There’s no getting around it: That first postpartum poop must happen—and it can be a real pain in the butt. No matter what type of delivery you had, you might try anything to ensure a smooth experience, but a C-section may mean it could take even longer for your bowels to get back in action.
C-sections are the most frequent procedure requiring overnight hospital stays in the United States, according to the U.S. Department of Health & Human Services. A hospital stay is necessary, because abdominal surgery can cause your intestines to temporarily shut down their normal muscle contractions. These effects can last a few days, while causing considerable discomfort, bloating, vomiting, constipation, cramps and loss of appetite for a mama who just wants to go home after birth.
How chewing gum after a c-section can help
Several large metastudies involving thousands of women have found that mamas who chew gum after having a C-section are able to pass gas and poop sooner than those who did not chew gum.
Gum chewing is a form of “sham feeding,” which is an action that mimics normal eating, but no food or drink is actually digested or absorbed. It stimulates saliva production to reduce post-surgery dry mouth and can wake up your bowels to get things moving. Mamas who chewed gum were able to reduce the time it took to pass gas by more than 10.5 hours and to poop on average nine hours sooner. And in general, they were less uncomfortable during the process and had a shorter hospital stay.
The exact recommendations for gum chewing have not been established, and all the studies varied slightly regarding when mamas began to chew gum (right after their C-section or up to 12 hours later), how long they chewed the gum (from 15 to 60 minutes) and the number of times per day they chewed it (from three to more than six).
In addition to stimulating bowel motility, chewing sugar-free gum sweetened with sugar alcohols is particularly effective in speeding up your bowels and the time till you can head home from the hospital.
Finding this kind of gum is as easy as a trip to your pharmacy. Used to sweeten sugar-free gum, sugar alcohols xylitol and sorbitol are fermented by the gut bacteria in your intestines, which create more gas for you to pass. And they can pull water into your intestines to produce a laxative effect, hastening your need to poop and get the heck out of there.
It’s a safe, practical, inexpensive and well tolerated way to help mamas who have already been through a lot to feel a whole lot better.
Should you pack gum to chew after your c-section?
Even though gum chewing after a C-section is a noninvasive and drug-free way to reactivate your bowels, a few studies cautioned that for many other abdominal surgeries it is not risk-free, because the physical process of chewing has been shown to suppress short-term appetite that could reduce your desire to restart a normal diet, or there’s a possibility of choking.
Even when planned, C-sections are major surgery. No wonder your stomach decides to sit things out for a few days.
Related: A brief history of the C-section
All of the studies were classified as having a high risk of bias because most of the outcomes were self-reported, so more large-scale and high-quality randomized controlled trials are needed to confirm these results.
But until more robust studies are conducted, a post-op chew likely does no harm, so be sure to pack some in that go-bag, mama, because it can’t hurt.
Ahuja V., Macho M., et al. Biological and Pharmacological Potential of Xylitol: A Molecular Insight of Unique Metabolism. Foods. 2020 Nov 2;9(11):1592. doi:10.3390/foods9111592
Craciunas L., Sajid MS., Ahmed AS. Chewing gum in preventing postoperative ileus in women undergoing caesarean section: a systematic review and meta-analysis of randomised controlled trials. BJOG An International Journal of Obstetrics and Gynecology. 2014 Jun;121(7):793-9; discussion 799. Epub 2014 Mar 14. PMID: 24628729. doi/10.1111/1471-0528.12696
Lee JT., Hsieh MH., et al. The Role of Xylitol Gum Chewing in Restoring Postoperative Bowel Activity After Cesarean Section. Biological Research for Nurses. 2016 Mar;18(2):167-72. doi: 10.1177/1099800415592966.
Lepore M, Fitzgerald JE. Gum chewing is associated with early recovery of bowel motility and shorter length of hospital stay for women after caesarean section. BMJ Evidence-Based Medicine, 2015;20:22. doi.org/10.1136/ebmed-2014-110058
Mäkinen KK. Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals. International Journal of Dentistry. 2016;2016:5967907. doi:10.1155/2016/5967907
Mohsenzadeh Ledari F, Barat S, et al. Chewing sugar-free gum reduces ileus after cesarean section in nulliparous women: a randomized clinical trial. Iran Red Crescent Medical Journal. 2013;15(4):330-334. doi.org/10.5812/ircmj.6458
Noble EJ, Harris R, et al. Gum chewing reduces postoperative ileus? A systematic review and meta-analysis. International Journal of Surgery. 2009 Apr;7(2):100-5. doi.org/10.1016/j.ijsu.2009.01.006
Nygren J, Thacker J, Carli F, et al. Guidelines for Perioperative Care in Elective Rectal/Pelvic Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations. World Journal of Surgery 37, 285–305 (2013). doi.org/10.1007/s00268-012-1787-6
Pereira Gomes Morais E, Riera R, et al. Chewing gum for enhancing early recovery of bowel function after caesarean section. Cochrane Database of Systematic Reviews 2016, Issue 10. Art. No.: CD011562. doi/10.1002/14651858.CD011562.pub2/full
Salli K., Lehtinen MJ., et al. Xylitol’s Health Benefits beyond Dental Health: A Comprehensive Review. Nutrients. 2019 Aug 6;11(8):1813. doi:10.3390/nu11081813
Short V, Herbert G, et al. Chewing gum for postoperative recovery of gastrointestinal function. Cochrane Database of Systematic Reviews 2015. Issue 2. Art. No.: CD006506. doi:10.1002/14651858.CD006506.pub3/full
A version of this story was published Oct. 1, 2021. It has been updated.