only way to get through the day is with the help and support of others. Some of my best and most valuable postpartum experiences were receiving the support and encouragement of another person when I was feeling vulnerable. It is through these moments that my passion for helping others navigate the postpartum period emerged.

I believe that when it comes to parenting, there are often 100 different ways of doing the same thing.  It’s our job as parents to choose what works best for our family, and it’s my job to provide you the support you need to make safe and healthy choices that help you achieve your goals during the postpartum period.