How to relieve constipation during pregnancy

Constipation, or having difficulty pooping, is a common problem during pregnancy: Up to 40% of pregnant women get constipated at some point.

Why do I have constipation during pregnancy?

One reason you might get constipated when you're pregnant is your body makes more of the hormone progesterone, which relaxes muscles throughout the body – including the digestive tract. This means that food moves through your intestines more slowly.

There are also changes in your blood vessels and total body fluid when you're pregnant. Your blood vessels dilate so they can hold about 50% more fluid by the time you deliver.

As your pregnancy progresses, your "hydration goal line," if you will, is constantly changing as your body holds on to more and more fluid. This can lead to symptoms of dehydration, including constipation and headaches.

Other factors that impact constipation can include eating a low-fiber diet (which many women switch to due to nausea or bloating), and reduced physical activity because of pregnancy fatigue and discomfort. Iron supplements, especially in high doses, can make constipation worse.

Will the constipation extend beyond the first trimester?

Constipation can last beyond the first trimester, yes. That's because some of the top factors for constipation – such as increased progesterone and lowered physical activity – can continue after your first trimester. Also, your intestines will absorb less water overall, which causes stools to dry out more.

Later in your pregnancy, these issues are exacerbated by your growing uterus, which may put pressure on your colon and rectum, slowing the movement of poop through your system.

For many people, healthy eating habits with lots of dietary fiber plus hydration and consistent physical activity is enough to keep things moving. Prevention is key when it comes to constipation!

- Kristin Cohen, DNP, certified nurse midwife and board-certified women's health nurse practitioner

Is constipation normal while pregnant?

Unfortunately, constipation is pretty typical during pregnancy because of all the hormone, body, and lifestyle changes that are taking place.

Occasionally, however, constipation during pregnancy can be a symptom of another problem. For example, health conditions that can cause constipation include:

• Endocrine issues like hypothyroidism or diabetes
• Irritable bowel syndrome
• Intestinal obstruction
• Neurologic disorders like multiple sclerosis
• Colorectal cancer

If you have severe constipation that's accompanied by abdominal pain, alternates with diarrhea, or you pass mucus or blood, call your healthcare provider right away.

Constipation can cause other problems, too. One of the most common is hemorrhoids, which are swollen veins in the rectum and anus. These are common in pregnancy due to the natural pressure put on your abdomen. Hemorrhoids are aggravated by straining during a bowel movement or passing a hard stool.

Hemorrhoids can be extremely uncomfortable, though they rarely cause serious problems. In most cases, they go away fairly soon after your baby is born. However, if the pain is severe, or if you have rectal bleeding, call your provider.

Straining with bowel movements can also affect your pelvic floor muscles, which help control your bladder. This can lead to a condition called stress urinary incontinence, when your urine leaks during activities – and that includes laughing, sneezing, or coughing.

This condition is already often related to pregnancy and childbirth because of the added pressure on your body from carrying a pregnancy and the process of vaginal delivery, but your risk of developing it could increase due to constipation.

Ways to get relief from pregnancy constipation

"The best way to manage constipation is to prevent it from happening in the first place," advises Kristin Cohen, DNP, a certified nurse-midwife, women's health nurse practitioner, and member of BabyCenter's Medical Advisory Board. "For many people, healthy eating habits with lots of dietary fiber plus hydration and consistent physical activity is enough to keep things moving. For people who need more than this, I find that using a fiber supplement like Metamucil every morning is usually very helpful. Again: Prevention is key when it comes to constipation!"

Here are some more tips for preventing and easing constipation when you're pregnant:

Drink plenty of water. Try to have 10 to 12 cups of water or other beverages daily. (Or sip throughout the day until your urine is clear or pale yellow in color – a sign of adequate hydration.) Drinking a glass of fruit juice – especially prune juice – every day can also be helpful. Some people find that drinking a warm liquid right after waking up helps get things moving. Keep in mind that humid weather, sweating, and exercise may increase how much fluid you need.

Eat high-fiber foods, including whole grain cereals and breads, brown rice, beans, and fresh fruits and vegetables and dried fruits like apricots and raisins every day. It can help to add a couple of tablespoons of unprocessed wheat bran (available at health food stores) to your cereal in the morning, though it may take a few days before you notice a difference. Options like these help to add bulk to your stools so they go through your system easier.

Exercise regularly. Walking, swimming, riding a stationary bike, and yoga can all ease constipation and leave you feeling more fit and healthy.

Listen to your body. Your bowels are most likely to be active after meals, so make time to use the bathroom after you eat if you need to. Don't put off going to the bathroom when you feel the urge.

Try a different vitamin. If your prenatal multivitamin has a large dose of iron (and you're not anemic), ask your healthcare provider about switching to a supplement with less iron. You can also take your iron supplements in smaller doses throughout the day (such as in liquid or gummy form), which can reduce their effect on your bowels. If you think your iron supplement is the culprit for your constipation, talk to your healthcare provider about how often you're taking it. It may be best to take it less often, depending on how bad your constipation is.

Try a stool softener, such as Colace (docusate sodium). It's not a laxative and won't "make you go," but it will make your bowel movements a lot easier to manage.

Ask your provider about taking magnesium. They may recommend you take 200 to 400 milligrams once or twice a day to help keep things regular.

If the measures above don't help (or it's hard for you to follow them), talk to your provider about taking an over-the-counter fiber supplement like Metamucil. Just make sure you also increase your water intake to compensate for the extra fiber.

These supplements are usually appropriate for most women, but sometimes they can cause uterine contractions, so it's important you follow your provider's directions. Also, if you're taking too much, you may actually experience diarrhea.

"I would definitely suggest speaking with your provider about how to prevent constipation from getting too bad," says BabyCenter Community member EllieB86. "There's only so much that fiber, tons of water, and regular movement (along with all the prunes and every over natural remedy people suggest) can do in some cases."

In general, constipation and other bathroom issues may extend into the postpartum period, but rest assured that you'll get back on track.

Often, you'll have a bowel movement within three or four days after delivery, though it may take a few months to get on a regular schedule. If you're still struggling by then, talk with your healthcare provider.