Whoever told you it’s unladylike to poop during labour is full of crap. (LOL.) You will, most likely, void a little while pushing, and you might actually feel like you need to take the biggest dump of your life—when in fact, that’s just your body’s way of saying the baby is coming out.
During labour with my first child, which came on fast and furiously at home, I ran to the toilet between every single contraction a couple minutes apart because I was convinced that if I could just relieve some of the pressure building up in my bowels then I could focus on all that labour and breathing stuff. It turns out of course that I was not actually constipated at the worst possible time. And yup, my baby was almost born on the toilet.
And what about all those stories you hear about women who actually do poop during labour?
“I tell my clients that almost every single person poops a little bit,” says Alix Bacon, a midwife in Richmond, BC, and the president of the Midwives Association of British Columbia. (She says the question comes up all the time.) “Childbirth is a goopy process. There's the mucus plug, bloody show, your waters releasing and continually draining, and often, a bit of poop.”
While it might sound somewhat embarrassing, there are more mortifying things than your body doing what it’s actually supposed to in order to get that baby out. Here’s what else you should know about making sh*t happen during labour:
First of all, you should expect to be pooping even before labour starts. In fact, diarrhea or loose bowel movements may be one of the early signs of labour in the couple days leading up to it, caused by the release of hormones called prostaglandins.
Then, during labour, the presenting part of the baby (usually the head) that’s leading the way through the birth canal presses the stretch receptors in the colon, stimulating the sacral nerve and sending the message to your brain that you need to poop, explains Bacon.
Usually this doesn’t occur until the baby is very low, but certain positions such as occipital posterior (when the back of the baby’s head is against the mother’s back) or breech (when the baby is positioned bottom or feet first), may cause this nerve to be stimulated prematurely.
There is also the fetal ejection reflex, caused by pressure on the cervix and vagina, which causes a desire to push. The combination of these factors results in the bearing down and relaxing of the anal sphincter, which helps bring down baby and any stool that’s in the rectum. It’s usually just a little poop—Bacon says to picture squeezing out the end of a tube of toothpaste.
Maybe your own mother or grandmother told you she was spared the "indignity" of pooping during childbirth by being given an enema to clear their bowels before labour (or maybe you've seen it on Call the Midwife). But this practice, while standard in generations past, is no longer considered helpful or necessary.
There’s a lot going on down there during labour, but many women can still feel it, even if they have an epidural. (Depending on the dose, an epidural doesn’t necessarily block the sensation of pressure.) “Or they can smell it,” says Bacon. Again, it’s not a big deal. The nurses or midwives will discreetly clean it up and gently wipe your bottom while they’re at it.
Nikki Jenkins,* a mom of three from East York, Ont., had an epidural with her last child and couldn’t feel much below the waist, but there were other tell-tale signs that it had happened. “I knew I had pooped because I let out this ginormous fart,” she says. “I was so embarrassed but my midwife just tried to reassure me.”
That OMG-I-have-to-poop sensation is actually very useful for knowing when the baby is ready to come out, says Bacon, and she encourages women to labour on the toilet if that’s what they feel they need to do. In fact, relaxing those pelvic muscles and pushing on the toilet is great practice leading up to the birth, too.
Rachel Johnson,* a mother of three in Toronto, says that even during her third labour, she was fooled by that pooping feeling. “The pushing phase was much shorter and more intense than my first two births. After a minute of pushing in the tub, I told my midwife that I must get out of the tub to get to the bathroom to poop,” Johnson recalls. “She calmly told me that the pressure I was feeling was the baby coming fast, and that either way, many people before and after me had pooped and will poop during labour, but I was adamant.” By the time she was sitting on the toilet, it was clear to everyone except her that the pressure was, in fact, the baby. “Finally, she took me by the shoulders, looked me in the eye and said, ‘Rachel, unless you want your baby to be born on the toilet, you need to stand up, and you need to stand up now.’ I barely made it back to the tub before the baby was born!”
This urge to sit and bear down during labor is a great argument for using a birthing chair or stool. Birthing stools have been used for hundreds of years but have been making a steady comeback since the 1980s, both in home births and hospital settings. Bacon says about half of her patients use them at some point during their birthing process. They’re great for providing upright support for birthing women in a more comfortable sitting or squatting position, as opposed to lying on their backs, and they’re designed with an opening in the centre of the seat so the baby can be caught by a midwife or OB without the labouring woman having to get up or move into into a bed.
It’s no joke that pregnant women—especially when it’s their first—are genuinely afraid of pooping during labour. But even in the middle of childbirth, women will apologize for it, which Bacon finds heartbreaking. “Even in the throes of pushing, some women become embarrassed and will start profusely apologizing,” she says. “It’s sad that it diminishes such an incredible feat they’ve accomplished, however they accomplish it. Giving birth is a hard-won prize.”
While some women may feel most ashamed in front of the birthing team, others can’t bear to think about their own partners seeing them poop. Jenkins admits her husband likes to joke around and remind her of it, but partners, take note: It is not OK to ever, ever tease a woman about what may—or may not!—have happened in that birthing room, or any of the dirty details. Bacon finds that if partners can’t handle what they might see down there, they’ll usually self-sort. “The ones who might be more grossed out stay away from where all the action is happening.”
It may be a... shitty feeling, but Bacon always reassures her birthing patients that they’re doing a great job, and that if they feel like they're having a bowel movement, then they are pushing in the right place, using the right muscles. Poop happens. Move on.
*Names have been changed.
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