constipation during pregnancy

When Should I Be Worried About Constipation During Pregnancy?

What can you do to make sure that your pregnancy-related constipation doesn’t get worse? 

Nearly three out of four women experience constipation and other bowel disorders during their pregnancies. 

Are you noticing a flutter or two in your belly lately? It’s not necessarily your baby kicking. 

Thanks to pregnancy hormones and an enlarged uterus, you might start feeling bloated, constipated, and generally uncomfortable. 

Constipation can also lead to hemorrhoids, another common side effect of pregnancy.

You expected morning sickness and fatigue during your pregnancy — but constipation and hemorrhoids?

Unfortunately, irregular bowel movements and constipation are common pregnancy complaints. 

And, all that straining can lead to painful hemorrhoids — swollen veins in the rectum. 

Pregnancy isn’t always the most relaxing time in a woman’s life, yet constipation and hemorrhoids can heighten the discomfort to an even greater degree.

Being unable to have regular bowel movements can make you feel even more bloated and miserable. So what’s slowing things down?

Constipation during pregnancy is a common problem, and nearly half of all pregnant women get constipated at some point. 

Constipation occurs when there is abdominal pain or discomfort, difficult and infrequent bowel movements, and the passage of hard stools.

Constipation is often an early sign of pregnancy, and sometimes it continues for all nine months (sorry!). Here’s what you can do to get relief from pregnancy constipation.

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What is constipation?

‘Normal’ bowel function differs from person to person, although some people find it difficult to regularly pass soft stools (poo). 

Constipation means having fewer than three bowel motions per week and stools that are hard to pass.

If you suffer from constipation, it may be difficult or painful to pass stools, and you may find you need to push or strain. 

Some people with constipation feel they have not fully emptied their bowels and that even after passing stools, they feel the need to give more.

Up to 1 in 4 women experience constipation during pregnancy. However, constipation will often resolve itself as pregnancy progresses.

causes constipation during pregnancy

Low levels of dietary fibre in your diet can contribute to constipation during pregnancy – as they can at any other time. 

There are, however, reasons why constipation is more common during pregnancy.

An increase in the pregnancy hormone progesterone can cause your gut to work less efficiently and your food to move more slowly through your intestines. 

This is known as reduced gastric motility.

Another cause of constipation is the medicines and supplements that some women take during pregnancy

Medicines prescribed for nausea and vomiting, antacids for heartburn, and some vital pain medicines can induce constipation in some women. 

Supplements like iron and calcium, as well as some multivitamins, can also trigger constipation.

If you take any of these during your pregnancy and are troubled by constipation, speak with your doctor about whether a change in the formulation of your medicine or supplement can help. 

Sometimes a simple change of brands or doses can reduce constipation. However, everyone is different, and one person’s formulation that causes constipation might work well for another.

Pregnant women experience constipation partly because of high levels of progesterone. 

This hormone causes the muscles in the bowel wall to relax, so they’re not making the contractions needed to help move things along. 

Plus, as your pregnancy progresses, your uterus enlarges and presses down on your bowels, which can slow their ability to empty.

Yet another culprit may be the iron in your prenatal vitamin or the iron supplement you may be taking because of anemia. 

Lastly, giving up caffeine, which naturally keeps the bowels moving, can be another cause of constipation.

So when does constipation in pregnancy start? It can appear around the second or third month, and it may stick around until Baby makes an appearance. 

When you become pregnant, rising levels of the hormone progesterone slow your digestive system to a snail’s pace, and for a good reason: your body is absorbing the extra nutrients and fluids it needs to grow a healthy baby

The result, though, is more brutal stools that are more difficult to pass. This happens so early that it’s the first sign of pregnancy for some women.

In your second and third trimesters, pressure from your growing uterus on your bowels can exacerbate the problem. That extra iron and calcium in your prenatal vitamins are binding, so they’re not doing your situation any favours, either. 

And if you suffered from constipation before pregnancy, there’s a good chance you’ll suffer in pregnancy. The risk of becoming constipated is enhanced if you have a predisposition to it.

While it can make you feel all sorts of awful, its rare constipation will lead to anything dangerous. 

The most severe cases might result in hemorrhoids and anal fissures caused by pressure on the veins around the rectum; these cause pain and discomfort but don’t put you or your baby in any danger.

