Managing Constipation During Pregnancy: Causes, Treatment, and Support

Highlights

• Constipation can cause hard, dry stools that are painful or difficult to pass.
• Up to 2 out of 5 people experience constipation during pregnancy.
• Hormonal changes, medication, and insufficient fiber intake are common causes.
• Prevention and management include a high-fiber diet, staying hydrated, and maintaining regular physical activity.
• Consult a healthcare provider if lifestyle changes don’t help.

In This Article

• What is Constipation?
• Causes of Constipation During Pregnancy
• Likelihood of Experiencing Constipation if You Had It Before Pregnancy
• How Constipation Is Treated During Pregnancy
• Serious Conditions Linked to Constipation
• Impact on Your Baby
• Postpartum Constipation
• Tools And Assistance

What is Constipation?

Bowel habits vary widely among individuals, but constipation is generally characterized by infrequent, painful, or incomplete bowel movements. During pregnancy, many people notice changes in their digestive patterns, including stools that are hard, dry, or challenging to pass. Straining, discomfort, and a persistent sensation of incomplete evacuation are common symptoms. Constipation affects up to 40% of pregnant individuals, making it one of the most frequent gastrointestinal complaints during this period.

Causes of Constipation During Pregnancy

Hormonal Changes

The hormone progesterone, which rises significantly during pregnancy, relaxes smooth muscle tissue throughout the body, including the intestines. This relaxation slows intestinal motility, allowing more time for water to be absorbed from digested food. As a result, stools become drier and harder, increasing the likelihood of constipation.

Medications and Supplements

Certain medications prescribed during pregnancy, such as iron supplements, antacids for heartburn, or anti-nausea drugs, can contribute to constipation. Iron supplements, in particular, are a common culprit due to their effect on stool consistency. If constipation becomes severe, discuss alternative formulations or dosages with a healthcare provider.

Dietary Factors

A diet low in fiber exacerbates constipation. Pregnant individuals may also reduce their fiber intake unintentionally due to food aversions, nausea, or cravings for processed foods. Insufficient hydration further compounds the issue, as water is essential for softening stools and supporting healthy digestion.

Physical and Lifestyle Factors

Reduced physical activity, pressure from the growing uterus on the intestines, and stress can all impair bowel function. Additionally, delaying bowel movements due to discomfort or a busy schedule may worsen symptoms over time.

Likelihood of Experiencing Constipation if You Had It Before Pregnancy

A history of constipation prior to pregnancy increases the likelihood of experiencing it during gestation. Hormonal shifts, dietary changes, and prenatal supplements often amplify preexisting digestive issues. To mitigate this, adopting preventive measures—such as a high-fiber diet, consistent hydration, and regular exercise—before conception can help establish healthier bowel habits. Early intervention is key to reducing the severity of symptoms later in pregnancy.

How Constipation Is Treated During Pregnancy

Dietary Adjustments

• Fiber-Rich Foods: Incorporate whole grains (oats, quinoa, brown rice), legumes (lentils, beans), fruits (apples, pears, berries), and vegetables (broccoli, spinach, carrots). Aim for 25–30 grams of fiber daily.
• Hydration: Drink at least 8–10 glasses of water daily. Warm liquids, such as herbal tea or broth, can stimulate bowel movements.
• Probiotics: Yogurt, kefir, and fermented foods like sauerkraut support gut health and regularity.

Toileting Habits

• Respond promptly to the urge to defecate. Delaying can lead to stool hardening.
• Establish a routine by visiting the bathroom 20–30 minutes after meals, as eating stimulates colonic activity.
• Optimize posture by using a footstool to elevate the knees above the hips, aligning the rectum for easier stool passage.

Physical Activity

Gentle exercises like walking, prenatal yoga, or swimming stimulate intestinal motility. Even 15–20 minutes of daily movement can improve digestion.

Medical Interventions

If lifestyle changes are insufficient, healthcare providers may recommend:

• Fiber Supplements: Psyllium husk or methylcellulose add bulk to stools.
• Osmotic Laxatives: Polyethylene glycol or lactulose draw water into the intestines to soften stools.
• Stool Softeners: Docusate sodium eases stool passage without stimulating contractions.

Always consult a healthcare provider before using laxatives, as some types may not be safe during pregnancy.

Serious Conditions Linked to Constipation

While constipation is typically benign, chronic or severe cases may indicate complications such as:

• Anal Fissures: Small tears in the anal lining caused by straining.
• Hemorrhoids: Swollen veins in the rectum or anus, often exacerbated by pregnancy.
• Fecal Impaction: A hardened stool mass that cannot be expelled without medical intervention.

Rarely, constipation may signal underlying conditions like hypothyroidism or colorectal disorders. Seek immediate medical attention if you experience rectal bleeding, unexplained weight loss, or intense abdominal pain.

Impact on Your Baby

Constipation does not directly harm the fetus, as it primarily affects the parent’s gastrointestinal system. However, excessive straining may cause discomfort or worsen hemorrhoids. Most laxatives and stool softeners are considered safe during pregnancy, as they act locally in the intestines and have minimal systemic absorption. Always verify medication safety with a pharmacist or doctor.

Postpartum Constipation

Postpartum constipation is common due to:

• Pain Medications: Opioids prescribed after cesarean sections or complicated deliveries can slow digestion.
• Perineal Discomfort: Fear of pain from episiotomy tears or hemorrhoids may lead to stool avoidance.
• Dehydration: Breastfeeding increases fluid needs, and inadequate hydration exacerbates constipation.
• Stress and Fatigue: New parents often prioritize infant care over their own dietary and toileting habits.

To manage postpartum constipation:

• Practice pelvic floor exercises to improve bowel motility.
• Gradually reintroduce high-fiber foods and fluids.
• Use a stool softener if approved by a healthcare provider.

Tools And Assistance

If dietary and lifestyle changes do not resolve your symptoms, here are some tools and support options you can consider:

1. Healthcare Provider Consultation: If lifestyle changes aren’t enough, a healthcare provider can help with additional guidance, personalized advice, or adjusting your treatment plan. They may recommend safe medications, fiber supplements, or other interventions.
2. Fiber Supplements: Products like psyllium husk or methylcellulose can be used to add bulk to stools, which helps with passing stools more easily. These are often prescribed when dietary fiber isn’t sufficient.
3. Hydration Guidance: A healthcare provider or nutritionist can help you set up a hydration plan, emphasizing the importance of drinking enough water throughout the day to support digestion.
4. Physical Therapy: A pelvic floor therapist or other specialists can assist in improving bowel motility and rectal function, especially postpartum, when you are recovering from delivery.
5. Support Groups: Connecting with other pregnant or new parents who are experiencing similar issues can provide emotional support and practical advice on managing symptoms.
6. Relaxation Techniques: Practicing relaxation or mindfulness techniques can help reduce stress, which in turn can support better digestive function.
7. Educational Resources: Hospitals and clinics often offer resources or classes on digestive health, nutrition during pregnancy, and postpartum recovery that can provide further guidance.

By utilizing these tools and seeking support when necessary, you can manage constipation effectively and ensure your overall well-being during and after pregnancy.