Anal incontinence postpartum

Written by Jessica McKinney, PT, MS and Samantha Pulliam, MD and sponsored by

You may have heard about the link between childbirth and urinary incontinence (or leakage) from family members, friends, or even the media, but other issues are less likely to be talked about. Fecal incontinence, including needing to rush to the bathroom to have a bowel movement or leakage of stool, impacts up to 6% of postpartum women.

The inability to control gas, also called flatal incontinence, is a more common complaint affecting 11 to 24% of postpartum moms. This condition can be embarrassing and have a significant impact on daily life. Accidental bowel leakage (ABL) refers to the unwanted loss of stool or gas, and one or both of these two issues may affect up to a quarter of new moms. Unfortunately, many women wait for years before talking to their health care provider about treatment options.

There are many factors that can cause ABL, including damage to the pelvic floor muscles, nerve damage, and scar tissue. Pregnancy and childbirth place stress on muscles, nerves and connective tissues of the pelvic floor and is a major risk factor for developing ABL. Researchers have identified certain risk factors associated with fecal incontinence (FI), specifically, in the postpartum period. They found that short-term FI in the first days or weeks postpartum was more likely to occur after a longer or more complicated delivery.

If you’re experiencing any symptoms of ABL, speak with your health care provider about treatment options. This may include or dietary modifications, such as adding supplemental fiber or eliminating certain foods that may irritate the gut. Pelvic floor muscle training and pelvic floor physical therapy can also help to strengthen the pelvic floor and sphincter muscles, so that you can better control your bowels. There are certain medications that can be helpful, and though usually a last resort, surgery may be indicated for some.

About the authors:
Ms. McKinney is a physical therapist and has specialized in pelvic and women’s health throughout her career. Her background includes women’s health education, advocacy, and business and program development in the US as well as in low-resource global health settings. She currently serves as Vice President of Medical Affairs and Clinical Advocacy at Renovia Inc. 

Dr. Pulliam a fellowship-trained and board certified urogynecologist, a subspecialty of medicine focused exclusively on female pelvic health. She has been in clinical and leadership positions at Massachusetts General Hospital and the University of North Carolina (Chapel Hill), as well as within the American Urogynecologic Society, and she currently serves as the Chief Medical Officer at Renovia Inc. 

  • Bharucha AE. Pelvic floor: Anatomy and function. Neurogastroenterol Motil. 2006;18(7):507-519. doi:10.1111/j.1365-2982.2006.00803.x.
  • Shin GH, Toto EL, Schey R. Pregnancy and Postpartum Bowel Changes : Constipation and Fecal Incontinence. Am J Gastroenterol. 2015;110(4):521-529. doi:10.1038/ajg.2015.76.
  • FernándezFraga X, Azpiroz F, Malagelada JR. Significance of pelvic floor muscles in anal incontinence. Gastroenterology. 2002;123(5):1441-1450. doi:10.1053/gast.2002.36586.

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