Maybe it started with a streak in your underwear that you couldn’t explain. Maybe gas became harder to control, or you began getting the urge to go with only a few seconds to find a bathroom. If these changes appeared after you had a baby, or even years later, you may wonder whether the two are connected.

They can be. Pregnancy and childbirth can contribute to bowel leakage, particularly when delivery affects the muscles or nerves involved in bowel control. Obstetric anal sphincter injuries and births assisted with forceps or a vacuum are recognized risk factors.1,3 However, childbirth isn’t the only possible cause. Diarrhea, constipation, other health conditions, medicines, and previous surgeries may also play a role.4,6

7% to 15%

of women living in the community are estimated to experience fecal incontinence, yet many don’t report their symptoms or seek care.1

What Can Bowel Leakage After Childbirth Look Like?

Fecal incontinence, also called bowel incontinence or accidental bowel leakage, can involve more than a complete loss of bowel control. You may first notice that gas is harder to control. You may find a small stain in your underwear, feel a sudden urge that’s difficult to hold, or leak liquid or solid stool.4

Bowel leakage after childbirth may look like:

  • Staining or small smears on your underwear
  • A sudden, strong urge that’s difficult to hold
  • Leaking stool without feeling it happen
  • Difficulty controlling gas
  • Leakage that happens mainly when your stool is loose

Healthcare providers often describe two patterns of bowel leakage:

Urge incontinence

You feel the need to have a bowel movement but can’t reach a toilet in time.

Passive incontinence

Stool or mucus passes without you realizing it.4

You don’t need to know which type you have. Before your appointment, simply describe what happens, whether you feel an urge beforehand, and how often you notice it.

Why Can Bowel Leakage Happen After Childbirth?

Bowel control depends on several parts of your body working together:6

Part of the BodyIts Role in Bowel Control
RectumHolds stool before a bowel movement
Pelvic-floor musclesSupport the bowel and other pelvic organs
Anal sphincter musclesHelp keep the anus closed
NervesHelp you sense when the rectum is filling and tell the muscles when to tighten or relax

Pregnancy and childbirth can affect these muscles and nerves in different ways. Two recognized risk factors are an obstetric anal sphincter injury, which is a childbirth-related tear involving the muscles that help control stool, and an assisted vaginal delivery using forceps or a vacuum.3,6

Having one of these risk factors doesn’t mean vaginal delivery will always lead to bowel leakage or that someone made the wrong decision during labor. More than one factor may be involved, and your symptoms alone can’t show exactly what’s causing the leakage.6

Perineal Tears and Anal Sphincter Injuries

The perineum is the area between the vaginal opening and the anus. Tears in this area can happen during vaginal delivery and are classified by how deeply they extend.

Third- and fourth-degree tears are known as obstetric anal sphincter injuries.2,3

Third-degree tear

Extends into the anal sphincter, the ring of muscle that helps keep the anus closed.3

Fourth-degree tear

Extends through the sphincter and into the lining of the rectum.3

Severe perineal tears are estimated to occur in approximately 4.4% to 11% of vaginal births, although rates vary among studies and populations.3 These injuries are associated with a higher risk of bowel or bladder leakage, pelvic-floor problems, pain, and sexual difficulties.2,3

Not sure what type of tear you had? If you know you had a third- or fourth-degree tear, mention it to your healthcare provider. If you aren’t sure, ask whether the details are included in your delivery record.

Can a Repaired Tear Still Matter Later?

Yes. Repairing the tear is an important part of care, but the earlier injury may still be relevant if you develop bowel symptoms later.6

That doesn’t necessarily mean the repaired tear is the only cause of your leakage. Changes in the anal sphincter, nearby nerves, stool consistency, or other health factors may also be involved. Your provider can consider all of these possibilities rather than assuming one factor explains everything.6

Can Symptoms Begin Months or Years Later?

Quick answer: Yes. Bowel leakage after childbirth doesn’t always begin during the first few weeks after delivery.

Some anal sphincter injuries are recognized right after childbirth, but bowel urgency or leakage may not become noticeable until later. Changes related to aging or menopause, pelvic-organ prolapse, obesity, and other health factors may also contribute. This can make it difficult to know how much an earlier delivery is affecting your symptoms now.6

One study followed women with and without an obstetric anal sphincter injury for 12 years after delivery to examine long-term fecal incontinence symptoms.7

If you develop bowel urgency or leakage for the first time years after giving birth, tell your provider about your childbirth history. It may be part of the picture, even when your symptoms are new.

What Else Can Affect Bowel Control?

