Constipation in Pregnancy

Constipation is a very common symptom that many women experience during pregnancy. About half of all pregnant women experience constipation at some point. It occurs when there is abdominal pain or discomfort, difficult and rare bowel movements, and hard stools. It begins around the second to the third month of pregnancy as soon as progesterone levels rise. This condition may get worse as the pregnancy progresses and the uterus grows.
Pregnancy causes many changes in a woman’s body, including an increase in the hormone progesterone. Increasing the level of this hormone can slow down the movement of the intestine, thus reducing the speed of movement of food and feces through the intestine. This slowing down can lead to constipation or difficulty passing stools.

Symptoms of constipation during pregnancy

Symptoms of constipation include:

Infrequent bowel movements
Abdominal pain
Hard, lumpy, or dry stool
Excessive straining to have a bowel movement
A feeling like all of the stool hasn’t passed

Causes

The cause of constipation during pregnancy depends on the stage at which the pregnant mother has difficulty defecating.

Prenatal vitamins

Prenatal vitamins are high in iron, an essential mineral that can sometimes be deficient during pregnancy. Taking iron supplements can cause hard, black stools and constipation.

Hormones

Changes in hormone levels early in pregnancy slow the bowel movement through the stool. This delay increases the amount of intestinal water absorbed from the stool, making the stool more solid and difficult to pass.

Pressure from the uterus

In later pregnancy, a growing uterus can pressure the bowel, making it harder for stool to move through the bowel.

Prevent constipation during pregnancy

Some pregnant women develop constipation after pregnancy, which is usually related to pregnancy hormones. Making a few lifestyle changes may help prevent constipation. While these measures may not work for everyone, many people find that regular care helps move the bowel.

Drink more water

Drinking enough water can help make bowel movements more frequent and easier to pass. Staying hydrated is important for everyone; this issue becomes more important during pregnancy.

Eat more fiber

Fiber is found in natural sources such as many fruits and vegetables and beans, and some grains. These natural resources help to regulate bowel movements.

Exercise more

Exercise is known to help regular bowel movements. It does not have to be an aerobics class or run for miles. Just adding more exercise to the lifestyle can improve bowel function. Increased activity can be simply walking or swimming in the pool. Anything that moves the body and raises the heart rate is good for overall health during and after pregnancy.

Watch calcium intake

Excessive calcium intake can cause constipation. Calcium is found in many foods and supplements, especially dairy products. For this reason, you should not overeat milk and cheese. Food allergies can sometimes contribute to constipation. For this reason, it is best to keep track of food intake and take notes to identify foods that cause problems with excretion.

Medications

Some medications can increase the risk of constipation. One of the main causes of pregnancy can be iron-containing pregnancy vitamins, often prescribed to prevent anemia. If a pregnant woman has a problem with vitamins, she should ask her doctor to change it.

Complications

In most cases, constipation during pregnancy is short-lived and resolves without treatment or at least treatment. But in rare cases, prolonged constipation can cause bowel problems, which may need to be removed by a doctor. Consistent use of certain types of laxatives can cause the gut to forget how to pass stool.
These drugs can also cause electrolyte or fluid imbalances in some people. Such issues usually affect people with other health problems, such as diabetes or kidney disease. It is best to talk to your doctor about the types of laxatives and how often to use them.

If the symptoms of constipation persist for a few weeks or more, it indicates chronic constipation that can lead to complications such as:

Hemorrhoids, which are swollen veins in the anus
Anal fissures, which are tears of the skin in the anus
Fecal impaction, which is when hardened stool accumulates in the intestines
Rectal prolapse, which is when the rectum protrudes from the anus

Treatments

Home remedies for constipation during pregnancy include lifestyle changes or over-the-counter medications. Following treatments may help relieve the symptoms.

Increase dietary fiber and water

A low-fiber diet can help with constipation. Two types of dietary fiber are:

Soluble fiber, which mixes with water in the intestines to form a gel-like substance. This type of fiber helps control blood sugar.
Insoluble fiber, which passes through the intestine without absorption. Increases stool size and can help you defecate faster.

