Black stool after delivery: what to know

Iron tablets commonly prescribed after childbirth can make bowel movements dark. That colour is usually more uniform and is not necessarily sticky or tar-like. Black, tarry stool can instead represent digested blood from the upper digestive tract. Gastritis, a peptic ulcer or Helicobacter Pylori Infection may be involved, although the stool colour alone cannot identify the cause. Post-delivery vaginal bleeding can also be confused with blood seen on toilet paper, so note where the blood appears and whether it is mixed with stool.

Check the name and timing of any iron or bismuth medicine and tell your midwife, obstetric team or doctor about the change. Do not stop prescribed iron without discussing it, particularly if you were treated for anaemia. Keep hydrated as advised, and record stool colour, texture, frequency and any abdominal discomfort. If you are unsure whether bleeding is vaginal or from the bowel, use the source of blood and associated symptoms to explain the concern rather than guessing.

Call emergency services for fainting, severe dizziness, breathlessness, confusion, a racing heartbeat, vomiting blood, severe abdominal pain or repeated black tar-like stools. Seek urgent advice as well if you feel increasingly weak or pale, or if black stool continues despite no iron or bismuth use. Do not delay because you are caring for a newborn.

Could my iron explain this appearance? How can I tell bowel bleeding from vaginal bleeding? Do I need a blood count or stomach assessment? Should I continue my current supplements?