Whatever you want to call it, everyone goes #2, poops, or has a bowel movement. Spoiler alert, yes, it is true that this could happen during labor. Let me spare you having to Google this and sift through message boards of expecting moms horrified at this thought. This is the truth about pooping during labor. This article discusses the possibility of pooping during labor, if it happens to everyone, and whether you can avoid it.
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Bowel Movements Before Labor
As your baby and your body get ready to go into labor there is so much going on internally. Your placenta triggers an increase in prostaglandins. These can affect your body similar to the way hormones do. In pregnancy, prostaglandins released help to soften the cervix to prepare it for effacing and dilating and help your uterus to contract. Some of the medications used to induce labor are prostaglandins. Like your uterus, your bowel is a smooth muscle and can also be stimulated by prostaglandins. This stimulation makes it common to have a bowel movement and loose stools before your labor starts or in early labor. The plus side of this is this helps empty your bowels in the first stage of labor, before birth.
Once you are at 10 centimeters and you start pushing you are in the second stage of labor. There are a couple of reasons why you may have a bowel movement during this stage of labor.
The mechanisms of pushing is very much like making a bowel movement. You are bearing down and using many of the same muscles to push your baby out that you use when you are having a bowel movement. Your bowel runs alongside your birth canal and during this stage, as your baby is traveling through the birth canal they can put pressure on your bowels. Both of these conditions are the reason why many women do poop a little bit during labor.
The Up Side of a Bowel Movement During Labor and Birth
You may be freaked out reading this but there are some positives to this. If you do poop during labor that is a good sign that you are using the right muscles to push your baby out. Another possible benefit is that this exposing your baby to bacteria. This may sound bad on the surface and there is still a lot we do not know about the science of bacteria and the microbiome. In utero your baby’s intestines are sterile and the bacteria they are exposed to at birth help to colonize their intestines. Babies born via cesarean are not exposed to vaginal bacteria or bacteria from fecal matter and in recent years there has been some research on exposing newborns being born via cesarean to vaginal bacteria with a procedure called vaginal seeding.
This study included 18 infants, and 11 of these were born via cesarean. Of those 11, researchers took four of those and put a piece of sterile gauze in the mother’s vagina prior to her having a cesarean section and after the baby was born the gauze was used to swab their mouth, face, and bodies. Bacteria samples were taken at six points during the first 30 days after birth and the babies who were swabbed with the gauze had a bacteria profile much more like the babies born vaginally than the others born via cesarean.
Of course, this study was taking bacteria from the vagina and not fecal matter. We are a long way away from making this a standard practice and some doctors have expressed concerns about transferring infections like group b strep. The point is that not all bacteria are bad and in a vaginal birth your baby is exposed to all kinds of bacteria from your vagina and potentially fecal matter.
How Common is It?
I tried to find some statistics on how many women have a bowel movement during labor. I couldn’t find any solid number. From interviews with doctors, midwives, and nurses, it is safe to say, the majority of women in labor do have a bowel movement at some point. Keep in mind we are not talking about a big volume of fecal matter.
One of the criticisms of water birth is that the water can be contaminated with fecal matter. From the research I have read I have not seen solid evidence that this is a big concern. If you are planning a water birth and this happens in the tub someone will fish it out of the water. Chances are this will happen without you even being aware of it. If you are not birthing in water and you do have some fecal matter on the bed or wherever you are birthing someone will just wipe it away and remove it.
What You Should and Should Not Do
For a lot of expecting moms pooping during labor is a horrifying and embarrassing thought. The truth is that it is not a big deal. Doctors, nurses, doulas, and hospital staff see this all of the time. They are very discreet. They will dispose of it and are not going to announce it or make a big deal out of it. For some expecting moms, it isn’t helpful to hear that it is not a big deal and not to worry about it. What can be helpful is some dos and don’ts. There is a lot of terrible advice on the internet around this topic. I want to give you the truths about what you should and should not do.
Do Not Limit Food and Liquids
Please do not cut yourself off from solid food leading up to your labor. Eating during labor was banned in a lot of hospitals for a long time and thankfully there is evidence that eating during labor is safe and beneficial. Labor is hard work and it can be a marathon. You need energy for your labor and eating can help with that.
Do Not Use Castor Oil
It is not a good idea to use castor oil prior to labor to try and clear out your bowels. Castor oil is probably the most controversial method of naturally inducing labor. Castor oil is a stimulant laxative and works by increasing the movement of the intestines. Since the intestines are smooth muscle in close proximity to the uterus, which is also a smooth muscle, the intestinal cramping can spread from the bowels to the uterus and cause contractions. In one study castor oil as used to induce labor had no effect on time in labor. Overall, the findings leave no justification for recommending castor oil for this purpose. The downside of using castor oil is nausea, diarrhea, and dehydration. All symptoms you do not want to be dealing with when you are in labor.
Do Not Give Yourself an Enema
For decades it was common or even routine practice to administer an enema to a woman before birth.
There were several reasons this was thought to be beneficial beyond reducing the chances of a bowel movement during labor. Practitioners thought an empty bowel would give more room for the baby to be born. They thought it would reduce the length of labor. Plus, they thought an enema would reduce the chance of infection for both the mother and the baby. It turns out this practice does not accomplish these goals.
A meta-analysis that included four randomized controlled trials shows that enemas do not have a significant beneficial effect on infection rates such as perineal wound infection or other neonatal infections and women’s satisfaction.
All of the evidence in at least the last decade shows that enemas before birth or in early labor are not an evidence-based practice. While we have largely stopped doing this in US hospitals it is still common in other areas of the world. One study from a Turkish hospital showed rates of women getting enemas in early labor at over 80% and that was recent, just from five years ago. Well after there was evidence to support not making this a routine practice. In the Czech Republic, rates are just below 60%.
Pooping in Front of Your Partner
Chances are if you do have some fecal matter expelled during your birth it will be wiped or taken away before you or your partner would even know. Your partner’s focus is going to be on you and chances are they will not even know about it. If you are really concerned about this you can choose to have your partner at your head so they couldn’t see it if you did poop. You want to be comfortable and feel like you are in a safe space during your labor. If you are stressed out about pooping it could potentially impact your labor and you want to avoid that. Labor is intense and while it is easy to tell you not to worry about it, you can have your partner in a position at your head if it makes you feel better.
Do Talk to Your Doctor or Midwife
If you are still absolutely horrified at the thought of pooping during labor share your concerns with your doctor or midwife. Hopefully, they can help put your mind at ease. Will you poop during labor? Maybe. If you do, you probably will not even be aware of it. Your partner likely will not know, nor will anyone else who is with you during your labor. Your doctor or midwife would know but to them, it is just a normal part of the birth process, and I hope you can look at it that way too.
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