labour and rectal pain - Mothering Forums
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#1 of 9 Old 10-24-2008, 05:21 AM - Thread Starter
 
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Background:

I was severely, severely constipated throughout my last pregnancy. I had hemorrhoids, rectal bleeding, the works.

Then at 39.5 weeks, my water started leaking (unrelated to the constipation). Labour did not start. After 72 hours, the midwife said that I had to be induced because there was a risk of infection. The morning that I was to be induced, I knew that the constipation was going to pose a problem during labour (it had been a number of days since I had gone number 2) and I asked the hospital staff for an enema. They told me that they "didn't do that". So no enema. They hooked my up to oxytocin (I think you call it pitocin in the States). 15 minutes of oxytocin was enough to start strong contractions three minutes apart. I had limited, completely manageable pain in the front, no back pain, and severe, severe, really really horribly severe pain in the rectum - like I was passing a bowling ball. I was totally unprepared for this type of pain, as everyone had described labour pain to me as being in the back or front. After one hour, I wanted the epidural. After they inserted the epidural, I asked for a higher dose. The pain was unbearable. My baby was born within three hours of inducing. The midwife was amazed that it took such a short time but there you go.

Strangely enough, not even the labour and birth pushed the fecal matter out of me. About two hours after the birth, I told the nurse that I needed to get up to go to the bathroom. She asked if I had to pee and I said no, it was to go number two. She said, "that's not possible. You just gave birth. Anything would have come out during the birth." But no, it was possible. It all came out two hours AFTER giving birth.

This time around, I plan to have a homebirth but I already know that there is absolutely no way that I will manage to stay home if I get that rectal pain again. It will end up in a transfer because I can't handle that rectal pain. I need to find a way to avoid it. So far this pregnancy, I have not been constipated as much, so I am hoping that maybe it just won't happen this time around. I am almost at 13 weeks, and last time around at 13 weeks, I was already really plugged up all the time, IYKWIM. BUT, I still want to do everything I can to avoid my last labour experience. So, some questions:

- how much of the rectal pain could be attributed to the fact that I was induced?
- what can I take when labour starts to ensure that my bowels are empty? I don't care whether it's natural or a drug, provided it doesn't hurt the baby.
- What else can I do to overcome any rectal pain?
- Any other advice.

Thanks.

Roman Goddess, mom to J (August 2004) and J (April 2009).    h20homebirth.gif signcirc1.gif
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#2 of 9 Old 10-24-2008, 07:43 AM
 
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There are a number of things that can cause/contribute to constipation for pregnant women--all of them able to be successfully addressed.

1. This is usually the worst culprit--iron supplementation. While taking some iron can be beneficial/necessary during pregnancy, the form of iron is very important. Ferrous sulfate is the worst, especially if you are ingesting more than about 20mg a day. The problem is that some iron supplements are not well-absorbed, and they bind in the bowel....the iron can't get into your body, but your bowels won't let much out! Ferrous gluconate and ferrous fumarate are not as bad for the bowels, but still can cause constipation. The least constipating forms of iron are herbal and plant based formulations, taken in doses of no more than about 30mg a day. Floradix is one product---there are others. I have found that whatever form of iron is used, it can be very helpful to supplement with Yellow Dock, which can be purchased as a powdered herb capsule, or in tincture form. Some of the herbal formulas contain YD already, btw. Yellow Dock has compounds that greatly aid the absorbtion of iron, and it also tends to loosen the stool a bit and promote good muscular activity in the bowels. I have used, and have clients that have successfully used YD by itself for iron deficiency in pregnancy--tho it only has a small amt of iron in it, it is just very effective in helping iron absorption from your food.

I won't go into all the possible forms of supplemental iron available, nowadays there are so many. I would look into this, though. Excess calcium supplementation can also cause constipation, but is not so likely as iron to cause the degree of constipation as you have mentioned. Making sure to get enough vit c can aid the absorption of both iron and calcium, tho--so that is something else to consider along with the forms of iron and calcium you might take. Often, the more generic brands of prenatal vitamins have the worst forms of iron and calcium where absorption is concerned. They also tend to have far more iron than you need--and too much iron ingestion in any form is not good.

2. You need plenty of fiber from both whole grains and fresh fruit/veg. Take a look at your diet, see if maybe you just weren't getting enough of these things.

