Pooing During Labour

The honest answer about frequency

People want a number and there is not one. No UK or Irish national body — not NICE, not the NHS, not the HSE, not the RCOG — publishes how often a woman passes stool during the pushing stage. Sites that give you a percentage have made it up or borrowed it from a small study without saying so.

What can be said is that maternity staff describe it as ordinary and expected, and that the guidance describing the pushing stage is written as though it is a normal event rather than a complication.

Why it happens

It is anatomy, not a failure of preparation. The baby's head descends through the pelvis and presses on the rectum and the same nerve pathways that signal the need to open your bowels. Anything in the lower bowel is squeezed out ahead of the baby.

The NHS describes the sensation without euphemism: once the cervix is fully dilated and the baby moves down the birth canal, "you may get an urge to push that feels a bit like you need to poo. You can push during contractions whenever you feel the urge."

The Obstetric Anaesthetists' Association makes the same comparison when explaining what an epidural cannot always remove: "As you get closer to giving birth, you may feel strong pressure in your bottom or vagina. This can feel like needing to poo. Even if the epidural is working, this pressure can be hard to take away completely."

That is worth sitting with. The sensation you are afraid of is the same sensation that tells you it is time to push. They are not two things.

The urge is useful information

NICE treats the urge to push as a clinical signal, not an embarrassment. Its recommendations on the second stage use the presence or absence of an urge to push as one of the things that shapes what happens next — for example, for a woman with regional analgesia at full dilatation, pushing may be delayed unless she has an urge to push or the baby's head is visible.

The HSE's guidance on birthing your baby describes the same relationship between the urge, the contraction and the push. If you are told to follow your body, this is the part of your body you are being asked to follow.

What the midwife does

Very little, and quickly. Stool that appears is wiped away with a pad and removed, usually without comment. Midwives are positioned to see it before you feel it and their working assumption is that you would rather it were not announced.

If you would prefer to be told, or prefer not to be, that is a reasonable line for a birth plan. NICE asks staff to treat women in labour "with kindness, dignity and respect", to respect personal space and privacy, and to be aware of "the importance of both tone and demeanour and the actual words used". This is precisely the sort of moment those recommendations were written for.

Enemas, and why nobody offers one

Routine enemas and shaving before birth were standard in British and Irish hospitals for much of the twentieth century, and they are gone.

NICE's guidance on inducing labour makes a related point about enemas as a method of starting labour: the available evidence does not support herbal supplements, acupuncture, homeopathy, castor oil, hot baths, enemas or sexual intercourse for inducing labour. No current NICE recommendation asks for bowel preparation before a vaginal birth, and none of the NHS, HSE or RCOG public material on labour mentions one.

If you want to empty your bowels in early labour, you may well do so anyway — loose stools in the hours before established labour are a common and well-described part of the latent phase. That is your body clearing the way, and it is one reason many women pass nothing at all later.

What it does not affect

It does not increase your risk of infection for the baby, it is not a reason to change your birth position, and it does not mean you have pushed wrongly. It is not a reason to hold back from pushing, and holding back is the one thing that genuinely slows the second stage.

Nor does it have anything to do with continence afterwards. Problems controlling your bowels after birth are a separate matter, usually related to injury to the anal sphincter, and NICE asks midwives to assess bowel function at each postnatal contact. Passing stool while pushing tells you nothing about whether that has happened.

If you have an epidural

You may feel less, or nothing, or only pressure. The OAA notes that a working epidural often leaves the late pressure in the bottom and vagina in place, and that if the pressure is intolerable, the anaesthetist should be told rather than assumed to be powerless.

What an epidural does not do is remove the possibility. It just means you are less likely to be the person who notices.

Things that genuinely help with the worry

Say it out loud to your midwife when you arrive. Most will answer in one sentence and move on, which is usually all the reassurance the fear needs.

Choose a position you can actually push in rather than one that feels less exposing — upright, on all fours, side-lying. NICE asks teams to encourage women to adopt whatever positions they find most comfortable, except lying flat on the back.

And keep some perspective about the audience. Everyone in the room has seen it many times, on the same day, and will not remember yours by the end of the shift.

The first one afterwards

The bowel movement people should be warned about is not the one during labour but the one a few days later, when stitches, iron tablets, opioids and dehydration converge. NICE's postnatal guideline lists bowel function among the things assessed at every contact, and the practical measures — fluids, fibre, and laxatives where opioids are involved — are worth asking about before you leave hospital rather than after.