Even if your leakage began after having a baby, childbirth may be only part of the picture. Your stool consistency, health history, medicines, and other conditions can also affect bowel control.4,6

Loose or Watery Stool

Loose or watery stool fills the rectum quickly and is harder to hold than formed stool. You may notice leakage only when you have diarrhea or a sudden need to use the bathroom.4

Constipation

It may seem backward, but constipation and bowel leakage can happen together. Watery or softer stool can sometimes build up behind hard stool and leak around it.4

Previous Surgery or Injury

Surgery involving the anus, rectum, or pelvic area may affect the muscles or nerves involved in bowel control. An injury near the anal area can also contribute.4,6

Nerve or Health Conditions

Diabetes, multiple sclerosis, stroke, spinal cord injuries, and other conditions that affect the nerves may change how well you sense or control a bowel movement.4 Some medicines and supplements may also affect your stool consistency or urgency.6

Bleeding or other bowel changes

Contact a healthcare provider promptly if you notice rectal bleeding along with bowel leakage. Changes in your bowel habits, increasing urgency, or mucus drainage may also need further evaluation.6

Who Should You Talk to About Postpartum Bowel Leakage?

You can start with your OB-GYN, primary care provider, or another provider who knows your health history. If you recently gave birth, you can also begin the conversation with your obstetric care team.1,6

Depending on your symptoms and the care available in your area, you may be referred to one or more specialists involved in digestive or pelvic-floor care:6

SpecialistWhat They Focus On
GastroenterologistThe digestive system
Colorectal specialistConditions involving the colon, rectum, and anus
UrogynecologistPelvic-floor conditions
Pelvic-floor physical therapistEvaluating and treating the muscles involved in bladder and bowel control

You probably won’t need to see all these professionals. The provider you start with can help determine whether a referral would be useful.

You also don’t have to wait for a scheduled postpartum checkup or until the leakage becomes severe. New, continuing, or worsening symptoms are worth discussing, especially when they begin to affect your work, exercise, sleep, travel, relationships, or other daily activities.4

Words That Can Help You Start

The first sentence may be the hardest part. Something short and direct is enough:

“I’ve been having trouble controlling my bowels since I gave birth.”

Then describe what’s been happening:

  • Is it staining, liquid stool, or solid stool?
  • Do you feel a sudden urge first, or does leakage happen without warning?
  • Is gas harder to control?
  • Do you tend to have diarrhea, constipation, or both?
  • When did the leakage begin, and has it changed over time?

These details match the questions providers commonly ask when evaluating bowel leakage.5 The more specific you can be, the easier it is for your provider to understand the pattern.

What to Bring Up About Your Delivery

Before your visit, write down:2–4

  • Any perineal tears or stitches
  • A third- or fourth-degree tear
  • An episiotomy
  • A delivery assisted with forceps or a vacuum
  • When the leakage began in relation to the delivery

Also note any previous pelvic, anal, or rectal surgeries, and bring a list of the medicines and supplements you take.6

If you have time, keep a simple stool diary for several days. Record when you have bowel movements, what the stool is like, whether leakage occurs, and whether you feel an urge beforehand. A bowel diary can document the frequency and severity of leakage episodes and may help your provider assess symptoms over time.5,6

Download the StaySure® Bowel Assessment Guide to organize information you may want to discuss with your provider.

What Might Your Evaluation Include After Childbirth?

Your provider will likely begin by asking about the leakage itself. They may ask when it began, how often it happens, whether you feel an urge beforehand, and whether it involves staining, liquid stool, or formed stool. They may also review your delivery history, bowel habits, medicines, previous surgeries, and other health conditions that could be contributing.5,6

A physical exam may include looking at the area around your anus and performing a digital rectal exam. During this exam, your provider inserts a lubricated, gloved finger into the rectum to assess the muscles, check for hard stool, and look for injuries or other concerns. Depending on your symptoms and history, the evaluation may also include a pelvic exam.5

If your provider needs more information, they may recommend specialized testing:

Endoanal ultrasound

Uses a small probe placed in the anal canal to create images of the anal sphincter muscles. It can help identify a sphincter injury, particularly if you’ve had a vaginal delivery.6

Anorectal manometry

Uses a narrow, flexible tube to measure how well the anal muscles and rectum are working, including muscle pressure, rectal sensation, and the rectum’s ability to hold stool.5,6

Good to know: You may not need either test. Specialized testing is considered when the results could help your provider better understand your symptoms or guide your care.6

What Can Help With Bowel Leakage After Childbirth?

Treatment depends on what’s contributing to your symptoms, how often leakage happens, what you’ve already tried, and your health and goals.6 Your plan may include one or more of the following:

OptionWhat It May Involve
Improving stool consistencyDietary changes, fiber, or medicine changes may help when diarrhea or constipation is involved. Talk with your provider before changing medicines, supplements, or fiber.6
Bowel trainingA planned routine may help you empty your bowels more completely or make bowel movements more predictable.6
Pelvic-floor physical therapy and biofeedbackGuided exercises and sensor-based feedback may help improve muscle awareness, strength, or coordination.6
Management products and prescription devicesSome options contain leakage after it happens, while others are designed to help prevent or manage it.6,8
Procedures or surgerySacral nerve stimulation or anal sphincter repair may be considered when other approaches haven’t helped enough.6

What works best for you will depend on the cause of your leakage. For example, leakage connected to loose stool may need a different approach than leakage related to an anal sphincter injury.6

Could StaySure® Help You Manage Ongoing Leakage?

