Haven’t been to the loo in a few days? Feeling backed up? You might be surprised to know that constipation during pregnancy is very common, and a concern that many expectant mothers face. It can be uncomfortable and concerning, but the good news is that there are things you can do to find relief. Constipation needs to be addressed, though some might not want to talk about, we know how important it is for your overall well-being. In this article, we’ll guide you through understanding constipation during pregnancy, and provide you some tips for pregnancy constipation relief.

 

Why we get constipated during pregnancy

Constipation is the difficulty in passing stools and the infrequency of bowel movements. If you have suffered with constipation in the past, it is very common for your symptoms to get worse throughout. For those who have never had issues with constipation, it may develop for the first time during pregnancy.

 

Up to 40% of women will suffer from constipation at some stage during their pregnancy.

 

Factors that could be causing your constipation:

  • Pregnancy hormones
  • Your growing baby
  • Lifestyle factors
  • Anxiety

 

Pregnancy Hormones

The hormone responsible for constipation during pregnancy is progesterone. As we know from the menstrual cycle [clickable link], progesterone is the hormone that thickens the lining in our uterus, which in pregnancy ensures that your baby grows in the right space and is able to get the nutrients needed to continue growing. 

Progesterone also relaxes the smooth muscles in our bodies, which includes our digestive tract. This relaxation slows down the passage of food through our intestines, leading to constipation. In short, progesterone slows down motility. 

Your growing baby

As your pregnancy progresses, so does the impact of your expanding uterus on your intestines and rectum. Every gestational week that passes the more pressure gets applied to these organ, making it harder for your stools to flow through and exit your body.

Have a look at these images:

This is a cross section comparison of the female reproductive system. Notice how the uterus with the baby is almost squeezing the rectum and the space between the reproductive organs and the rectum is significantly smaller. As the baby grows, the digestive organs are restricted further. This effect is more pronounced in the later stages of pregnancy, especially in the third trimester when your baby is growing rapidly, occupying more space in your abdomen.

 

Lifestyle Factors

Your lifestyle (your diet and exercise in particular), play a significant role in influencing pregnancy constipation, making them key to consider.

Dehydration can make constipation worse because the body absorbs fluids from your intestines to ensure optimal function, leaving your stools dry, hard and difficult to pass. If you suffer with morning sickness or hyperemesis gravidarum, the likelihood is that your fluid levels are chronically low and you are frequently dehydrated. A link between dehydration and constipation during pregnancy has been established, so drinking regular sips of water will help combat this. 

Speaking of morning sickness, hyperemesis gravidarum, and not forgetting nausea, these common pregnancy symptoms can leave you feeling like you have ‘gone off’ of food, or perhaps your food preferences change. Often times during pregnancy, we may find ourselves leaning toward foods that are quick and easy to eat, but these tend to lack in fibre. The lack of fibre in the diet can contribute to constipation. Fibre helps to bulk out your stools, making them bigger and easier for the body to pick up and know they need to be removed out of the body.

Not eating on time or not eating breakfast will affect gut reaction to regular stimulation and be more difficult to defecate.

A common myth is that we need to rest and avoid exercise during pregnancy. Research has shown time and time again that this couldn’t be further from the truth, and actually, reducing your exercise during pregnancy can lead your constipation worsening. When exercise decreases, like likelihood of constipation goes up. 

 

Anxiety

You may be surprised to find out about the connection between anxiety and constipation. It is a well-documented phenomenon that can come into play during pregnancy. It will come as no surprise to you, but during pregnancy, stress and anxiety levels can become heightened. Unfortunately, these feelings impact the digestive system. Your bowel movements slow down,  leading to constipation. Anxiety impacts how your gut functions. This, coupled with some changes to your eating habits during pregnancy will contribute to the discomfort you feel. 

 

An honourable mention – Iron supplements

We wouldn’t be able to talk about constipation, without mentioning iron supplements. Often these are prescribed or taken during pregnancy for a variety of reasons, but they can cause constipation, and make constipation even worse.