3. Water/clear fluids--make sure you are getting plenty every day, at least 1/2 gallon. If it's hard for you to remember to drink enough, then get yourself a 1liter drinking bottle, fill it in the morning and bring it everywhere you go (even from room to room when you're home. Make sure you drink it all--even by little sips at a time--by midday, then refill it and drink the rest by bedtime.

4. Exercise--really really really helps with bowel efficiency and all body system functioning. Walking for 30min a day, or most days, can help a lot...or any other form of exercise you are willing to do. Chasing toddlers doesn't count! Nor does housekeeping. Needs to be 30 min of focussed exercise, just for you. Does not have to be aerobic/exerting, but should be as brisk as you can comfortably manage, not just a lazy stroll.

5. Calories--women who are not eating enough will get constipated. Review your intake, be sure it's enough--get help figuring this out if needed. When insufficient calories are moving through, the pregnant body tends to hold onto food, trying to wring every last everloving bit of energy and nutrients from it--leading to constipation.

Constipation--or at least, bowels that are slower moving than usual--is not so uncommon in pregnancy for various reasons including hormone action that tends to relax the smooth muscle of the bowel. However, it need not--and really, should not--be as much a problem as you have described. The above things--sometimes just one of them, sometimes a couple together--have never failed to ease constipation in the women I've worked with. Hopefully, your hbmw can help you sort through these possible issues, and help you make this pregnancy far different than the last one--which should make the next birth far less painful than your last one.

good luck
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#3 of 9 Old 10-24-2008, 02:33 PM - Thread Starter
 
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Thanks for the constipation advice. It's not as bad this time around, probably because I decided to forego the prenatal vitamins (I take separate folic acid supplements) and, as I am not working this time around, I get to exercise a lot more. Must remember about the water.

Is there anything I can take before the birth to clear my system, so to speak? A friend told me today that the fact that I was induced meant that might body never got the chance to clear itself, which normally happens at the start of labour. Is this right?

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#4 of 9 Old 10-24-2008, 04:57 PM
 
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Bowel clearing does usually occur prior to labor; for some, it's several pooping sessions in early labor, for others it's a process that takes place over the final days or weeks of pregnancy. I think the only reason you did not do this the first time, was due to your extreme constipation. I bet you will, tho, this time. But not all women do this clearing in a dramatic way, and as long as you're not constipated again, I wouldn't worry about it. If you do have trouble moving your bowels during the final weeks of pregnancy (chronic trouble, not just the occasional day), then you might want to do a plain water enema during early labor.
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#5 of 9 Old 10-24-2008, 05:23 PM
 
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Eating prunes or drinking real prune juice is a great natural laxative. You could try drinking that before birth?

I agree with the iron - if I take that I get horribly constipated, and I'm constipated enough during pregnancy, so I take one every 3 days as I do need a bit of supplement unfortunately.

I hope you find something that works, the rectal pain sounds awful!!!

good luck!

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#6 of 9 Old 10-24-2008, 07:03 PM - Thread Starter
 
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Quote:
Originally Posted by MsBlack View Post
Bowel clearing does usually occur prior to labor; for some, it's several pooping sessions in early labor, for others it's a process that takes place over the final days or weeks of pregnancy. I think the only reason you did not do this the first time, was due to your extreme constipation.
Could it also be because the labour was induced? i.e. my bowels did not get the chance to "clean themselves" and the major contractions started right away.

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#7 of 9 Old 10-25-2008, 03:27 AM - Thread Starter
 
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Just bumping this up for more comments.

Roman Goddess, mom to J (August 2004) and J (April 2009).    h20homebirth.gif signcirc1.gif
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#8 of 9 Old 10-25-2008, 07:19 AM
 
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As for pitocin--I can't really say. It could have played a part--but I think your constipation was the main culprit.
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#9 of 9 Old 10-26-2008, 10:28 PM
 
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I also had horrible "back end" pain during labor... it completely freaked me out! I had periods of constipation during pg, but nothing horrible or out of the ordinary. But during labor it was unreal! I couldn't sit down on anything but the toilet or one of those hemorrhoid-donut pillows. Laying was very uncomfortable.

During pushing I kept thinking that I was working to push out a bm.... Like "As soon as I get this poop out there will be room for the baby to come." I had no idea that I was actually birthing my son the whole time!

That weird rectal pain was the WORST. So disconcerting.

Just like you I had SROM, but labor never started on its own. I was given Pit after 24 hours.

Sleepy mama to Colin Theodore 8-12-08 and Trevor Arthur 7-17-12.

 

 

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