Treatments such as pelvic-floor therapy or changes to your bowel routine may address specific factors contributing to leakage. Even with treatment, you may still want more protection from unexpected accidents during your day.

StaySure® is a prescription option for adults with accidental bowel leakage. It’s a soft, flexible silicone insert that you place using a disposable applicator. Once in place, it helps stop stool from leaking out before an accident happens. You can wear it for up to 24 hours or remove it before a bowel movement. It may also come out naturally during a bowel movement.8

Your healthcare provider can review your symptoms, medical history, and current treatments to help determine whether StaySure® may be an option for you.

Ready to talk with your provider?

If bowel leakage is still affecting your daily life, tell your provider what you’ve tried and where you still need help. Ask whether another treatment or symptom-management option, including StaySure®, may fit your needs.

StaySure® requires a prescription. If your provider agrees it may be appropriate for you, the next step is to request an evaluation kit.

Request a StaySure® Evaluation Kit See How StaySure® Works

StaySure® is available by prescription. Read answers to common StaySure® questions or review the current Instructions for Use for complete product and safety information.

Frequently Asked Questions

Is bowel leakage normal after childbirth?

Bowel leakage can happen after pregnancy or childbirth, especially when delivery affects the anal sphincter, pelvic-floor muscles, or nearby nerves.1–3 However, continuing leakage shouldn’t be dismissed as a normal part of recovery. Talk with a healthcare provider if it continues, worsens, or affects your daily life.

Can a perineal tear cause bowel incontinence?

Yes. A third- or fourth-degree tear affects the anal sphincter and can increase the risk of bowel leakage and other pelvic-floor problems.2,3 However, a previous tear may be only one factor contributing to your current symptoms.

Can bowel leakage begin years after childbirth?

Yes. Bowel leakage can begin years after delivery. An earlier sphincter injury may play a role, along with aging, menopause, pelvic-organ prolapse, stool consistency, obesity, or other health changes.6

Which doctor should I see for bowel leakage after giving birth?

Start with your OB-GYN, primary care provider, or another provider you trust. If needed, they may refer you to a gastroenterologist, colorectal specialist, urogynecologist, or pelvic-floor physical therapist.1,6

Can pelvic-floor therapy help with bowel leakage?

It may help some people improve muscle awareness, strength, and coordination.6 Whether it’s right for you depends on what’s causing your leakage and how severe your symptoms are.

What if my current treatment hasn’t provided enough protection?

Tell your provider what you’ve tried, what’s improved, and where you still need help. Your current plan may need to be adjusted, or another treatment or symptom-management option may be available. Depending on your needs, that conversation may include a prescription device such as StaySure®.8

This article is for general education and isn’t a substitute for medical advice. Talk with a qualified healthcare provider about your symptoms.

References

  1. American College of Obstetricians and Gynecologists. (2019, April). Fecal incontinence (Practice Bulletin No. 210). https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2019/04/fecal-incontinence 
  2. American College of Obstetricians and Gynecologists. (2018, September). Prevention and management of obstetric lacerations at vaginal delivery (Practice Bulletin No. 198). https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2018/09/prevention-and-management-of-obstetric-lacerations-at-vaginal-delivery
  3. Freeman, M., Rich, N. G., Hickman, L. C., & Propst, K. (2025). Obstetrical anal sphincter injury: Counseling for future deliveries. American Journal of Obstetrics and Gynecology, 233(5), 345–352. https://doi.org/10.1016/j.ajog.2025.06.037
  4. National Institute of Diabetes and Digestive and Kidney Diseases. (2017, July). Symptoms & causes of fecal incontinence. Retrieved September 7, 2026, from https://www.niddk.nih.gov/health-information/digestive-diseases/bowel-control-problems-fecal-incontinence/symptoms-causes
  5. National Institute of Diabetes and Digestive and Kidney Diseases. (2017, July). Diagnosis of fecal incontinence. Retrieved September 7, 2026, from https://www.niddk.nih.gov/health-information/digestive-diseases/bowel-control-problems-fecal-incontinence/diagnosis
  6. Bordeianou, L. G., Thorsen, A. J., Keller, D. S., Hawkins, A. T., Messick, C., Oliveira, L., Feingold, D. L., Lightner, A. L., & Paquette, I. M. (2023). The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of fecal incontinence. Diseases of the Colon & Rectum, 66(5), 647–661. https://doi.org/10.1097/dcr.0000000000002776
  7. de Rham, M., Tarasi, B., Lepigeon, K., Achtari, C., & Baud, D. (2024). Evaluation of fecal incontinence after obstetric anal sphincter injury: A 12-year follow-up cohort study. American Journal of Obstetrics & Gynecology MFM, 6(10), Article 101461. https://doi.org/10.1016/j.ajogmf.2024.101461
  8. Minnesota Medical Technologies Corporation. (2025, August). StaySure® fecal incontinence insert: Instructions for use (Document No. 540002[R6]). https://www.staysuretoday.com/uploads/userfiles/files/documents/120133-StaySure-Instructions.pdf