 

 

Symptoms of pregnancy constipation

The symptoms of constipation during pregnancy are the same as when you are not pregnant:

  • Difficulty passing stools
  • Feeling as though you still need to go, after emptying your bowels
  • Not passing stools every other day
  • Straining during bowel movements
  • Bloating and pain in your abdomen
  • Feeling backed up
  • Large, hard and painful stools

 

How to get relief from pregnancy constipation

Lets be honest, you’ve probably come to this article looking for what you can do to alleviate the constipation you are experiencing. We get it, it is pretty cr*p, pardon the pun!

 

Lifestyle Adjustments

You may be looking for something to improve your constipation immediately, but the truth is, the best way to address pregnancy constipation is in your every day routine. Prevention is better than cure, right?

 

Regular physical activity

We’ve emphasised the importance of exercise during pregnancy, but did you know it’s a key factor for maintaining regular bowel movements? Let’s delve into the connection between exercise and digestion.

After your stomach completes the digestion process, extracting essential vitamins and nutrients, the food progresses into your intestines. For the food to continue through your intestines and reach the exit (toilet), the waste must move along the digestive system because of muscular-like contractions, called peristaltic waves.

FUN FACT! Your intestines stretch over 15 feet in length

One way that you can help peristaltic waves to occur and waste be moved along your digestive tract is to stimulate the digestive system by exercising. Exercise increases blood flow to muscles, but also to your digestive system! 

When the digestive system is stimulated by exercise, the waste will flow through quicker. This will also continue when you have stopped exercising and are resting altogether. 

With regular physical activity, you are encouraging the digestive system to function optimally, promoting healthy digestion and preventing constipation.

 

Eat regularly

Eating regularly and having regular meals support your digestive system finding its natural rhythm and help to coordinate the peristaltic waves which aid digestion.

If you are suffering with constipation during pregnancy, you may try having smaller but more frequent meals across the day. This is a great tip for if you are feeling nauseous too!

Eating at regular intervals will help to regulate your blood sugar levels. Fluctuations in your blood sugar levels can impact how well your digestive system functions. Try to avoid prolonged periods between meals, ensuring a steady release of energy and maintaining those blood sugar levels.

The more consistent you are with your eating habits, the easier it is for your body to encourage the production of your stools. Which leads us to our next point…

 

Go to the toilet when you need to…do not delay!

Putting off going to the toilet for a few minutes whilst you finish that piece of work or folding the washing? STOP!

Your body is incredibly smart and the more you put off going to the toilet, the weaker your defecation reflex becomes. If this prolonged, you can lose this reflex altogether. 

 

The defecation reflex occurs when the rectum is full, the anal sphincter relaxes and the external anal sphincter contracts and the surrounding muscles push your stools out.

Your body will adapt to your schedule. Eating regularly makes it easier for your body to anticipate and respond to the need for bowel movements. 

By eating regularly or having meals at the same time each day, you are allowing your body to anticipate and respond to the need of bowel movements. 

Eating regularly, and emptying your bowels when you need to can significantly reduce your constipation.  

 

Stay hydrated

One of the biggest hacks we can give you, is to keep a bottle of water with you at all times. 

When you are adequately hydrated, your body can maintain the necessary fluid balance to support many important functions, including digestion.

Regular sips of water and a consistent hydration status will soften your stools, making them easier to pass. This is especially important during pregnancy, as prenatal vitamins can contribute to firmer stools. 

Being dehydrated can force your body to absorb water needed for functioning from your stool, making them hard, dry and difficult to pass. Small sips of water throughout the day will prevent this. This can also reduce the likelihood of developing haemorrhoids. 

More hydration, easier bowel movements, less straining, no haemorrhoids. 

To stay hydrated during pregnancy, aim to consume 2.5L of water daily. You need to more water because of your pregnancy. This includes decaffeinated coffee and teas.

 

Dietary Adjustments

Maintaining a well-balanced diet is paramount during pregnancy, not only for the health of your growing baby and your overall health, but also for preventing constipation during pregnancy. Below, we list the 3 dietary adjustments that will have the biggest impact in helping the digestion process when pregnant:

 

Increase the fibre in your diet.

By regularly including fibre-rich foods in your daily diet. The Association of British Dieticians recommend consuming around 30g of fibre daily.

The fibre content is foods will help to bulk our your stools and help it move through the digestive system more easily. Some examples of high-fibre foods are:

  • Shredded whole wheat or bran cereals
  • Wholemeal options (wholemeal bread, spaghetti etc)
  • Figs, berries and fruits with the skin on.
  • Nuts (almonds, peanuts and sesame in particular!)
  • Broccoli, green beans, and other vegetables
  • Chia seeds and other seeds
Try eating some prunes, or having prune juice!

