In plain words
The puborectalis is a pelvic floor muscle shaped like a sling around the back passage, the rectum. It helps hold stool in and then relaxes to let stool pass. After birth, pain in the can make the muscle guard and tighten when you try to have a bowel movement. This can make the stool harder to pass, and the stool can get harder the longer it waits. That is one reason first bowel movements after birth can feel frightening. Gentle, relaxed positioning and softer stool can help some mothers. can help when the muscle is not relaxing well. Ask your provider about it if pain or straining continues beyond the first weeks.
The deeper version
The puborectalis is the medial portion of the that forms a sling around the anorectal junction and maintains the anorectal angle. Dyssynergic defecation involves paradoxical contraction or failure of relaxation during attempted defecation, documented in the American Gastroenterological Association position statement on constipation (Bharucha and colleagues, Gastroenterology, 2013). Perineal and incisional pain produce reflex guarding, which can prolong retention and increase fecal water absorption. Pelvic floor physical therapy with biofeedback is a recognized treatment for dyssynergia. The main controversy concerns how commonly postpartum constipation reflects dyssynergia versus simple hard stool, and how to measure it.
Where it comes up
- The first poop, constipation, and hemorrhoids after birthPostpartum: Your Body
- Your pelvic floor after birthPostpartum: Your Body
- Healing a tear or stitchesPostpartum: Your Body
- Prolapse: heaviness, bulging, and what helpsPostpartum: Your Body
What mothers here say about puborectalis
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Sources
- Bharucha AE et al. — American Gastroenterological Association medical position statement on constipation. Gastroenterology (2013)
- American College of Obstetricians and Gynecologists — Committee Opinion 736: Optimizing Postpartum Care (2018)