And there are plenty of natural ways to curb constipation before it gets to that point—prevention, says Wong, is critical.

constipation during pregnancy

The Link Between Constipation and Hemorrhoids

On its own, pregnancy increases your risk of swollen veins around your rectum. But if your stool is uncomfortable to pass and you’re straining to do so, it can make hemorrhoids worse. 

This is serious because they can be with you for life. However, you can prevent pregnancy hemorrhoids by managing constipation using the tips below. 

Constipation in Pregnancy Treatment and Prevention

If constipation is your issue, there are a few ways to get things, er, moving along. Here are some tips to help you deal with your constipation in pregnancy.

  • Drink plenty of liquids, especially water and prune juice or other fruit juices.
  • Eat high-fibre foods, such as fruits, vegetables, beans, wholegrain bread, and bran cereal. Aim for about 25 grams each day.
  • Walk or do another safe exercise every day. A simple walk around the block will help things get moving.
  • Try eating smaller meals more frequently.
  • Ask your doctor about bulking agents such as FiberCon, which add fibre and water to your digestive system, or stool softeners.

Prevention is Key

The best thing you can do about constipation and hemorrhoids during pregnancy is to prevent them.

By being proactive and staying ahead of it, you can avoid many of the problems.

How can I prevent or treat constipation during pregnancy?

Prevention and treatment of constipation involve many of the same steps.

Here are a few things that you can do to help prevent constipation from occurring or treat it if you are already experiencing it:

Eat a high fibre diet:

Ideally, you will consume 25 to 30 grams per day of dietary fibre from fruits, vegetables, breakfast cereals, wholegrain bread, prunes, and bran. 

This helps ensure bulkier stools that are easier to poop.

A diet rich in fibre — wholegrain bread and cereals, beans, fresh fruits, and vegetables — will help you eliminate waste. Aim for 30 grams of fibre a day.

Drink a lot of fluids:

Drinking plenty of fluids is essential, remarkably when increasing fibre intake helps ensure softer stools. Drink 10 to 12 cups of fluids each day. 

It combines a high fibre diet and plenty of liquids that best help you eliminate your waste. Sweat, hot/humid climates, and exercise may increase your need for additional fluids.

Exercise routinely: 

If you are inactive, you have a greater chance of constipation. Walking, swimming, and other moderate exercises will help the intestines work by stimulating your bowels. Schedule exercise three times a week for 20-30 minutes each.

Over-the-counter remedies: 

There are over-the-counter products such as Metamucil (Category B), which may help soften your bowel movements and reduce constipation. However, always speak to your health care provider before using over-the-counter medications.

Reduce or eliminate iron supplements: Iron supplements may contribute to constipation. However, good nutrition can often meet your iron needs during pregnancy. 

Taking smaller doses of iron throughout the day rather than taking it all at once can reduce constipation. 

Talk to your health care provider about checking your iron levels and recommendations to manage iron intake during pregnancy. 

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Stay Hydrated

Double your water intake. Drinking at least eight 12-ounce glasses of water daily will keep solids moving through your digestive tract and help keep stools soft. Your increased fluid intake will also help with blood volume.

Pace Yourself

Spread out your food intake by eating smaller, more frequent meals. For example, try to eat five or six mini-meals each day.

Get Moving

Simply getting up and moving can help constipation. In addition, regular exercise during pregnancy — walking 10 to 15 minutes several times a day — helps stimulate bowel movements and keep the digestive tract healthy.

Say No to Laxatives

If lifestyle changes aren’t working, ask your doctor about over-the-counter stool softeners, such as Colace. 

Avoid laxatives, though: the ingredient that stimulates the bowel to the contract also may stimulate the uterus to contract.

What remedies should not be used for constipation during pregnancy?

Laxative pills are NOT recommended for the treatment of constipation during pregnancy because they might stimulate uterine contractions and cause dehydration. 

Talk to your doctor about taking an over-the-counter fibre supplement or a laxative or stool softener.

Mineral oils should NOT be used during pregnancy because they reduce nutrient absorption.

The best line of defence is threefold: a high-fibre diet, plenty of fluids and moderate physical activity. We recommend whole grains and at least five portions of fruits and vegetables a day. 

For some, that’s easier said than done: I couldn’t stand greens while pregnant. The absence of them likely contributed to my constipation.

But there are enough high-fibre foods—dried fruit, hummus, oatmeal, lentils and bran, among others—that if you develop an aversion to one, you can surely pick up the pace with another.