Increasing dietary fiber should be the first step in treating constipation during pregnancy. Fiber-rich foods include:

Bran cereals
Beans
Legumes
Vegetables
Fruits
Chia seeds
Nuts
Quinoa

Increasing water consumption along with increasing fiber consumption can be helpful. Pregnant women should drink 10 glasses of water daily.

Exercise

A sedentary lifestyle increases the risk of difficult and rare bowel movements. Increasing daily exercise can help with constipation. Walking is one of the best ways to increase activity during pregnancy. It has very little risk and can help with bowel movements.

Probiotics

Millions of healthy bacteria live in the gut and help it function properly. Probiotics may help regenerate intestinal bacteria with healthy strains that cause normal bowel movements. Foods rich in probiotics include sauerkraut, yogurt, and kimchi.

Don’t max out at mealtime

Excessive meals can over-compress the digestive tract. Eating six small meals a day instead of three large meals puts less strain on the digestive tract. It may also cause less gas and bloating.

Laxatives

There are several types of laxatives that doctors may recommend, including:

Bulk-forming laxatives: These laxatives increase the weight of the stool, which makes it easier for the stool to pass through the digestive tract. The body does not absorb these bulky laxatives, so they are considered safe for long-term use in pregnancy. They may have unwanted side effects such as bloating, gas, and cramps and may not always be effective.
Stool softeners: Stool softeners containing sodium docusate are safe during pregnancy.
Lubricant laxatives: Lubricating laxatives act like mineral oil by covering a waterproof layer on stool and digestive tract. Retains water in the stool, which makes it softer and easier to pass.
Osmotic laxatives: Osmotic laxatives work by absorbing water into the bowel from the surrounding tissues. This softens the stool and increases bowel function. Prolonged use of osmotic laxatives can lead to electrolyte imbalance when there is an imbalance in the fluids inside and outside the cells.
Stimulant laxatives: Stimulant laxatives act on the intestinal wall. They increase intestinal muscle contractions. They can have unpleasant side effects such as cramps. Like osmotic laxatives, long-term use of stimulant laxatives can cause electrolyte imbalance.

Position on the toilet

Having a proper position on the toilet can help when emptying the bowel. Use a Step or footstool under your feet. Lean forward as far as you can. Place your elbows on your knees. Try to keep your back straight. Do not push or hold your breath. Prolonged, slow, deep breathing through the mouth helps to relax the abdominal muscles.

When to see a doctor

Pregnant women need to consult their doctor before taking any medication, including laxatives or other medications. It is recommended to see a doctor in case of additional symptoms, including the following:

Nausea
Stomach pain
Vomiting
Constipation that lasts for longer than 1–2 weeks
Bleeding from the rectum
No relief after using a laxative

The bottom line

Almost half of all women experience constipation during pregnancy. It is an annoying condition associated with abdominal pain and discomfort, difficult bowel movements, and the passage of hard stools.
With pregnancy, the body needs to absorb more nutrients and fluids needed to grow a healthy fetus. Therefore, the level of progesterone increases to speed up the movement of the digestive system and thus increase the rate of absorption. Other causes, such as anxiety, inactivity, or a low-fiber diet, may also contribute to constipation. Proper eating habits and regular exercise encourage the digestive system to work faster, thus preventing constipation during pregnancy. In some cases, the doctor may prescribe medications to reduce symptoms. During pregnancy, any medication should be monitored by your doctor.

Arjang Naim MD solves any problems for pregnant women by providing prenatal care.

Additional questions

Can constipation during pregnancy hurt the baby?

No ،All the pressure caused by constipation in the mother’s stomach is uncomfortable for the mother, but it does not harm the baby.

Can pushing from constipation cause miscarriage?

Straining to have a bowel movement does not cause miscarriage. Most miscarriages are caused by: problems with the baby’s chromosomes, hormonal problems, and the mother’s uterus or cervix.

What is an Anal fissure?

An anal fissure is a small tear in the thin, moist tissue (mucosa) that covers the anus. Anal fissures may occur when the stool is hard or large during bowel movements. An anal fissure usually causes pain and bleeding with bowel movements.

What is Rectal prolapse?

Rectal prolapse occurs when the rectum is stretched and protrudes from the anus.

When does pregnancy constipation start?

Constipation begins as soon as the progesterone level increases in the second to the third month of pregnancy and may worsen as the pregnancy progresses and the uterus grows.