What terrifies a mom-to-be more than pushing a 6-to-8-pound person out of her vagina? Pooping at the very same time. "It was all I could think about with my first pregnancy!" admits Lauren Smith, a mother of two in Palm Bay, Florida. "Throughout active labor, I kept asking my husband if I was pooping. He reassured me that, no, I wasn't, but I felt like he was lying! I couldn't focus on breathing or listen to what my body was trying to tell me. I was fixated and terrified that I was pooping."
Think Smith is extreme? Not so much. The fear of pooping during labor "comes up nine times out of ten — at least!" says Marie Bigelow, a staff doula at Boise Women's Health & Birth Center in Idaho. "And having a bowel movement during pushing is extremely common."
So stop obsessing, mama! Here's what you need to know about the pushing-and-pooping connection.
Why Do We Poop While in Labor?
There's a simple reason: The very same muscles that you engage when you're having a bowel movement are the same ones you use when you're pushing, says Bigelow. Plus, when you're in labor, you have extra pressure on your colon and rectum from the weight of the baby moving through the birth canal. (Think of your colon as a tube of toothpaste. Baby squeezes out any poop left in the lower part of the tube as he or she exits.) "It's the perfect recipe for pooping during labor," she says.
Adding to your poop probability: prostaglandins. These hormones are naturally involved in normal bowel function, says Jason James, M.D., chairman of the ob-gyn department at Baptist Hospital of Miami, but "they're also the main hormones implicated in the initiation of labor. In fact, some prostaglandins are used to induce labor."
Can I Prevent This?
Not really. But you might naturally have a bowel movement before the final stage of labor, which reduces the amount of stool in the colon that would come out while pushing, says Katie Page, a Certified Nurse-Midwife in Forest, Virginia. (This is thanks, once again, to the release of prostaglandins.) That's what happened to Stafford, Virginia, mom and children's book author Sandra Magura. "I was so grateful that my body decided to get rid of everything first, because I was so afraid of pooping during labor," she says. Whether you're allowed to get up to use the bathroom at the pre-push stage of the game, however, depends on whether you have an epidural and on your health-care provider. "Some hospitals and providers don't encourage it, but in my practice, the clients are up and out of bed unless they have a major pregnancy problem that it is harmful to her or the baby. And If you feel like you have to poop and it's not a baby's head coming out, you can go to the bathroom and see what happens," says Page.
Some docs still promote pre-labor enemas to clear the way, but it's no longer standard practice. In fact, the routine use of enemas during labor is now discouraged, according to a 2013 Cochrane review, which is a systematic review of several studies on the subject. The report notes that these types of enemas didn't show benefit to laboring women. Yet some doctors still recommend them for the psychological benefit they may have with patients.
Do Epidurals Increase My Chance of Pooping?
Not really. But if you have an epidural you won't feel the sensation of needing to empty your bowels. "If there is stool in the rectum, it is going to come out one way or another as you push the baby through the birth canal," says Dr. James. "With an epidural, you may be more relaxed and stool may pass on its own, or the stool may simply be released as you push."
What Will My Doctor Think?!
"A lot of my patients have this fear," says Dr. James. "But they should all know that, as an obstetrician, I'm very accustomed to patients moving their bowels while pushing — and it doesn't bother me at all. It's just a fact of life and part of the whole process." What does bother Dr. James — and other birthing pros — is that the fear of pooping can inhibit pushing effectively. "Resisting that urge, or trying to fight what your body is doing, can make the pushing part of birth particularly miserable, and may even increase the time of pushing," says Page. "I understand that women are afraid of the smell, worried about what family members may think, or especially worried about having a BM in front of their partner, but your body will eventually have the uncontrollable urge to push, so you can't be inhibited forever!"
As for Lauren Smith, she barely gave pooping-while-pushing a thought her second go-round in the delivery room. "It was the least of my concerns," she says. "Since I knew what to expect, I didn't psych myself out as much. Instead, during hard labor, I made sure to have a focal point and simply let my body do what came natural…even if that involved pooping."
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