 

Consider probiotics

Probiotics are often referred to as ‘good’ or ‘friendly’ bacteria for your gut and can be beneficial for helping constipation during pregnancy. Your gut microbiome can be affected during pregnancy, especially if you are suffering with constipation regularly. 

The live microorganisms in probiotics help to restore the balance of the bacteria is your gut, help your digestion to function optimally and regulate your bowel movements. By taking probiotics and having a healthier gut, your body will break down food more efficiently and ensure that you are absorbing as many nutrients from your food as possible. 

BONUS TIP: Probiotics restoring your gut bacteria or microbiome will help other bodily functions like your immune system

Probiotics will foster a healthier gut environment, helping to alleviate constipation symptoms, but we recommend that you speak with your Doctor or midwife before you start taking any. It is best to double check if they will suit you, and if the type you choose in particular are safe for your pregnancy. 

Limit processed foods

We love a biscuit with a cup of tea on the occasion too, but processed foods may be sneakily contributing to your constipation. 

During pregnancy (and when you aren’t pregnant!) cutting back on processed foods will support your digestion and lower the risk of constipation. Processed foods lack the fibre and nutrients found in whole foods, and sometimes, they pack additives and preservatives into that can disrupt your guts microbiome into these treats. We aren’t telling you to cut them out completely, but you need to have a look at your whole diet; if a lot of what you are eating is processed, this could be impacting your digestive system.

Wherever possible, opt for whole and unprocessed foods like fruits, vegetables and wholegrains that are rich in fibre for smoother bowel movements. This shift ensures you and your baby are getting vital nutrients, promoting better digestion and reducing your constipation during pregnancy. 

Have a look at our food swap suggestions:

Easy Processed vs Unprocessed Food Swaps

 

Safe Medications and Supplements

Trying to navigate constipation during pregnancy can be frustrating and very uncomfortable, and it can lead you to consider medications and supplements for relief. 

There are supplements and medications that can help, but you have to approach these with caution and speak to your midwife or GP before taking any. Over the counter anti-constipation medication is not created with pregnancy in mind. 

Over-the-counter anti-constipation medications are not specifically designed for pregnancy. Options like laxatives, stool softeners, or fiber supplements vary in safety for pregnancy. Occasionally, doctors may prescribe fybogel (ispaghula husk), a fiber supplement to bulk up stool. Alternatively, a senna-based medication or supplement, a stimulant laxative, might be prescribed, stimulating gut muscles to facilitate movement in your stools. 

*Senna products are available over the counter, but you must know that senna-based products are not suitable for long-term use and will damage your digestive tract with sustained use.

Peppermint

During pregnancy, peppermint can be a safe and effective option to alleviate digestion issues and discomfort. Peppermint is known for its antispasmodic properties, which can be incredibly helpful for treating constipation during pregnancy. This natural supplement can aid in relieving the stomach cramps, bloating, and flatulence that you may be experiencing as a side effect. Peppermint facilitates digestion by helping the muscles of the bowel wall relax, promoting the smoother movement of food through the digestive system. 

Peppermint isn’t only useful for constipation, It may offer relief from common digestive symptoms such as gas, bloating, and indigestion too. Perfectly safe to use during pregnancy. Peppermint is typically available in a variety of forms like capsules, tea, or oil and is available to buy in your local supermarket. As with any supplement, we advise you to consult with your GP or midwife before incorporating peppermint into your routine, just to be safe. 

 

When to seek professional help

If you are experiencing persistent constipation during pregnancy, you need to speak to your GP or midwife. 

If you notice:

  • Severe abdominal pain
  • Blood in your stool
  • Persistent discomfort
  • Or you haven’t had any bowel movements for 4 days or more

You must make an appointment or call to speak to someone at your earliest convenience. 

If you are regularly implementing the lifestyle changes and dietary advice, and this proves ineffective, speaking to a healthcare professional is very important. Constipation on regular basis can occasionally indicate an underlying issue that requires more evaluation. 

Before speaking with your midwife or GP, we recommend going in prepared so you can get the help you need right away. The best way to do this is to keep a brief diary and present this to the medical professional that you see. 

