Remarks

• The Guideline Development Group (GDG) highlighted that the current recommendation is applicable in the context of prevention of functional postpartum constipation, defined as infrequent, hard, dry or bulky stools that are difficult or painful to pass, or a feeling of incomplete evacuation or obstruction. This recommendation does not apply to chronic constipation and acute constipation associated with other organ dysfunctions (i.e. acute gastrointestinal dysfunction).
• In making this recommendation, the GDG considered a stepwise approach for the prevention and treatment of constipation in the adult population, where the use of laxatives is only applied if dietary modifications or fibre supplementation fail to relieve the constipation. The GDG suggested that this approach be applied in the immediate postpartum to stimulate first maternal bowel movements after childbirth and through the entire postnatal period, after both vaginal and caesarean birth.
• All women should be asked about their bowel movements during their postpartum stay in health facilities, and at each postnatal care contact, and should receive dietary advice and information on factors associated with constipation as per Recommendation 12 in this guideline.
• The GDG agreed that further investigation on the effects of routine use of laxatives for preventing constipation in postpartum women is not a research priority.