How To Relieve Constipation During Pregnancy?

Pregnancy constipation is defined as having fewer than three bowel movements a week that can be painful. Constipation is common in pregnancy and stool softeners are considered safe to use during this period. Making a few lifestyle changes can help prevent pregnancy constipation. For example:

• Staying Hydrated
• Exercise and Yoga
• Intake of fibre in the diet

Constipation remains the most common gastrointestinal complaint in pregnancy. It is described as infrequent bowel movements or difficulty in the evacuation of faeces. Bowel movement is prolonged in pregnant ladies due to the fact that there is a rise in progesterone and a reduction in motilin hormone which is essential for timely bowel emptying. Higher levels of progesterone hormone cause the relaxation of muscles including the intestines.¹ Slower digestion is directly linked to slower movements of the intestines. This in turn leads to constipation.

Another reason is the increase in water absorption from the intestines which makes the stool dry. Pregnant ladies are usually supplemented with lots of vitamins like iron and calcium which can further lead to constipation. With time, the uterus enlarges and this slows the faecal movement.

Approximately 11 to 38% of women experience constipation during pregnancy.¹ The most important aspect of treating constipation is educating clients on the proper use of their diet and drink to maximise stool formation. Constipation can cause significant discomfort and stress for mothers who experience it during pregnancy.

Understanding constipation during pregnancy

Constipation is usually a common problem during pregnancy. It is due to the fact that the time taken for food to get through the bowel is increased in the 2^nd and 3^rd trimesters. This phenomenon has been linked to an increase in progesterone levels.

It has also been observed that during the first trimester and postpartum period, bowel movement is easier as compared to the 2^nd and 3^rd trimesters.²

Mild laxatives are known to help pregnancy constipation but it is always advised to supplement with fibre to avoid any side effects. Adding bulk laxatives may cause diarrhoea or abdominal pain that is worrisome.

Bran or wheat fibre helps women relieve faecal matter easily during pregnancy, but if the problem is more complicated, women can resort to stimulant laxatives which prove to be highly effective.² Supplementing fibre is effective without any side effects and is also more acceptable to patients.

Another complication during pregnancy is gestational diabetes - a type of diabetes that can develop during pregnancy in women who don’t have pre-existing diabetes. Insulin resistance increases your body’s need for insulin, but the story doesn’t end there. Pregnant women with gestational diabetes also have an increased risk of developing type 2 diabetes later in life, due to their tendency for higher body mass index and obesity.³

If you are not able to lose weight, then you may find it hard to keep it off.  Remedies to try that should not raise blood sugar levels include increasing the amount of green leafy vegetables in your diet, and adding flaxseed or chia seeds into your diet. Trying overnight chia seeds and yoghurt for breakfast are some good options.

Laxatives are a great way to help relieve constipation. The most commonly prescribed laxatives for pregnant women are Fybogel, Matulane and Lactulose. They all work in different ways and are suitable for use during pregnancy.

Source: Gestational Diabetics UK

Causes and symptoms

Causes of constipation during pregnancy depends on the stage, and may include the following:

Vitamins

Prenatal vitamins are full of iron and calcium - iron is known to cause hard stools.

Increasing pressure from the uterus

As the uterus grows, it creates pressure on the bowel thus making it harder for the movement of stool through the intestines.

Changing hormones

Due to the increase in progesterone and decrease in motilin, bowel motility is reduced. There is water retention in the colon, making the stools dry and harder to pass out.

Additionally bloating, stomach discomfort, and haemorrhoids are other issues associated with constipation during pregnancy.

Symptoms of constipation during pregnancy

An increase in the number of hard stools may be due to a lack of fibre or an intolerance to certain foods and drinks (like milk).

Pooping less: Not only can this lead to a feeling of discomfort and stress, but it also wreaks havoc on your digestive system and regularity.

Pain on passing a bowel motion, passing wind (farting), or cramp-like pains in the abdomen area.

Tips to relieve constipation during pregnancy

Drink 2-3 litres of water every day

During pregnancy, you should drink double the amount of water than specified for a normal person. Water helps to soften the stool and supports the baby. You can also include smoothies, green tea, juices, and other options. Prune juice is known to help a great deal.

Exercising regularly

Pregnancy restricts movement which is not good for the bowel. Practising light exercises or yoga as prescribed by your healthcare provider can help relieve constipation during this time.

Eat Right

Fibre helps soften the stools and helps them to pass out easily. Fruits, beans, peas, whole grains and lentils are the foods you should include in your diet.

Switching to a different prenatal vitamin

Sometimes the iron in the prenatal is too much for the digestive system and switching to a different one can help.

FAQs

How do you diagnose constipation during pregnancy?

Passing stools less than three times a week, hardened stools, and pain while pooping is all signs that indicate there is something wrong with the digestive system. Consulting a healthcare provider may help in making a diagnosis. The doctor will ask you how much you’re pooping and what your stools look like. Questions about daily habits can help your physician find out what’s likely causing your constipation or making it worse.

How can I reduce the risk of being constipated during pregnancy?

There are certain self-care measures that one can take to avoid pregnancy constipation which includes: drinking plenty of water; eating your greens; regular physical activity that includes any sport like walking and cycling; and always following the advice given by your healthcare provider. If need be, fibre supplements can be taken to reduce the risk of constipation.

Does being constipated hurt the baby during pregnancy?

Constipation often occurs during pregnancy, but it's completely normal and doesn't affect the baby. The discomfort that causes constipation typically occurs in the mother's gut and bowels, but it doesn't pass directly to her baby, which is why it's not a concern during pregnancy.

When should I see my doctor?

If constipation is not resolved after trying out these home remedies, it is time to talk to your doctor. Recommendations like changing your lifestyle, changes in medication, or other treatments will be advised. Talking to the doctor is always beneficial as it can underline any other health condition associated with pregnancy. They are the trusted sources that can get your bowel moving again so don’t hesitate to talk to your doctor about this.

Summary

For pregnancy constipation, the first line of treatment is increasing fibre in the diet, water intake and regular exercise. If the first line of therapy fails, pregnant ladies can turn to laxatives. Laxatives do not pose any risk to the unborn child as it is not absorbed systemically. In the general population, stimulants and osmotic laxatives should be used for a short period only because it leads to dehydration of the colon.^1,2