Whether you have a vaginal birth or a caesarean birth, your bladder and bowels may take some time to ‘wake up’ after birth. Your midwife will ask about their function regularly as part of their assessment of your recovery.
It is important to stay well hydrated after birth, as this helps to discourage constipation and keeps your bladder working well. It is normal to pass urine very often in the first week after birth, as your body offloads the extra blood plasma that it made during pregnancy.
Bladder care after a vaginal birth
It may take your bladder several hours to ‘wake up’ and signal that you need to empty it, but it is important to empty your bladder regularly even before those signals start to come through well. When you first get up to shower after birth, it is important to pass urine (either on the toilet or in the shower, where it might sting a bit less if you have any grazes or tears).
You should aim to empty your bladder every couple of hours until you regain the normal sensation of needing to pass urine. If you have not passed a normal amount of urine within four hours of having your baby (either none at all or very small amounts), please alert the staff if you are in a birthing facility, or call your midwife.
Bladder care after vaginal birth with an epidural and indwelling urinary catheter, or after a caesarean birth
Your indwelling urinary catheter will be removed when you have regained enough sensation in your lower body to safely get up to the toilet. This is sometimes called a trial removal of catheter (TROC). Once your catheter has been removed, you will need to measure two voids of more than 200mL within six hours. If you are unable to do this, the obstetric team at the hospital will review you to make sure your bladder is not too full, and may recommend an in/out catheter or a reinsertion of an indwelling urinary catheter for a while.
For more information about urinary catheters, Healthify has this page available.
Bladder issues after any kind of birth
Whether you had a vaginal birth or a caesarean birth, the muscles surrounding your bladder are affected. The hormones of pregnancy relax the muscle that controls your bladder, and the weight of your pregnancy can weaken your pelvic floor muscles.
Additionally, if you have a vaginal birth, the bladder is displaced upwards as you push your baby out, stretching the urethra and sometimes bruising it.
As a result of these hormonal changes and any damage to your pelvic floor, you may have problems with stress incontinence beginning in later pregnancy or after birth. Stress incontinence is when you leak a bit of urine when you cough, laugh, sneeze, lift something, walk, or put stress on your pelvic floor in similar ways.
If you have problems with urinary incontinence after birth, please tell your midwife. They can refer you to a pelvic floor physiotherapist who can help.
Bowel care after any kind of birth
No matter how you birth, your digestion is somewhat slowed after birth, either by the hormones of labour or the body’s response to surgery. Needing opioid pain relief, such as tramadol or sevredol, slows your digestion further. As a result, you may not pass a bowel motion for a few days after you have your baby.
Your midwife will ask about your bowel habits as part of their regular top to toe assessment of your wellbeing. If you have had a caesarean, the nurses and/or midwives on the postnatal ward will also ask regularly about your bowels, and whether you have passed any wind, as this is an important marker that your bowels are beginning to function again.
If you have not passed a bowel motion within about three days of birth, or it starts to feel uncomfortable, please let your midwife know. They can prescribe medications to help your bowels move. It can feel embarrassing to talk about, but it is a very important part of postnatal care! If your bowels do not regain function properly, then it can cause serious complications.
If you find that you are leaking faeces, it is very important that you let your midwife know, especially if you had a vaginal birth, as this can be evidence of an undiagnosed serious tear. Even if you birthed by caesarean, it is important to tell your midwife, as they can provide support and refer you for help.