Click here [clickable link] to download our pregnancy constipation diary. Fill this out and have it on hand when speaking with your midwife or GP. Having this information ready and to hand when speaking to your GP or midwife will give them a clear insight into the nature and potential causes of your constipation.

Frequently Asked Questions

Find out more about this topic…

Is constipation common during pregnancy?
Yes, it is a very common side effect of pregnancy. Research states that it affects over 40% of women in pregnancy, but some UK statistics have shown to be over 50%!
What causes constipation in pregnant women?
The causes of constipation during pregnancy can be physiological (hormonal), physical, lifestyle factors, anxiety or all of the above. [jumplink]
Are there safe over-the-counter laxatives for pregnancy constipation?
There are safe over the counter laxatives, but we recommend speaking to your midwife or GP before taking any. A popular laxative that is safe for pregnancy is fybogel or lactulose.
How can I relieve constipation without medication during pregnancy?
The best way to relieve constipation without medication is to make small changes to your daily lifestyle, which will lower your chances of developing constipation. Click here [clickable link] to read our lifestyle change recommendations, and you may be interested in our go-to supplement [jumplink to peppermint]
What role does diet play in preventing constipation during pregnancy?
Diet is one of only factors that we can control, that influences constipation during pregnancy. It is inevitable that our baby will grow and put pressure on our digestive system, but with some dietary adjustments [clickable link] we can ensure that the food passing through our digestive system is soft and easy to move.
Are there specific exercises or stretches to alleviate pregnancy constipation?
Any movement will do the trick! Some people find jogging or fast paced walking helps to stimulate their digestive system, but whatever you can manage – do that!
When should I seek medical help for constipation during pregnancy?
You should seek medical attention [jumplink] if you have not had any bowel movements for 4 days or more, if you are experiencing pain from being constipated or have blood in your stools.
What are the effects of constipation on the developing baby?
Constipation does not impact the development of your baby. If you have concerns about this, or would like to speak to someone, please do contact your midwife or GP.
How long does constipation typically last during pregnancy?
A bout of constipation during pregnancy is typically very short-lived, only lasting a few days before being resolved. If this is persistent or you suffer from chronic constipation, please do speak to a medical professional.

References

Read more background on this article

References
Bradley CS, Kennedy CM, Turcea AM, Rao SS and Nygaard IE. Constipation in pregnancy: prevalence, symptoms, and risk factors. Obstet Gynecol 2007; 110: 1351-1357. Cheng C, Chan AO, Hui WM, Lam SK. Coping strategies, illness perception, anxiety and depression of patients with idiopathic constipation: a population-based study. Aliment Pharmacol Ther. 2003 Aug 1;18(3):319-26. doi: 10.1046/j.1365-2036.2003.01663.x. PMID: 12895216. Cullen, G., & O’Donoghue, D. (2007). Constipation and pregnancy. Best Practice & Research Clinical Gastroenterology, 21(5), 807-818 Derbyshire E, Davies J, Costarelli V and Dettmar P. Diet, physical inactivity and the prevalence of constipation throughout and after pregnancy. Matern Child Nutr 2006; 2: 127- 134. Fan, W., Kang, J., Xiao, X., Li, L., & Yang, X. (2020). Causes of constipation during pregnancy and health management. Int J Clin Exp Med, 13(3), 2022-2026. Gabbe SG, Niebyl JR and Galan HL. Obstetrics: Normal and Problem Pregnancies. 6th edition. Philadelphia PA: Saunders Elsevier; 2012. Mawer S, Alhawaj AF. Physiology, Defecation. 2023 Nov 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30969554. Obuchowska A, Gorczyca K, Standyło A, Obuchowska K, Kimber-Trojnar Ż, Wierzchowska-Opoka M, Leszczyńska-Gorzelak B. Effects of Probiotic Supplementation during Pregnancy on the Future Maternal Risk of Metabolic Syndrome. Int J Mol Sci. 2022 Jul 26;23(15):8253. doi: 10.3390/ijms23158253. PMID: 35897822; PMCID: PMC9330652. https://www.bda.uk.com/resource/fibre.html#:~:text=Adults%20are%20recommended%20to%20get,aim%20for%2015g%20per%20day.

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