It’s recommended that women drink 10 cups of fluids daily during pregnancy, but if you overthink water is too much to down, don’t worry—other liquids count too. 

Often something warm first thing in the morning, like herbal tea or hot lemon water, is enough to get things going. 

As for exercise—a 20- to 30-minute walk a day can be enough to stimulate digestion. A pregnant woman drinking a cup of tea   

If you’re eating well and exercising, and you’re still constipated, We suggest changing vitamins until you find a brand that’s less constipating. 

A fibre supplement like Metamucil can also get you out of your bind and is considered safe in pregnancy

Never take a laxative or stool softener to treat constipation, though, without speaking with your healthcare provider first, says Wong.

Is constipation during pregnancy ever severe?

Usually not, but occasionally constipation during pregnancy can be a symptom of another problem. 

If you have severe constipation that’s accompanied by abdominal pain, alternates with diarrhea, or you pass mucus or blood, call your doctor or midwife immediately.

Am I more likely to experience constipation if I had it before pregnancy?

Women who have had constipation before pregnancy are, unfortunately, likely to experience worsening symptoms during pregnancy.

If you have constipation and plan a pregnancy, try to get into good habits before becoming pregnant. 

Keeping to a healthy diet, drinking plenty of fluids, and doing regular exercise may help you maintain periodic bowel motions.

It is better to prevent constipation early on rather than wait to treat it later.

How is constipation treated during pregnancy?

The first step in treating constipation is to increase the fluids and fibre in your diet. In addition, eating wholegrain foods, fruit and vegetables can often resolve constipation. 

If symptoms continue, then fibre supplements or laxatives may be a short-term solution. However, it is always better to stimulate the bowel with a healthy diet rather than take medications. 

Taking laxatives can sometimes result in side effects such as abdominal pain and diarrhoea.

Could it be a sign of something more serious?

While most cases of constipation are not a sign of illness, sometimes there are complications such as haemorrhoids, faecal impaction or rectal prolapse. 

In rare cases, constipation can be caused by more severe conditions such as tumours.

Speak with your doctor if you are concerned, and especially if you notice blood in your stools.

Will it affect my baby?

If you’re pregnant, you don’t need to worry that constipation will affect your baby since the discomfort occurs in the mother’s gut and bowels and isn’t passed on to the baby. 

Most laxatives are not well absorbed into the bloodstream and can be taken during pregnancy and breastfeeding, but always check with your pharmacist before taking medicine while pregnant.

Will it continue after I’ve had the baby?

There are several reasons why constipation may continue after birth. 

Women who have had a caesarean often experience constipation for a few days until their regular bowel movements return. 

Women who have stitches after a vaginal birth may hesitate on the toilet, which can cause a build-up in their bowels.

If you’ve taken strong pain medication after having your baby, this may also cause constipation.

New mothers are often busier than usual in the first few weeks and months of motherhood. 

It may seem like taking care of yourself has become less of a priority, but your health is no less important now than it was during your pregnancy. 

Be sure to have plenty of fibre-rich fruit, vegetables, and whole grains, as well as increase your fluid intake while breastfeeding to encourage healthy bowel movements, even when you are busy.

constipation during pregnancy

Postpartum constipation—you’re not done pushing yet.

Delivery doesn’t necessarily mean an end to your constipation woes. (And be warned: the first bowel movement post-delivery can require some courage. 

If you deliver vaginally, your perineal area is still healing, and you’ll want to be careful not to disturb any stitches.) 

The combination of extra iron supplements (to make up for any blood loss), narcotics (in the case of a C-section), limited mobility (because, well, you just had a baby) and a fear of pain while straining to go can all contribute to postpartum constipation. 

If this is the case, the same rules of pregnancy constipation apply: stick to high-fibre foods (aim for 25 grams a day), hydrate and move around as much as you can.

Where to get help?

Constipation can vary in severity and if changes to your diet do not help relieve your symptoms, ask your midwife, doctor or pharmacist for guidance on choosing and using a laxative.

Constipation during pregnancy has many causes. For one, progesterone relaxes the muscles of the intestines, which slows down your gastrointestinal intestinal tract. 

The increased blood supply requires more fluid intake, leaving you dehydrated and contributing to slow bowel movements. The iron in your prenatal vitamins also may be constipating.

Here’s the good news: bowel problems don’t affect a pregnant woman’s quality of life all that much. 

But if you’ve been spending more (or less) time in the bathroom than usual lately, at least you know you’re not alone!

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